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      The Health Utilities Index (HUI ®): concepts, measurement properties and applications

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          Abstract

          This is a review of the Health Utilities Index (HUI ®) multi-attribute health-status classification systems, and single- and multi-attribute utility scoring systems. HUI refers to both HUI Mark 2 (HUI2) and HUI Mark 3 (HUI3) instruments. The classification systems provide compact but comprehensive frameworks within which to describe health status. The multi-attribute utility functions provide all the information required to calculate single-summary scores of health-related quality of life (HRQL) for each health state defined by the classification systems. The use of HUI in clinical studies for a wide variety of conditions in a large number of countries is illustrated. HUI provides comprehensive, reliable, responsive and valid measures of health status and HRQL for subjects in clinical studies. Utility scores of overall HRQL for patients are also used in cost-utility and cost-effectiveness analyses. Population norm data are available from numerous large general population surveys. The widespread use of HUI facilitates the interpretation of results and permits comparisons of disease and treatment outcomes, and comparisons of long-term sequelae at the local, national and international levels.

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          Multiattribute and single-attribute utility functions for the health utilities index mark 3 system.

          David H. Feeny, William Furlong, George Torrance … (2002)
          The Health Utilities Index Mark 3 (HUI3) is a generic multiattribute preference-based measure of health status and health-related quality of life that is widely used as an outcome measure in clinical studies, in population health surveys, in the estimation of quality-adjusted life years, and in economic evaluations. HUI3 consists of eight attributes (or dimensions) of health status: vision, hearing, speech, ambulation, dexterity, emotion, cognition, and pain with 5 or 6 levels per attribute, varying from highly impaired to normal. The objectives are to present a multiattribute utility function and eight single-attribute utility functions for the HUI3 system based on community preferences. Two preference surveys were conducted. One, the modeling survey, collected preference scores for the estimation of the utility functions. The other, the direct survey, provided independent scores to assess the predictive validity of the utility functions. Preference measures included value scores obtained on the Feeling Thermometer and standard gamble utility scores obtained using the Chance Board. A random sample of the general population (> or =16 years of age) in Hamilton, Ontario, Canada. Estimates were obtained for eight single-attribute utility functions and an overall multiattribute utility function. The intraclass correlation coefficient between directly measured utility scores and scores generated by the multiattribute function for 73 health states was 0.88. The HUI3 scoring function has strong theoretical and empirical foundations. It performs well in predicting directly measured scores. The HUI3 system provides a practical way to obtain utility scores based on community preferences.
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            Multiattribute utility function for a comprehensive health status classification system. Health Utilities Index Mark 2.

            G W Torrance, D H Feeny, W J Furlong … (1996)
            The Health Utilities Index Mark 2 (HUI:2) is a generic multiattribute, preference-based system for assessing health-related quality of life. Health Utilities Index Mark 2 consists of two components: a seven-attribute health status classification system and a scoring formula. The seven attributes are sensation, mobility, emotion, cognition, self-care, pain, and fertility. A random sample of general population parents were interviewed to determine cardinal preferences for the health states in the system. The health states were defined as lasting for a 60-year lifetime, starting at age 10. Values were measured using visual analogue scaling. Utilities were measured using a standard gamble technique. A scoring formula is provided, based on a multiplicative multiattribute utility function from the responses of 194 subjects. The utility scores are death-anchored (death = 0.0) and form an interval scale. Health Utilities Index Mark 2 and its utility scores can be useful to other researchers in a wide variety of settings who wish to document health status and assign preference scores.
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              Introducing economic and quality of life measurements into clinical studies.

              M. Bradley Drummond (2001)
              Although the collection of cost and quality of life data alongside clinical studies generates detailed patient level data in a timely fashion, it also raises practical and methodological challenges. These include the fact that the settings and patients enrolled in trials may not be typical of those found in regular clinical practice, that costs and quality of life may be influenced by the trial protocol, that the clinical alternatives compared in trials may not be the most relevant for cost-effectiveness assessments, that the length of follow-up may be too short to observe changes in cost and quality of life, and that adding these data will increase the overall measurement burden in the trial. This paper discusses these challenges and the ways in which they might be overcome, focussing particularly on preference-based measures of quality of life. In particular, recommendations are given for choosing the range of quality of life instruments, sample size calculations for quality of life measurement and the measurement of quality of life in multinational studies.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Health Qual Life Outcomes
                Title: Health and Quality of Life Outcomes
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1477-7525
                Publication date Collection: 2003
                Publication date (Electronic): 16 October 2003
                Volume: 1
                Page: 54
                Affiliations
                [1 ]Health Utilities Inc., Dundas, ON, Canada
                [2 ]Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
                [3 ]Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
                [4 ]Institute of Health Economics and University of Alberta, Edmonton, AB, Canada
                [5 ]Innovus Research Inc., Burlington, ON, Canada
                Article
                Publisher ID: 1477-7525-1-54
                DOI: 10.1186/1477-7525-1-54
                PMC ID: 293474
                PubMed ID: 14613568
                SO-VID: 45cef60b-42b6-4712-9945-150576fce3e8
                Copyright © Copyright © 2003 Horsman et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
                History
                Date received : 31 July 2003
                Date accepted : 16 October 2003
                Categories
                Subject: Review

                ScienceOpen disciplines: Health & Social care
                Keywords: hrql,multi-attribute,health status,health utilities index,quality of life,hui2,hui3,utility scores,single-attribute,utilities,qalys,review paper,hui
                Data availability:
                ScienceOpen disciplines: Health & Social care
                Keywords: hrql, multi-attribute, health status, health utilities index, quality of life, hui2, hui3, utility scores, single-attribute, utilities, qalys, review paper, hui

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