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Construct validity of SF-6D health state utility values in an employed population

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Abstract

Background

Health utility values permit cost utility analysis in workplace health promotion; however, utility measures of working populations have not been validated.

Aim

To investigate construct validity of SF-6D health utility in a public service workforce.

Methods

SF-12v2 Health Survey was administered to 3,408 randomly selected public service employees in Australia in 2010. SF-12 scores were converted to SF-6D health utility values. Associations and correlates of SF-6D with health, socio-demographic and work characteristics [comorbidities, body mass index (BMI), Kessler-10 psychological distress (K10), education, salary, effort-reward imbalance (ERI), absenteeism] were explored. Ceiling effects were analysed. Nationally representative employee SF-6D values from the Household, Income and Labour Dynamics in Australia (HILDA) survey (n = 11,234) were compared. All analyses were stratified by sex.

Results

Mean (SE) age was 45.7 (0.35) males; 44.5 (0.22) females. Females represented 72 % of the sample. Mean (SE) health utility 0.792 (0.004); 0.771 (0.003) was higher in males. SF-6D demonstrated both a significant inverse association (p < 0.01) and negative correlations (female; male) with K10 (r = −0.63; r = −0.66), comorbidity count (r = −0.40; r = −0.33), ERI (r = −0.37; r = −0.34) and absenteeism (p < 0.005, r = −0.25; r = −0.21). Mean (SE) SF-6D in HILDA was 0.792 (0.002); 0.775 (0.003) males; females. Correlates and associations in all samples were similar. The general employed demonstrated a significant inverse association with age and positive association with salary. SF-6D was independent of BMI.

Conclusions

Psychological distress, comorbidity, effort-reward imbalance and absenteeism are negatively associated with employee health. SF-6D is a valid measure of perceived health states in working populations.

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References

  1. Baxter, S., Sanderson, K., Venn, A. J., Blizzard, C. L., & Palmer, A. J. (2014). The relationship between return on investment and quality of study methodology in workplace health promotion programs. American Journal of Health Promotion, 28(6), 347–363.

    Article  PubMed  Google Scholar 

  2. Shemilt I, M. M., Vale L, Marsh K, Donaldson C (editors) (2010). Evidence-based decisions and economics: Health care, social welfare, education and criminal justice (2nd ed., Evidence-based medicine series). Chichester, West Sussex, UK; Hoboken, NJ: Wiley-Blackwell/BMJ Books.

  3. Drummond, M. F., Sculpher, M. J., & Torrance, G. W. (2005). Methods for the economic evaluation of health care programmes (3rd ed.). USA: Oxford University Press.

    Google Scholar 

  4. Brazier, J., Roberts, J., & Deverill, M. (2002). The estimation of a preference-based measure of health from the SF-36. Journal of Health Economics, 21(2), 271–292. doi:10.1016/s0167-6296(01)00130-8.

  5. Brazier, J. E., & Roberts, J. (2004). The estimation of a preference-based measure of health from the SF-12. Medical Care, 42(9), 851–859.

    Article  PubMed  Google Scholar 

  6. Ware, J. E, Jr, Kosinski, M., & Keller, S. D. (1996). A 12-Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220–233.

    Article  PubMed  Google Scholar 

  7. Ware Jr, J. E., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30(6), 473–483.

  8. Norman, R., Church, J., van den Berg, B., & Goodall, S. (2013). Australian health-related quality of life population norms derived from the SF-6D. Australian and New Zealand Journal of Public Health, 37(1), 17–23.

    Article  PubMed  Google Scholar 

  9. Lam, C. L., Brazier, J., & McGhee, S. M. (2008). Valuation of the SF-6D health states is feasible, acceptable, reliable, and valid in a Chinese population. Value in Health, 11(2), 295–303.

    Article  PubMed  Google Scholar 

  10. Marra, C. A., Woolcott, J. C., Kopec, J. A., Shojania, K., Offer, R., Brazier, J. E., et al. (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 and Medicine, 60(7), 1571–1582.

    Article  PubMed  Google Scholar 

  11. Khanna, D., Furst, D. E., Wong, W. K., Tsevat, J., Clements, P. J., Park, G. S., et al. (2007). Reliability, validity, and minimally important differences of the SF-6D in systemic sclerosis. Quality of Life Research, 16(6), 1083–1092.

    Article  PubMed  Google Scholar 

  12. Richardson J, M. J., Bariola E. (in press). In: A. Culyer (Ed.) Encyclopedia of health economics. San Diego: Elsevier Science. http://www.buseco.monash.edu.au/centres/che/pubs/researchpaper64.pdf

  13. Hou, W. H., Liang, H. W., Hsieh, C. L., Sheu, C. F., Hwang, J. S., & Chuang, H. Y. (2013). Integrating health-related quality of life with sickness leave days for return-to-work assessment in traumatic limb injuries. Quality of Life Research, 22(9), 2307–2314. doi:10.1007/s11136-013-0364-2.

    Article  PubMed  Google Scholar 

  14. McEachan, R. R., Lawton, R. J., Jackson, C., Conner, M., Meads, D. M., & West, R. M. (2011). Testing a workplace physical activity intervention: A cluster randomized controlled trial. International Journal of Behavioral Nutrition and Physical Activity, 8, 29.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Petrou, S., & Hockley, C. (2005). An investigation into the empirical validity of the EQ-5D and SF-6D based on hypothetical preferences in a general population. Health Economics, 14(11), 1169–1189.

    Article  PubMed  Google Scholar 

  16. Barton, G. R., Sach, T. H., Avery, A. J., Jenkinson, C., Doherty, M., Whynes, D. K., et al. (2008). A comparison of the performance of the EQ-5D and SF-6D for individuals aged ≥45 years. Health Economics, 17(7), 815–832. doi:10.1002/hec.1298.

    Article  PubMed  Google Scholar 

  17. Brazier, J., Roberts, J., Tsuchiya, A., & Busschbach, J. (2004). A comparison of the EQ-5D and SF-6D across seven patient groups. Health Economics, 13(9), 873–884.

    Article  PubMed  Google Scholar 

  18. Leung, Y. Y., Png, M. E., Wee, H. L., & Thumboo, J. (2013). Comparison of EuroQol-5D and short form-6D utility scores in multiethnic Asian patients with psoriatic arthritis: a cross-sectional study. Journal of Rheumatology, 40(6), 859–865.

    Article  PubMed  Google Scholar 

  19. Longworth, L., & Bryan, S. (2003). An empirical comparison of EQ-5D and SF-6D in liver transplant patients. Health Economics, 12(12), 1061–1067.

    Article  PubMed  Google Scholar 

  20. Franks, P., Hanmer, J., & Fryback, D. G. (2006). Relative disutilities of 47 risk factors and conditions assessed with seven preference-based health status measures in a national U.S. sample: Toward consistency in cost-effectiveness analyses. Medical Care, 44(5), 478–485.

    Article  PubMed  Google Scholar 

  21. Kudielka, B. M., Hanebuth, D., von Kanel, R., Gander, M. L., Grande, G., & Fischer, J. E. (2005). Health-related quality of life measured by the SF12 in working populations: Associations with psychosocial work characteristics. Journal of Occupational Health Psychology, 10(4), 429–440.

    Article  PubMed  Google Scholar 

  22. Silva, L. S., & Barreto, S. M. (2012). Adverse psychosocial working conditions and poor quality of life among financial service employees in Brazil. Journal of Occupational Health, 54(2), 88–95. doi:10.1539/joh.11-0072-OA.

  23. Hanebuth, D., Meinel, M., & Fischer, J. E. (2006). Health-related quality of life, psychosocial work conditions, and absenteeism in an industrial sample of blue- and white-collar employees: A comparison of potential predictors. Journal of Occupational and Environmental Medicine, 48(1), 28–37. doi:10.1097/00043764-200601000-00004.

  24. Lerner, D. J., Levine, S., Malspeis, S., & D’Agostino, R. B. (1994). Job strain and health-related quality of life in a national sample. American Journal of Public Health, 84(10), 1580–1585.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  25. Hemingway, H., Nicholson, A., Stafford, M., Roberts, R., & Marmot, M. (1997). The impact of socioeconomic status on health functioning as assessed by the SF-36 questionnaire: The Whitehall II Study. American Journal of Public Health, 87(9), 1484–1490.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  26. Marmot, M., & Brunner, E. (2005). Cohort profile: the Whitehall II study. International Journal of Epidemiology, 34(2), 251–256.

    Article  PubMed  Google Scholar 

  27. Kilpatrick, M., Sanderson, K., Blizzard, L., Teale, B., & Venn, A. (2013). Cross-sectional associations between sitting at work and psychological distress: Reducing sitting time may benefit mental health. Mental Health and Physical Activity, 6, 103–109.

  28. Walters, S. J., & Brazier, J. E. (2005). Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D. Quality of Life Research, 14(6), 1523–1532.

    Article  PubMed  Google Scholar 

  29. Wooden, M., & Watson, N. (2007). The HILDA Survey and its Contribution to Economic and Social Research (So Far)*. Economic Record, 83(261), 208–231.

    Article  Google Scholar 

  30. Watson, N., & Wooden, M. (2004). The HILDA Survey four years on. Australian Economic Review, 37(3), 343–349.

    Article  Google Scholar 

  31. Watson, W. L., Ozanne-Smith, J., & Richardson, J. (2005). An evaluation of the assessment of quality of life utility instrument as a measure of the impact of injury on health-related quality of life. International Journal of Injury Control and Safety Promotion, 12(4), 227–239.

    Article  PubMed  Google Scholar 

  32. Kessler, R. C., Andrews, G., Colpe, L. J., Hiripi, E., Mroczek, D. K., Normand, S.-L. T., et al. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32(6), 959–976.

    Article  CAS  PubMed  Google Scholar 

  33. Kessler, R. C., Barber, C., Beck, A., Berglund, P., Cleary, P. D., McKenas, D., et al. (2003). The world health organization health and work performance questionnaire (HPQ). Journal of Occupational and Environmental Medicine, 45(2), 156–174.

    Article  PubMed  Google Scholar 

  34. Kessler, R. C., Ames, M., Hymel, P. A., Loeppke, R., McKenas, D. K., Richling, D. E., et al. (2004). Using the World Health Organization Health and Work Performance Questionnaire (HPQ) to evaluate the indirect workplace costs of illness. Journal of Occupational and Environmental Medicine, 46(6), S23–S37. doi:10.1097/01.jom.0000126683.75201.c5.

    Article  PubMed  Google Scholar 

  35. Hawthorne, G., Korn, S., & Richardson, J. (2013). Population norms for the AQoL derived from the 2007 Australian National Survey of Mental Health and Wellbeing. Australian and New Zealand Journal of Public Health, 37(1), 7–16. doi:10.1111/1753-6405.12004.

    Article  PubMed  Google Scholar 

  36. ANZSCO (2006). Australian and New Zealand Standard Classification of Occupations (ANZSCO), First edition, 2006 (ABS Cat. No. 1220.0).

  37. Siegrist, J., Starke, D., Chandola, T., Godin, I., Marmot, M., Niedhammer, I., et al. (2004). The measurement of effort–reward imbalance at work: European comparisons. Social Science and Medicine, 58(8), 1483–1499.

    Article  PubMed  Google Scholar 

  38. Babor, T., Higgins-Biddle, J., Saunders, J., & Monteiro, M. (2001). AUDIT: The alcohol use disorders identification test guidelines for use in primary care. Geneva: World Health Organization.

    Google Scholar 

  39. The Royal Australian College of General Practitioners Guidelines for preventive activities in general practice 8th edition, Appendix C: Audit-C. http://www.racgp.org.au/your-practice/guidelines/redbook/appendices/appendix-3-audit-c/

  40. Guidelines for the data processing and analysis of the International Physical Activity Questionnaire. (2005). Revised Nov 2005, downloaded from http://www.ipaq.ki.se

  41. Craig, C. L., Marshall, A. L., Sjostrom, M., Bauman, A. E., Booth, M. L., Ainsworth, B. E., et al. (2003). International physical activity questionnaire: 12-Country reliability and validity. Medicine and Science in Sports and Exercise, 35(8), 1381–1395. doi:10.1249/01.MSS.0000078924.61453.FB.

    Article  PubMed  Google Scholar 

  42. Hagstromer, M., Oja, P., & Sjostrom, M. (2006). The International Physical Activity Questionnaire (IPAQ): A study of concurrent and construct validity. Public Health Nutr, 9(6), 755–762.

    Article  PubMed  Google Scholar 

  43. Hofler, M., Pfister, H., Lieb, R., & Wittchen, H. U. (2005). The use of weights to account for non-response and drop-out. Social Psychiatry and Psychiatric Epidemiology, 40(4), 291–299. doi:10.1007/s00127-005-0882-5.

    Article  PubMed  Google Scholar 

  44. Fryback, D. G., Dunham, N. C., Palta, M., Hanmer, J., Buechner, J., Cherepanov, D., et al. (2007). US norms for six generic health-related quality-of-life indexes from the National Health Measurement study. Medical Care, 45(12), 1162–1170.

    Article  PubMed Central  PubMed  Google Scholar 

  45. Li, C. Y., & Sung, F. C. (1999). A review of the healthy worker effect in occupational epidemiology. Occup Med (Lond), 49(4), 225–229.

    Article  CAS  Google Scholar 

  46. Naimi, A. I., Richardson, D. B., & Cole, S. R. (2013). Causal inference in occupational epidemiology: Accounting for the healthy worker effect by using structural nested models. American Journal of Epidemiology, 178(12), 1681–1686.

    Article  PubMed Central  PubMed  Google Scholar 

  47. Richardson J, Iezzi A, Khan MA, & Maxwell A. (2012). Cross-national comparison of twelve quality of life instruments. MIC Paper 2. Melbourne: Centre for Health Economics, Monash University.

  48. Cook, E. L., & Harman, J. S. (2008). A comparison of health-related quality of life for individuals with mental health disorders and common chronic medical conditions. Public Health Reports, 123(1), 45–51.

    PubMed Central  PubMed  Google Scholar 

  49. Pietersma, S., de Vries, M., & van den Akker-van Marle, M. E. (2014). Domains of quality of life: results of a three-stage Delphi consensus procedure among patients, family of patients, clinicians, scientists and the general public. Quality of Life Research, 23(5), 1543–1556. doi:10.1007/s11136-013-0578-3.

    PubMed Central  PubMed  Google Scholar 

  50. de Jonge, J., Bosma, H., Peter, R., & Siegrist, J. (2000). Job strain, effort-reward imbalance and employee well-being: A large-scale cross-sectional study. Social Science and Medicine, 50(9), 1317–1327. doi:10.1016/S0277-9536(99)00388-3.

    Article  PubMed  Google Scholar 

  51. Buddeberg-Fischer, B., Klaghofer, R., Stamm, M., Siegrist, J., & Buddeberg, C. (2008). Work stress and reduced health in young physicians: Prospective evidence from Swiss residents. International Archives of Occupational and Environmental Health, 82(1), 31–38. doi:10.1007/s00420-008-0303-7.

    Article  PubMed  Google Scholar 

  52. Rusli, B. N., Edimansyah, B. A., & Naing, L. (2008). Working conditions, self-perceived stress, anxiety, depression and quality of life: A structural equation modelling approach. BMC Public Health, 8, 48.

    Article  PubMed Central  PubMed  Google Scholar 

  53. McCrone, P., Patel, A., Knapp, M., Schene, A., Koeter, M., Ammadeo, F., et al. (2009). A comparison of SF-6D and EQ-5D utility scores in a study of patients with schizophrenia. Journal of mental health policy and economics, 12(1), 27–31.

    PubMed  Google Scholar 

  54. Menn, P., Weber, N., & Holle, R. (2010). Research Health-related quality of life in patients with severe COPD hospitalized for exacerbations-comparing EQ-5D, SF-12 and SGRQ. Health and Quality of Life outcomes, 8, 39.

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Acknowledgments

HILDA staff, Nicole Watson (Senior Research Fellow and HILDA Deputy Director of Survey Methodology, Melbourne Institute) and Professor Robert Bruenig (Australian National University) ‘This paper uses unit record data from the Household, Income and Labour Dynamics in Australia (HILDA) Survey. The HILDA Project was initiated and is funded by the Australian Government Department of Social Services (DSS) and is managed by the Melbourne Institute of Applied Economic and Social Research (Melbourne Institute). The findings and views reported in this paper, however, are those of the author and should not be attributed to either DSS or the Melbourne Institute.’ NHMRC Grant No. H0010501.

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  1. Menzies Research Institute Tasmania, University of Tasmania, Medical Science 2 Building, 17 Liverpool St, Private Bag 23, Hobart, TAS, 7000, Australia

    Siyan Baxter, Kristy Sanderson, Alison Venn, Petr Otahal & Andrew J. Palmer

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Correspondence to Siyan Baxter.

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Baxter, S., Sanderson, K., Venn, A. et al. Construct validity of SF-6D health state utility values in an employed population. Qual Life Res 24, 851–870 (2015). https://doi.org/10.1007/s11136-014-0823-4

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