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A comparison of generic, indirect utility measures (the HUI2, HUI3, SF-6D, and the EQ-5D) and disease-specific instruments (the RAQoL and the HAQ) in rheumatoid arthritis

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  • Marra, Carlo A.
  • Woolcott, John C.
  • Kopec, Jacek A.
  • Shojania, Kamran
  • Offer, Robert
  • Brazier, John E.
  • Esdaile, John M.
  • Anis, Aslam H.

Abstract

Rheumatoid arthritis (RA) is a common, chronic disease where health-related quality of life (HRQL) is one of the main goals of therapy. As such, instruments used to measure HRQL in RA must be able to discriminate across RA severity. The two basic categories of instruments used to measure HRQL are generic instruments and disease-specific instruments. Generic instruments can be further subdivided into preference-based measures which yield both single and multi-attribute utility values anchored at zero (death) and 1.00 (perfect health) as a measure of HRQL. The scores from these types of instruments can be integrated into cost-utility analyses as the weightings for quality adjusted life years. We assessed the construct validity of utility scores from four generic preference-based measures (the Health Utilities Index 2 and 3 (HUI2, HUI3), the EuroQol 5D (EQ-5D), and the Short Form 6-D (SF-6D) and disease specific measures (the Rheumatoid Arthritis Quality of Life Questionnaire (RAQoL) and the Health Assessment Questionnaire (HAQ)) in a sample of 313 RA patients in British Columbia, Canada. We also estimated the minimally important differences (MID) for each of the measures. Generally, as anticipated, the disease-specific measures were better able to discriminate across groups with higher RA severity; however, utility scores from each of the scales also appeared to discriminate well across RA severity categories. The MID values agreed with those previously reported in the literature for the HUI2, SF-6D and the HAQ and provided new information for the HUI3, EQ-5D and the RAQoL. We conclude that the all of the preference-based utility measures that were evaluated appear to adequately discriminate across levels of RA severity.

Suggested Citation

  • Marra, Carlo A. & Woolcott, John C. & Kopec, Jacek A. & Shojania, Kamran & Offer, Robert & Brazier, John E. & Esdaile, John M. & Anis, Aslam H., 2005. "A comparison of generic, indirect utility measures (the HUI2, HUI3, SF-6D, and the EQ-5D) and disease-specific instruments (the RAQoL and the HAQ) in rheumatoid arthritis," Social Science & Medicine, Elsevier, vol. 60(7), pages 1571-1582, April.
  • Handle: RePEc:eee:socmed:v:60:y:2005:i:7:p:1571-1582
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    References listed on IDEAS

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    1. 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.
    2. Louise Longworth & Stirling Bryan, 2003. "An empirical comparison of EQ‐5D and SF‐6D in liver transplant patients," Health Economics, John Wiley & Sons, Ltd., vol. 12(12), pages 1061-1067, December.
    3. John Brazier & Mark Deverill, 1999. "A checklist for judging preference‐based measures of health related quality of life: Learning from psychometrics," Health Economics, John Wiley & Sons, Ltd., vol. 8(1), pages 41-51, February.
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