Benchmarking health-related quality-of-life data from a clinical setting

Health-related quality of life (HRQoL) is an important clinical outcome, yet there is little guidance for its interpretation in clinical settings. One approach would use benchmarking to contextualize HRQoL results. Our objective was to construct a nationally representative HRQoL benchmark for use with a clinical sample.

Cross-sectional analysis of HRQoL scores from: 1) the 2011 Medical Expenditures Panel Survey (MEPS), a representative sample of the noninstitutionalized US population; and 2) outpatient academic and community cardiology clinics within a large health system in 2012 and 2013.

The 2011 MEPS includes 21,959 adults who completed the HRQoL measures; 414 reported visiting a cardiologist. Of 1945 outpatient index visits during the study period that were not for outpatient cardiac catheterization, 1434 patients completed the HRQoL measures. The primary outcome was the Short Form 6-Dimension questionnaire (SF-6D). The secondary outcomes were the Mental Component Summary score and the Physical Component Summary score.

The local cardiology clinic sample was 42% female with a mean Charlson Comorbidity Index (CCI) score of 1.74. The MEPS subsample of cardiology patients more closely matched the local cardiology clinic sample (43% female; mean CCI score of 1.57) than the entire MEPS sample (52% female; mean CCI score of 0.62). SF-6D scores for the local cardiology clinic sample were significantly better, statistically and clinically, in 4 of 5 age strata than the MEPS subsample of cardiology patients.

HRQoL benchmarks can be created from current public datasets. Subgroups in national samples may provide more valid benchmarks for clinical populations.