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A view from the bridge: agreement between the SF-6D utility algorithm and the Health Utilities Index

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Author Info
Bernie J. O'Brien
Marian Spath
Gordon Blackhouse
J.L. Severens (Department of Health Organisation, Policy & Economics, University of Maastricht, Netherlands)
Paul Dorian (Department of Medicine, St. Michael's Hospital, Toronto, Canada)
John Brazier (Sheffield Health Economics Group, University of Sheffield, UK)
Abstract

Background: The SF-6D is a new health state classification and utility scoring system based on 6 dimensions ('6D') of the Short Form 36, and permits a “bridging” transformation between SF-36 responses and utilities. The Health Utilities Index, mark 3 (HUI3) is a valid and reliable multi-attribute health utility scale that is widely used. We assessed within-subject agreement between SF-6D utilities and those from HUI3.

Methods: Patients at increased risk of sudden cardiac death and participating in a randomized trial of implantable defibrillator therapy completed both instruments at baseline. Score distributions were inspected by scatterplot and histogram and mean score differences compared by paired t-test. Pearson correlation was computed between instrument scores and also between dimension scores within instruments. Between-instrument agreement was by intra-class correlation coefficient (ICC).

Results: SF-6D and HUI3 forms were available from 246 patients. Mean scores for HUI3 and SF-6D were 0.61 (95% CI 0.60-0.63) and 0.58 (95% CI 0.54-0.62) respectively; a difference of 0.03 (p<0.03). Score intervals for HUI3 and SF-6D were (-0.21 to 1.0) and (0.30-0.95). Correlation between the instrument scores was 0.58 (95% CI 0.48-0.68) and agreement by ICC was 0.42 (95% CI 0.31-0.52). Correlations between dimensions of SF-6D were higher than for HUI3.

Conclusions: Our study casts doubt on the whether utilities and QALYs estimated via SF-6D are comparable with those from HUI3. Utility differences may be due to differences in underlying concepts of health being measured, or different measurement approaches, or both. No gold standard exists for utility measurement and the SF-6D is a valuable addition that permits SF-36 data to be transformed into utilities to estimate QALYs. The challenge is developing a better understanding as to why these classification-based utility instruments differ so markedly in their distributions and point estimates of derived utilities. Copyright © 2003 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.789
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Publisher Info
Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 12 (2003)
Issue (Month): 11 ()
Pages: 975-981
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Handle: RePEc:wly:hlthec:v:12:y:2003:i:11:p:975-981

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Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:

  1. Torrance, George W., 1986. "Measurement of health state utilities for economic appraisal : A review," Journal of Health Economics, Elsevier, vol. 5(1), pages 1-30, March. [Downloadable!] (restricted)
  2. Brazier, John & Roberts, Jennifer & Deverill, Mark, 2002. "The estimation of a preference-based measure of health from the SF-36," Journal of Health Economics, Elsevier, vol. 21(2), pages 271-292, March. [Downloadable!] (restricted)
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(explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)

  1. Tubeuf, S, 2008. "Income-related inequalities in self-assessed health: comparisons of alternative measurements of health," Health, Econometrics and Data Group (HEDG) Working Papers 08/04, HEDG, c/o Department of Economics, University of York. [Downloadable!]
  2. Stavros Petrou & Christine Hockley, 2005. "An investigation into the empirical validity of the EQ-5D and SF-6D based on hypothetical preferences in a general population," Health Economics, John Wiley & Sons, Ltd., vol. 14(11), pages 1169-1189. [Downloadable!]
  3. Cecilia Quercioli & Gabriele Messina & Emanuela Barbini & Giovanni Carriero & Mara Fanì & Nicola Nante, 2009. "Importance of sociodemographic and morbidity aspects in measuring health-related quality of life: performances of three tools," The European Journal of Health Economics, Springer, vol. 10(4), pages 389-397, October. [Downloadable!] (restricted)
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