Evidence on the construct validity of the Health Utilities Index Mark 2 and Mark 3 in patients with chronic kidney disease
This study assessed the construct validity of the Health Utilities Index Mark 2 (HUI2) and Mark 3 (HUI3) in the context of chronic kidney disease (CKD) and compared their ability to discriminate between groups of patients with varying disease severity.
Study design and setting
The HUI2 and HUI3 were correlated with the Medical Outcomes 36-Item Short-Form, Kidney Disease Quality of Life Questionnaire, and the Beck Depression Inventory II in 185 patients with stage 4 and 5 CKD.
About 86% of a priori hypotheses were confirmed for HUI2 and 95% for HUI3, providing support for the construct validity of both measures. Mean (SD) overall utility score for the HUI2 was 0.74 (0.20), significantly higher than that for the HUI3, 0.58 (0.26) (P < 0.001). The cognitive, emotion, and pain attributes of the HUI3 were able to identify a significantly greater proportion of patients with impairment compared to the HUI2.
The results are consistent with construct validity for the HUI2 and HUI3 in patients with stage 4 and 5 CKD. However, the HUI3 appears to have superior psychometric properties compared with the HUI2 in this patient population.
KeywordsChronic kidney disease Health-related quality of life Health Utilities Index Utility measurement Validation
The study was partially funded by a grant award to Sara Davison from the Institute of Health Economics, Edmonton, AB, Canada. David Feeny has a proprietary interest in Health Utilities Incorporated, Dundas, Ontario, Canada, which distributes copyrighted Health Utilities Index (HUI) materials and provides methodological advice on the use of HUI. The authors acknowledge the useful comments and suggestions provided by three reviewers and the editor.
- 4.Hays, R. D. (1998). R36 H.S.I. Rand 36—36 health status inventory. Harcourt Brace & Company.Google Scholar
- 5.Hays, R. D., Kallich, J. D., Mapes, D. L., Coons, S. J., Amin, N., Carter, W. B., et al. (1997). Kidney disease quality of life short form (dkqol-sf), version 1.3: A manual for use and scoring. Santa Monica, CA: RAND.Google Scholar
- 6.Annual Data Report. (2007). Atlas of end-stage renal disease in the United States. American Journal of Kidney Diseases, 49(Supplement 1), S1–S239.Google Scholar
- 11.Feeny, D., Torrance, G. W., & Furlong, W. (1996). Quality of life and pharmacoeconomics in clinical trials. In B. Spilker (Ed.), Health utilities index (pp. 239–51). Philadelphia, PA: Lippincort-Raven.Google Scholar
- 15.Ware, J. E. (1993). SF-36 Health survey: Manual and interpretation guide. Boston, MA: New England Medical Centre.Google Scholar
- 16.Beck, A. T., Steer, R. A., & Brown, G. K. (1996). BDI-II manual (2nd ed.). San Antonio, Texas: Harcourt Brace.Google Scholar
- 18.Newmann, S. P. (2002). A randomised controlled trial of a psychological intervention to promote emotional expression and adaptation in individuals with chronic renal failure (CRF) and end stage renal disease (ESRD). UK: National Research Registry.Google Scholar
- 23.Van Manen, J. G., Korevaar, J. C., Dekker, F. W., Boeschoten, E. W., Bossuyt, P. M., & Krediet, R. T. (2003). Adjustment for comorbidity in studies on health status in ESRD patients: Which comorbidity index to use? Journal of the American Society of Nephrology, 14(2), 478–485.PubMedCrossRefGoogle Scholar
- 25.Fayers, P. M., & Machin, D. (2000). Quality of life: Assessment, analysis and interpretation. Willey.Google Scholar
- 30.Canadian Organ Replacement Register. (2002). Dialysis and renal transplantation. Ottawa, Ontario: Canadian Institute for Health Information. Report No.: 2001 Report.Google Scholar
- 36.Davison, S. N., Jhangri, G. S., & Feeny, D. (2008). Comparing the health utilities index mark 3 (HUI3) with the short-form 36 preference-based SF-6D in chronic kidney disease. Value in Health (in press).Google Scholar