Longitudinal construct validity of the minimum data set health status index

Area of Science:

• Health Services Research
• Quality of Life Measurement
• Gerontology

Background:

• The Minimum Data Set Health Status Index (MDS-HSI) is a generic, preference-based measure of health-related quality of life (HRQOL).
• It is derived from the Resident Assessment Instrument - Minimum Data Set (RAI-MDS) and mapped to the Health Utilities Index Mark 2.
• Previous studies examined its cross-sectional validity, but longitudinal validity remained unexplored.

Purpose of the Study:

• To investigate the longitudinal construct validity of the MDS-HSI.
• To assess the reliability of the MDS-HSI in tracking health status changes over time in a home care population.

Main Methods:

• Retrospective cohort study of 25,182 home care patients in Ontario, Canada (2010-2014).
• Convergent validity assessed using Spearman correlations between MDS-HSI change and changes in six validated RAI-MDS health domain indices.
• Known-groups validity examined using multivariable linear regression, correlating MDS-HSI change with changes in health domains and disease symptoms, controlling for age and sex.

Main Results:

• All Spearman correlations between MDS-HSI change and health domain index changes were statistically significant (0.1 < ρ < 0.5).
• Clinically important changes in all six health domain indices and 13 of 15 disease symptoms were significantly associated with clinically important MDS-HSI changes.
• These findings support the hypothesized relationships for longitudinal construct validity.

Conclusions:

• The study supports the longitudinal construct validity of the MDS-HSI in home care settings.
• MDS-HSI can be utilized for evaluating HRQOL changes in clinical research, economic evaluations, and health technology assessments.
• The measure is also suitable for system-level applications using routinely collected population-level data.