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Test–retest reliability of health utilities index scores: Evidence from hip fracture

Published online by Cambridge University Press:  04 August 2005

C. Allyson Jones ,
David Feeny  and
Ken Eng
C. Allyson Jones
Affiliation:
University of Alberta Institute of Health Economics
David Feeny
Affiliation:
University of Alberta Institute of Health Economics Health Utilities Incorporated
Ken Eng
Affiliation:
Institute of Health Economics
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Abstract

Objectives: There is relatively little evidence on the test–retest reliability of utility scores derived from multiattribute measures. The objective was to estimate test–retest reliability for Health Utilities Index Mark 2 (HUI2) and Mark 3 (HUI3) utility scores in patients recovering from hip fracture.

Methods: We enrolled an inception cohort of hip fracture patients within 3 to 5 days of surgery. Baseline assessments included the Functional Independence Measure (FIM™), Folstein Mini-Mental State Examinations, and the HUI2 and HUI3 questionnaire. Follow-up assessments at 1, 3, and 6 months also included a global change question. Test–retest reliability was assessed as agreement between 3- and 6-month scores using the intraclass correlation coefficient (ICC). Two approaches were used to classify patients as stable; a third approach based on the generalizability theory was also used. Patients were classified as stable if their FIM™ overall scores changed by 10 points or fewer and if they classified themselves as having experienced no or only a little change according to their global change question.

Results: Complete data at both the 3- and 6-month assessments based on self-report were available for 196 patients; 141 patients with complete data were classified as stable. The ICCs for HUI2 and HUI3 for stable patients were 0.71 and 0.72; the ICCs derived from the generalizability theory were 0.76 and 0.77.

Conclusions: Test–retest reliability for HUI in this cohort was similar to reliability estimates for other preference-based multiattribute and generic health-profile measures—in the acceptable range for making valid group-level comparisons.

Keywords

Test–retest reliabilityHealth Utilities IndexHUIHip fracture
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 21 , Issue 3 , July 2005 , pp. 393 - 398
Copyright
© 2005 Cambridge University Press

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References

Boyle MH, Furlong W, Feeny D, Torrance G, Hatcher J. 1995 Reliability of the Health Utilities Index - Mark III used in the 1991 Cycle 6 General Social Survey Health Questionnaire. Qual Life Res. 4: 249– 257.Google Scholar
Brazier J, Walters SJ, Nicholl JP, Kohler B. 1996 Using the SF-36 and Euroqol on an elderly population. Qual Life Res. 5: 195– 204.Google Scholar
Brazier J, Deverill M, Green C, Harper R, Booth A. 1999 A review of the use of health status measures in economic evaluation. Health Technol Assess. 3: i–iv 1– 164.Google Scholar
Brazier J, Roberts J, Deverill M. 2002 The estimation of a preference-based measure of health status from the SF-36. J Health Econ. 21: 271– 292.Google Scholar
Charlson ME, Pompei P, Ales KL, MacKenzie CR. 1987 A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chron Dis. 40: 373– 383.Google Scholar
Coons SJ, Rao S, Keininger DL, Hays RD. 2000 A comparative review of generic quality-of-life instruments. Pharmacoeconomics. 17: 13– 35.Google Scholar
Deyo RA, Diehr P, Patrick DL. 1991 Reproducibility and responsiveness of health status measures: Statistics and strategies for evaluation. Control Clin Trials. 12: 142S– 158S.Google Scholar
Dorman P, Slattery J, Farrell B. 1998 Qualitative comparison of the reliability of health status assessments with the EuroQol and the SF-36 questionnaires after stroke. Stroke. 29: 63– 68.Google Scholar
Feeny D, Furlong W, Barr RD, et al. 1992 A comprehensive multiattribute system for classifying the health status of survivors of childhood cancer. J Clin Oncol. 10: 923– 928.Google Scholar
Feeny D, Furlong W, Torrance GW, et al. 2002 Multi-attribute and single-attribute utility functions for the Health Utilities Index Mark 3 system. Med Care. 40: 113– 128.Google Scholar
Folstein MF, Folstein SE, McHugh PR. 1975 Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatric Res. 12: 189– 198.Google Scholar
Furlong WJ, Feeny DH, Torrance GW, Barr RD. 2001 The Health Utilities Index (HUI) system for assessing health-related quality of life in clinical studies. Ann Med. 33: 375– 384.Google Scholar
Granger CV, Cotter AC, Hamilton BB, Fiedler RC, Hen MM. 1990 Functional assessment scales: A study of persons with multiple sclerosis. Arch Phys Med Rehabil. 71: 870– 875.Google Scholar
Granger CV, Hamilton BB, Linacre JM, Heinemann AW, Wright BD. 1993 Performance profiles for the functional independence measure. Am J Phys Med Rehabil. 72: 84– 89.Google Scholar
Hays RD, Anderson R, Revicki D. 1993 Psychometric considerations in evaluating health-related quality of life measures. Qual Life Res. 2: 441– 449.Google Scholar
Horsman J, Furlong W, Feeny D, Torrance G. 2003 The Health Utilities Index (HUI®): Concepts, measurement properties and applications. Health Qual Life Outcomes. 1: 54.Google Scholar
Juniper EF, Guyatt GH, Jaeschke R. 1996 How to develop and validate a new health-related quality of life instrument. Quality of life and pharmacoeconomics in clinical trials. In: Spilker S, ed. 2nd ed. Philadelphia: Lippincott-Raven Publishers; 49– 56.
Kaplan RM, Anderson JP. 1996 The general health policy model: An integrated approach. Quality of life and pharmacoeconomics in clinical trials. In: Spilker B, ed. 2nd ed. Philadelphia: Lippincott-Raven Publishers; 309– 322.
Landis RJ, Koch GG. 1977 The measurement of observer agreement for categorical data. Biometrics. 33: 159– 174.Google Scholar
Luo N, Chew LH, Fong KY, et al. 2003 A comparison of the EuroQol-5D and the Health Utilities Index Mark 3 in patients with rheumatic disease. J Rheumatol. 30: 2268– 2274.Google Scholar
Macran S. Test-retest performance of EQ-5D. In: Brooks R, Rabin R, de Charro F, eds. The measurement and valuation of health status using EQ-5D: A European perspective. Evidence from the EuroQol BIOMED Research Programme. Dordrecht: Kluwer Academic Publishers; 2003 43– 54.
McDowell I, Newell C. 1996. Measuring health: A guide to rating scales and questionnaires. 2nd ed. New York: Oxford University Press
McHorney CA, Tarlov AR. 1995 Individual-patient monitoring in clinical practice: Are available health status surveys adequate? Qual Life Res. 4: 293– 307.Google Scholar
Medical Outcomes Trust, Scientific Advisory Committee. 2002 Assessing health status and quality-of-life instruments: Attributes and review criteria. Qual Life Res. 11: 193– 205.Google Scholar
Norman G. 2003 Hi! How are you? Response shift, implicit theories and differing epistemologies. Qual Life Res. 12: 239– 249.Google Scholar
Ottenbacher KJ. 1994 Mann WC, Granger CV, et al. Inter-rater agreement and stability of functional assessment in the community-based elderly. Arch Phys Med Rehabil. 75: 1297– 1301.Google Scholar
Ottenbacher KJ, Hsu Y, Granger CV, Fiedler RC. 1996 The reliability of the functional independence measure: A quantitative review. Arch Phys Med Rehabil. 77: 1226– 1232.Google Scholar
Petrella N, Overend T, Chesworth B. 2002 FIM after hip fracture: Is telephone administration valid and sensitive to change? Am J Phys Med Rehabil. 81: 639– 644.Google Scholar
Pollak N, Rheault W, Stoecker JL. 1996 Reliability and validity of the FIM for persons aged 80 years and above from a multilevel continuing care retirement community. Arch Phys Med Rehabil. 77: 1056– 1061.Google Scholar
Rabin R, de Charro F. 2001 EQ-5D: A measure of health status from the EuroQol group. Ann Med. 33: 337– 343.Google Scholar
Revicki D, Osoba D, Fairclough D, et al. 2000 Recommendations on health-related quality of life research to support labeling and promotional claims in the United States. Qual Life Res. 9: 887– 900.Google Scholar
Roccaforte WH, Burke WJ, Bayer BL, Wengel SP. 1992 Validation of a telephone version of the Mini-Mental State Examination. J Am Geriatr Soc. 40: 697– 702.Google Scholar
Schuck P. 2004 Assessing reproducibility for internal data in health-related quality of life questionnaires: Which coefficient should be used? Qual Life Res. 13: 571– 586.Google Scholar
Segal ME, Gillard M, Schall R. 1996 Telephone and in-person proxy agreement between stroke patients and caregivers for the functional independence measure. Am J Phys Med Rehabil. 75: 208– 212.Google Scholar
Shrout PE, Fleiss JL. 1979 Intraclass correlations: Uses in assessing rater reliability. Psychol Bull. 86: 420– 428.Google Scholar
Smith PM, Illig SB, Fiedler RC, Hamilton BB, Ottenbacher KJ. 1996 Intermodal agreement of follow-up telephone functional assessment using the functional independence measure in patients with stroke. Arch Phys Med Rehabil. 77: 9431– 435.Google Scholar
Streiner DL, Norman GR. 1995. Health measurement scales. A practical guide to their development and use. 2nd ed. Oxford: Oxford University Press;
Suarez-Almazor ME, Kendall C, Johnson JA, Skeith K, Vincent D. 2000 Use of health status measures in patients with low back pain in clinical settings. Comparison of specific, generic, and preference-based instruments. Rheumatology. 39: 783– 790.Google Scholar
Tombaugh TN, McIntyre NJ. 1992 The Mini-Mental State Examination: A comprehensive review. J Am Geriatr Soc. 40: 922– 935.Google Scholar
Torrance GW, Feeny DH, Furlong WJ, et al. 1996 Multi-attribute preference functions for a comprehensive health status classification system: Health Utilities Index Mark 2. Med Care. 34: 702– 722.Google Scholar
Wallace D, Duncan PW, Lai SM. 2002 Comparison of the responsiveness of the Barthel Index and the motor component of the functional independence measure in stroke. The impact of using different methods for measuring responsiveness. J Clin Epidemiol. 55: 922– 928.Google Scholar