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Comparing and Explaining Differences in the Magnitude, Content, and Sensitivity of Utilities Predicted by the EQ-5D, SF-6D, HUI 3, 15D, QWB, and AQoL-8D Multiattribute Utility Instruments

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  • Jeff Richardson
  • Munir A. Khan
  • Angelo Iezzi
  • Aimee Maxwell

Abstract

Background. Cost utility analysis permits the comparison of disparate health services by measuring outcomes in comparable units, namely, quality-adjusted life-years, which equal life-years times the utility of the health state. However, comparability is compromised when different utility instruments predict different utilities for the same health state. The present paper measures the extent of, and reason for, differences between the utilities predicted by the EQ-5D-5L, SF-6D, HUI 3, 15D, QWB, and AQoL-8D. Methods. Data were obtained from patients in seven disease areas and members of the healthy public in six countries. Differences between public and patient utilities were estimated using each of the instruments. To explain discrepancies between the estimates, the measurement scales and content of the instruments were compared. The sensitivity of instruments to independently measured health dimensions was measured in pairwise comparisons of all combinations of the instruments. Results. The difference between public and patient utilities varied with the choice of instrument by more than 50% for every disease group and in four of the seven groups by more than 100%. Discrepancies were associated with differences in both the instrument content and their measurement scales. Pairwise comparisons of instruments found that variation in the sensitivity to physical and psychosocial dimensions of health closely reflected the items in the instrument's descriptive systems. Discussion. Results indicate that instruments measure related but different constructs. They imply that commonly used instruments systematically discriminate against some classes of services, most notably mental health services. Differences in the instrument scales imply the need for transformations between the instruments to increase the comparability of measurement.

Suggested Citation

  • Jeff Richardson & Munir A. Khan & Angelo Iezzi & Aimee Maxwell, 2015. "Comparing and Explaining Differences in the Magnitude, Content, and Sensitivity of Utilities Predicted by the EQ-5D, SF-6D, HUI 3, 15D, QWB, and AQoL-8D Multiattribute Utility Instruments," Medical Decision Making, , vol. 35(3), pages 276-291, April.
    • Handle: RePEc:sae:medema:v:35:y:2015:i:3:p:276-291
    DOI: 10.1177/0272989X14543107
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    References listed on IDEAS

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    1. Brazier, John & Ratcliffe, Julie & Salomon, Joshua & Tsuchiya, Aki, 2016. "Measuring and Valuing Health Benefits for Economic Evaluation," OUP Catalogue, Oxford University Press, edition 2, number 9780198725923.
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    1. Michael J. Zoratti & A. Simon Pickard & Peep F. M. Stalmeier & Daniel Ollendorf & Andrew Lloyd & Kelvin K W Chan & Don Husereau & John E. Brazier & Murray Krahn & Mitchell Levine & Lehana Thabane & Fe, 2021. "Evaluating the conduct and application of health utility studies: a review of critical appraisal tools and reporting checklists," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(5), pages 723-733, July.
    2. Suzi Claflin & Julie A. Campbell & Richard Norman & Deborah F. Mason & Tomas Kalincik & Steve Simpson-Yap & Helmut Butzkueven & William M. Carroll & Andrew J. Palmer & C. Leigh Blizzard & Ingrid van d, 2023. "Using the EQ-5D-5L to investigate quality-of-life impacts of disease-modifying therapy policies for people with multiple sclerosis (MS) in New Zealand," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(6), pages 939-950, August.
    3. Tom Lung & Kirsten Howard & Christopher Etherton-Beer & Moira Sim & Gill Lewin & Glenn Arendts, 2017. "Comparison of the HUI3 and the EQ-5D-3L in a nursing home setting," PLOS ONE, Public Library of Science, vol. 12(2), pages 1-10, February.
    4. Bruno Casal & Eva Rodríguez-Míguez & Berta Rivera, 2020. "Measuring intangible cost-of-morbidity due to substance dependence: implications of using alternative preference-based instruments," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(7), pages 1039-1048, September.
    5. Ann-Kathrin Richter & Ludger Klimek & Hans F. Merk & Norbert Mülleneisen & Harald Renz & Wolfgang Wehrmann & Thomas Werfel & Eckard Hamelmann & Uwe Siebert & Gaby Sroczynski & Jürgen Wasem & Janine Bi, 2018. "Impact of increasing treatment rates on cost-effectiveness of subcutaneous immunotherapy (SCIT) in respiratory allergy: a decision analytic modelling approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(9), pages 1229-1242, December.
    6. Christian R. C. Kouakou & Thomas G. Poder, 2022. "Willingness to pay for a quality-adjusted life year: a systematic review with meta-regression," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(2), pages 277-299, March.

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