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Relationship between psychometric and utility-based approaches to the measurement of health-related quality of life

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Abstract

This paper summarizes selected evidence pertaining to the relationship between psychometric health status measures and utility/preference measures of health outcome. Few studies contain measures of both health status and utility/preference. The evidence to date suggests that various health status measures are at best only moderately correlated with standard gamble (SG) and time trade-off (TTO) utilities. Results from regression analysis, predicting SG or TTO utilities from combinations of health status scales, typically have an R2 of 0.18 to 0.43. Preferences determined by rating scale methods are more strongly related to health status scores, but correlations are variable ranging from 0.17 to 0.46 and only about 27% to 34% of variance can be explained in regression models. The Quality of Well-Being Scale and other multiattribute preference measures have low to moderate correlations with health status measures (r=0.03 to 0.71). Health utility/preference measures and psychometric health status scores are only moderately correlated. Health utility and psychometric health status scales may measure different attributes of health. Although both approaches are useful for evaluating medical outcomes, they are not interchangeable indicators of health-related quality of life.

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References

  1. Revicki DA, Rothman M, Luce BR. Health-related quality of life assessment and the pharmaceutical industry. Pharmacoeconomics 1992; 1: 394–408.

    Google Scholar 

  2. Patrick DL, Deyo R. Generic and disease specific measures in assessing health status and quality of life. Med Care 1989; 27: S217-S232.

    Google Scholar 

  3. Stewart A, Ware JEJr. Measuring Functioning and Well-Being: The Medical Outcomes Study Approach. Durham, NC: Duke University Press, 1992.

    Google Scholar 

  4. Bergner M. Quality of life, health status, and clinical research. Med Care 1989; 27 (suppl): S148-S156.

    Google Scholar 

  5. Patrick DL, Erickson P. Health Status and Health Policy: Allocating Resources to Health Care. New York: Oxford University Press, 1992.

    Google Scholar 

  6. Revicki DA. Medical technology assessment and health-related quality of life. In: Banta D, Luce B. Health Care Technology and Its Assessment: An International Perspective. New York: Oxford University Press, 1993.

    Google Scholar 

  7. Feeny D, Torrance GW. Incorporating utility-based quality-of-life assessment measures in clinical trials. Med Care 1989; 27: S190-S204.

    Google Scholar 

  8. Froberg D, Kane R. Methodology for measuring health-state preferences-I: measurement strategies. J Clin Epidemiol 1989; 42: 345–354.

    Google Scholar 

  9. Froberg D, Kane R. Methodology for measuring health-state preferences-II: scaling methods. J Clin Epidemiol 1989; 42: 459–471.

    Google Scholar 

  10. Froberg D, Kane R. Methodology for measuring health-state preferences-III: population and context effects. J Clin Epidemiol 1989; 42: 585–592.

    Google Scholar 

  11. Froberg D, Kane R. Methodology for measuring health-state preferences-IV: progress and a research agenda. J Clin Epidemiol 1989; 42: 675–685.

    Google Scholar 

  12. Kaplan RM. Utility Assessment for Estimating Quality-Adjusted Life Years. La Jolla, CA: University of California, San Diego, 1993.

    Google Scholar 

  13. Kaplan RM, Anderson J, Wu A, et al. The Quality of Well-Being Scale: applications in AIDS, cystic fibrosis, and arthritis. Med Care 1989; 27: S27-S43.

    Google Scholar 

  14. Torrance GW. Measurement of health state utilities for economic appraisal. J Health Econ 1986; 5: 1–30.

    Google Scholar 

  15. Spilker B ed. Quality of Life Assessments in Clinical Trials. New York: Raven Press, 1990.

    Google Scholar 

  16. Kirschner B, Guyatt G. A methodological framework for assessing health indices. J Chron Dis 1985; 38: 27–36.

    Google Scholar 

  17. Guyatt G, Jaeschke R. Measurements in clinical trials: choosing the appropriate approach. In Spilker B, ed. Quality of Life Assessments in Clinical Trials, Raven Press, New York, 1990: 47–57.

    Google Scholar 

  18. Kaplan RM. The Hyppocratic Predicament: Affordability, Access and Accountability in Health Care. San Diego: Academic Press, 1993.

    Google Scholar 

  19. Deyo R, Patrick DL. Barriers to the use of health status measures in clinical investigation, patient care, and policy research. Med Care 1989; 27 (suppl): S254-S268.

    Google Scholar 

  20. Revicki DA. Relationship between health utility and psychometric health status measures. Med Care 1992; 30 (suppl): MS274-MS282.

    Google Scholar 

  21. Torrance GW, Feeny D. Utilities and quality-adjusted life years. Int J Technology Assess Health Care 1989; 5: 559–575.

    Google Scholar 

  22. Revicki DA, Allen H, Bungay K, et al. Responsiveness and Calibration of the General Well-Being Adjustment Scale in Patients with Hypertension. Washington, DC: Battelle Medical Technology Assessment and Policy Research Center, 1993.

    Google Scholar 

  23. Testa MA, Anderson RB, Nackley JF, et al. Quality of life and antihypertensive therapy in men: a comparison of captopril and enalapril. N Engl J Med 1993; 328: 901–913.

    Google Scholar 

  24. Torrance GW, Zhang Y, Feeny D, et al. Multi-Attribute Preference Functions for a Comprehensive Health Status Classification System. Paper 92-18. Hamilton, Ontario: McMaster University, 1992.

    Google Scholar 

  25. Kaplan RM, Bush J. Health-related quality of life measurement for evaluation research and policy analysis. Health Psych 1982; 1: 61–80.

    Google Scholar 

  26. Guyatt GH, Feeny DH, Patrick DL. Measuring health-related quality of life. Ann Intern Med 1993; 118: 622–629.

    Google Scholar 

  27. Canadian Erythropoietin Study Group. Association between recombinant human erythropoietin and quality of life and exercise capacity of patients receiving haemodialysis. Br Med J 1990; 300: 573–578.

    Google Scholar 

  28. Revicki DA, Brown RE, Henry D. Health Status Outcomes of Recombinant Human Erythropoietin Therapy for Predialysis Chronic Renal Disease Patients. Washington, DC: Battelle Medical Technology Assessment and Policy Research Center, 1993.

    Google Scholar 

  29. Bombardier C, Ware J, Russell I, et al. Auranofin therapy and quality of life in patients with rheumatoid arthritis: results of a multicenter trial. Am J Med 1986; 81: 565–578.

    Google Scholar 

  30. Wu AW, Mathews WC, Brysk LT, et al. Quality of life in a placebo-controlled trial of zidovudine in patients with AIDS and AIDS-related complex. Journal of Acquired Immune Deficiency Syndromes 1990; 3: 683–690.

    Google Scholar 

  31. Mully A. Assessing patient's utilities: can the ends justify the means? Med Care 1989; 27: S269-S281.

    Google Scholar 

  32. Read J, Quinn R, Berwick D, et al. Preferences for health outcomes: comparisons of assessment methods. Medical Decision Making 1984; 4: 315–329.

    Google Scholar 

  33. Brazier J, Jones N, Kind P. A comparison of two health status measures: Euroqol meets SF-36. Presentation at the Health Economics Study Group/Faculty of Public Health Medicine Conference, University of York, York, UK, January, 1993.

  34. Fryback DG, Dasbach EJ, Klein R, et al. Health assessment by SF-36, quality of well-being index and time-tradeoffs: predicting one measure from another. Medical Decision Making 1992; 12: 348 (abstract).

    Google Scholar 

  35. Fryback DG, Dasbach EJ, Klein R, et al. The Beaver Dam Health Outcomes Study: initial catalog of health-related quality factors. Medical Decision Making 1993; 13: 89–102.

    Google Scholar 

  36. Read J, Quinn R, Hoefer M. Measuring overall health: an evaluation of three important approaches. J Chron Dis 1987; 40: 7S-22S.

    Google Scholar 

  37. Revicki DA, Weinstein M, Alderman M, et al. Health Utility and Health Status Outcomes of Antihypertensive Treatment. Washington, DC: Battelle Medical Technology Assessment and Policy Research Center, 1992.

    Google Scholar 

  38. Churchill D, Torrance GW, Taylor DW, et al. Measurement of quality of life in end-stage renal disease: the time trade-off approach. Clinical and Investigational Medicine 1987; 10: 14–20.

    Google Scholar 

  39. Tsevat J, Solzan JG, Tolan KK, et al. Health status and utilities of HIV+ and primary care patients. Clin Res 1992; 40: 569 A (abstract).

    Google Scholar 

  40. Hughes TE. Comparison of the Quality of Well-Being Scale and the MOS-HIV-34 health survey in HIV-infected patients. Doctoral Dissertation, University of Arizona, 1993.

  41. Liang MH, Larson MG, Cullen KE, et al. Comparative measurement efficiency and sensitivity of five health status instruments for arthritis research. Arthritis and Rheumatism 1985; 28: 542–547.

    Google Scholar 

  42. Llewellyn-Thomas HA, Sutherland HJ, Tritchler DL, et al. Benign and malignant breast disease: the relationship between women's health status and health values. Medical Decision Making 1991; 11: 180–188.

    Google Scholar 

  43. Tsevat J, Goldman L, Lamas GA, et al. Functional status versus utilities in survivors of myocardial infarction. Med Care 1991; 29: 1153–1159.

    Google Scholar 

  44. Nichol G, Thiel E, Llewellyn-Thomas HA, et al. Do patients with angina report utilities that are consistent with their level of functional impairment on standard scales? Medical Decision Making 1992; 12: 352 (abstract).

    Google Scholar 

  45. Laupacis A, Wong C, Churchill D, Canadian Erythropoietin Study Group. The use of generic and specific quality-of-life measures in hemodialysis patients treated with erythropoietin. Controlled Clinical Trials 1991; 12: 168S-179S.

    Google Scholar 

  46. Tsevat J, Goldman L, Soukup JR, et al. Stability in time-tradeoff utilities in survivors of myocardial infarction. Medical Decision Making 1993; 13: 161–165.

    Google Scholar 

  47. Tsevat J, Dawson NV, Matchar DB. Assessing quality of life and preferences in the seriously ill using utility theory. J Clin Epidemiol 1990; 43: 73S-77S.

    Google Scholar 

  48. Green ML, Tsevat J, Cook EF, et al. Correlates of utilities in seriously ill patients. Clin Res 1992; 40: 567A (abstract).

    Google Scholar 

  49. Kaplan RM, Anderson JP. The general health policy model: an integrated approach. In Spilker B, ed. Quality of Life Assessments in Clinical Trials. New York: Raven Press, 1990: 131–149.

    Google Scholar 

  50. Veit CT, Rose BJ, Ware JE. Effects of physical and mental health on health-state preferences. Med Care 1982; 20: 386–401.

    Google Scholar 

  51. Tversky A, Kahneman D. The framing of decisions and the psychology of choice. Science 1981; 211: 453–458.

    Google Scholar 

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Authors and Affiliations

  1. Battelle Medical Technology Assessment and Policy Research Center, 901 D Street, SW, 20024, Washington, DC, USA

    D. A. Revicki

  2. Division of Health Care Sciences, Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, CA, USA

    R. M. Kaplan

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  1. D. A. Revicki
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  2. R. M. Kaplan
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Revicki, D.A., Kaplan, R.M. Relationship between psychometric and utility-based approaches to the measurement of health-related quality of life. Qual Life Res 2, 477–487 (1993). https://doi.org/10.1007/BF00422222

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