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Comparing the Health Utilities Index Mark 3 (HUI3) with the Short Form-36 preference-based SF-6D in chronic kidney

Sara N Davison1, Gian S Jhangri, David H Feeny

  • 1University of Alberta, Edmonton, AB, Canada. sara.davison@ualberta.ca

Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research
|July 29, 2008
PubMed

Insights

The Health Utilities Index Mark 3 (HUI3) and SF-6D provide different health scores for chronic kidney disease (CKD) patients. The HUI3 is better for assessing severe disability in CKD populations.

Area of Science:

  • Nephrology
  • Health Economics
  • Psychometrics

Background:

  • Health-related quality of life (HRQoL) is crucial for managing chronic kidney disease (CKD).
  • Preference-based outcome measures (PROMs) like the SF-6D and Health Utilities Index Mark 3 (HUI3) are used to assess HRQoL.
  • Understanding agreement and discriminative abilities of these PROMs in CKD is essential for accurate health assessment.

Purpose of the Study:

  • To assess within-subject agreement between the SF-6D and HUI3.
  • To compare the discriminative abilities of the SF-6D and HUI3 in patients with CKD.
  • To evaluate the suitability of SF-6D and HUI3 for different patient severities.

Main Methods:

  • Prospective study of 185 incident patients with stage 4 and 5 CKD.
  • Self-completion of the SF-6D (derived from the Short Form-36) and the HUI3.
  • Analysis included correlation, intraclass correlation, and examination of floor/ceiling effects and discrimination between subgroups.

Main Results:

  • SF-6D yielded higher mean scores (0.67) than HUI3 (0.58) (P < 0.01).
  • Strong association (r=0.55) but moderate agreement (ICC=0.44) between SF-6D and HUI3.
  • HUI3 better captured severe illness burden and depressive symptoms; SF-6D better captured upper-range differences.

Conclusions:

  • SF-6D and HUI3 generate distinct scores in CKD patients; direct comparison requires caution.
  • HUI3 is more suitable for populations with greater disability, such as CKD patients.
  • Further research needed to assess longitudinal changes in preference scores within each instrument.
Abstract

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