Evidence on the construct validity of the Health Utilities Index Mark 2 and Mark 3 in patients with chronic kidney disease
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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.
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