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A Comparison of the EuroQol-5D and the Health Utilities Index Mark 3 in Patients with Rheumatic Disease
NAN LUO, LING-HUO CHEW, KOK-YONG FONG, DOW-RHOON KOH, SWEE-CHENG NG, KAM-HON YOON, SHEILA VASOO, SHU-CHUEN LI, and JULIAN THUMBOO
ABSTRACT.
Methods. Consecutive outpatients with rheumatic diseases were interviewed twice within 2 weeks using a standard questionnaire containing the EQ-5D, HUI3, and the Medical Outcome Study Short-Form 36 Health Survey (SF-36, used to categorize health status) and assessing clinical and demographic characteristics. EQ-5D and HUI3 utility scores were compared and their construct validity and test-retest reliability were examined by comparing these scores in groups differing in health status and using intraclass correlation coefficients (ICC), respectively. Results. EQ-5D and HUI3 utility scores in 114 patients differentiated well between varying health states; e.g., patients with higher SF-36 vitality scores had better EQ-5D and HUI3 utility scores (mean: 0.79 for both instruments) than patients with lower vitality scores (mean: 0.68 and 0.69, respectively) (p < 0.01 for both comparisons). ICC values for the EQ-5D and HUI3 were 0.64 and 0.75, respectively (n = 90, median interval: 7 days). EQ-5D and HUI3 utility scores were similar (mean ± SD: 0.75 ± 0.21 vs 0.76 ± 0.17, p = 0.647, paired t test) and showed moderate correlation (Spearman's r: 0.45, p < 0.001). Differences were present in patients' responses to these 2 instruments: e.g., 12 patients reporting no problems with mobility (EQ-5D item) reported different levels of disability with ambulation (HUI3 item). Conclusions. The EQ-5D and HUI3 performed equally well in measuring utility-based HRQoL in patients with rheumatic disease, although they measured slightly different, though related, dimensions of health. (J Rheumatol 2003;30:2268-74) Key Indexing Terms:
QUALITY OF LIFE
From the Department of Pharmacy, and the Department of Medicine, National University of Singapore; the School of Health Sciences, Nanyang Polytechnic; and the Department of Medicine, National University Hospital, Singapore. N. Luo, MSc, Research Scholar; S-C. Li, PhD, Assistant Professor, Department of Pharmacy, National University of Singapore; L-H. Chew, BAppSc(NEd), Lecturer, School of Health Sciences, Nanyang Polytechnic; K-Y. Fong, FRCP (Edin), Associate Professor; D-R. Koh, PhD, Associate Professor; K-H. Yoon, MRCP (UK), Assistant Professor; J. Thumboo, FRCP (Edin), Associate Professor, Department of Medicine, National University of Singapore and Department of Medicine, National University Hospital; S-C. Ng, MMed (Internal Medicine), Visiting Consultant; S. Vasoo MRCP (UK), Registrar, Department of Medicine, National University Hospital. Address reprint requests to Dr. J. Thumboo, Department of Rheumatology and Immunology, Singapore General Hospital, Outram Road, Singapore, 169608. E-mail: julian_thumboo@sgh.com.sg Submitted December 16, 2002; revision accepted March 28, 2003. |