VALIDITY OF THE HEALTH UTILITIES INDEX (HUI-III) IN EPILEPSY
Abstract number :
1.269
Submission category :
Year :
2002
Submission ID :
1984
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Samuel Wiebe, Suzan Matijevic. Clinical Neurological Sciences, University of Western Ontario, London, Ontario, Canada; London Health Sciences Centre, London, Ontario, Canada
RATIONALE: Instruments that measure health state preferences (utilities) are essential to obtain quality adjusted life years, or QALYs. The latter are the standard metric cost-effectiveness analyses. There are very few data on the use of utility instruments in epilepsy. We assess the validity and clinical relevance of the Health Utilities Index (HUI-III) in epilepsy. The HUI-III is one of the most commonly used instruments worldwide to obtain health state preferences and QALYs, but there are no data on its performance and relevance in epilepsy. At the end of this activity the participants will have an understanding of the validity and clinical relevance of the HUI-III in patients with epilepsy.
METHODS: We evaluated 80 surgically or medically treated adults with temporal lobe epilepsy. All patients answered a battery of instruments including the self-administered Quality of Life Inventory in Epilepsy-89 (QOLIE-89) and HUI-III. Instruments were completed in the same order and on the same day, and they were reviewed for completeness and validity of responses. We assessed the internal consistency (Cronbach[ssquote]s alpha), floor and ceiling effects of the constituent subscales and the global score of the HUI-III. Construct validity of HUI-III was assessed using the QOLIE-89 constituent subscales as criterion constructs. Test-retest reliability and responsiveness of HUI-III were also assessed.
RESULTS: The response rate was 100%. The internal consistency of HUI-III was satisfactory for all multi-item subscales and for the global score (Cronbach[ssquote]s alpha = 0.72 to 0.9). Floor effects occurred in 0% to 2.5%, and ceiling effects occurred in 31% to 93% of individuals across subscales. The global, multi-attribute HUI-III utility score demonstrated adequate validity. Construct validity varied among subscales but it was generally adequate. The HUI-III subscales demonstrating stronger associations with corresponding QOLIE-89 constructs were pain, cognition, emotion, ambulation and hearing.
CONCLUSIONS: The HUI-III demonstrated adequate reliability and validity in a population of medically and surgically treated patients with temporal lobe epilepsy. We conclude that HUI-III yields reliable and valid information about health state preferences in patients with epilepsy. Its use in this population for the purpose of obtaining QALYs and performing cost-effectiveness analyses seems justified.
[Supported by: The Physicians[ssquote] Services Incorporated Foundation (Canada)]