The concurrent validity and responsiveness of the health utilities index (HUI 3) among patients with advanced HIV/AIDS
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To assess the concurrent validity and responsiveness of the Health Utility Index 3 (HUI3) in patients with advanced HIV/AIDS, and to determine the responsiveness of this measure, the MOS-HIV and EQ-5D to HIV-related clinical events.
Data from the OPTIMA (OPTions In Management with Antiretrovirals) trial was analyzed. Two aspects of the validity of the HUI3 were considered: concurrent validity was evaluated using Spearman correlations with MOS-HIV component and summary scores. Responsiveness to AIDS-defining events (ADE) and all adverse events (our external change criterion) was assessed using area under the receiver operating characteristic (AUROC) curves.
The study enrolled 368 patients (mean follow-up: 3.66 years); 82% had at least one severe adverse event and 27% had at least one ADE. The HUI3 scale and items showed good concurrent validity, with 85% of the expected relationships with the MOS-HIV subscales verified. The HUI3 was responsive to both adverse events (AUROC [95%CI]: 0.68 [0.57, 0.80]) and ADEs (0.62 [0.51, 0.74]). The EQ-5D was responsive to ADEs (0.66 [0.56, 0.76]), but not responsive to adverse events (0.56 [0.46, 0.68]).
The HUI3 is a valid and responsive measure of the change in HRQoL associated with clinical events in an advanced HIV/AIDS population.
KeywordsHealth utilities index MOS-HIV EQ-5D HIV/AIDS
Human immunodeficiency virus
Acquired immune deficiency syndrome
Area under the receiver operating characteristic curve
Mental health score
Physical health score
The OPTIMA study was funded by the Canadian Institutes of Health Research (Canada), Cooperative Studies Program of the US Department of Veterans Affairs Veterans Health Administration (USA), and the Office of Research and Development, Cooperative Studies Program, United Kingdom Medical Research Council. BN was supported by doctoral research awards from the Michael Smith Foundation for Health Research, the Canadian Institutes of Health Research, and the Research in Addictions and Mental Health Policy & Services CIHR strategic training initiative.
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