Comparing the Health Utilities Index Mark 3 (HUI3) with the Short Form-36 Preference-Based SF-6D in Chronic Kidney Disease
Comparing the Health Utilities Index Mark 3 (HUI3) with the Short Form-36 Preference-Based SF-6D in Chronic Kidney Disease
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DOI：
10.1111/j.1524-4733.2008.00433.x
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发表时间：
2009-03-01
期刊：
影响因子：
4.5
通讯作者：
Feeny, David H.
中科院分区：
文献类型：
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作者：
Davison, Sara;Jhangri, Gian S.;Feeny, David H.
评估受试者内一致性并比较 SF-6D 和健康公用事业指数标记 3 (HUI3) 在慢性肾病 (CKD) 患者中的区分能力。HUI3 和 Short Form-36 由参加一项针对 4 期和 5 期 CKD 患者的前瞻性研究的 185 名 CKD 患者自行完成。相比之下，SF-6D 基于偏好的平均评分为 0.67 +/- 0.13 HUI3 为 0.58 +/- 0.26 (P < 0.01)。 SF-6D 和 HUI3 评分之间存在很强的相关性（Pearson 相关系数 0.55，95% CI 0.43-0.65），并且组内相关系数为 0.44，具有中等一致性。 HUI3 能够更好地捕捉更严重的疾病负担，同时减少底线效应。 SF-6D 能够更好地捕捉量表顶部范围内患者之间的差异，且天花板效应较少。 HUI3 和 SF-6D 都能够区分疾病严重程度不同的患者组，定义为透析前与透析依赖性和抑郁症状，使用贝克抑郁量表 II 评分 >= 14 作为截止值。 HUI3 能够更好地区分更严重的抑郁症状。SF-6D 和 HUI3 为 CKD 患者生成不同的基于偏好的评分，应谨慎进行它们评分之间的任何比较。 HUI3 似乎更适合测量 CKD 患者等残疾程度较高的人群的健康状况。当人们随着时间的推移比较仪器内偏好分数的差异时，这些差异是否仍然存在还有待确定。
Assess within-subject agreement and compare discriminative abilities between the SF-6D and the Health Utilities Index Mark 3 (HUI3) in patients with chronic kidney disease (CKD).The HUI3 and Short Form-36 were self-completed by 185 CKD patients enrolled in a prospective study of incident patients with stage 4 and 5 CKD.The mean preference-based score for the SF-6D was 0.67 +/- 0.13 compared to 0.58 +/- 0.26 for the HUI3 (P < 0.01). There was a strong association between SF-6D and HUI3 scores (Pearson correlation coefficient 0.55, 95% CI 0.43-0.65) and moderate agreement with an intraclass correlation coefficient of 0.44. The HUI3 was better able to capture more severe burden of illness with fewer floor effects. The SF-6D was better at capturing differences among patients at the top range of the scale with fewer ceiling effects. Both the HUI3 and SF-6D were able to discriminate between patient groups differing in disease severity defined as predialysis versus dialysis dependent and depressive symptoms using a Beck Depression Inventory II score of >= 14 as the cutoff. The HUI3 was better able to discriminate greater depressive symptoms.The SF-6D and the HUI3 generate different preference-based scores for patients with CKD and any comparison between their scores should be made with caution. The HUI3 appears more suitable for measuring the health of populations with greater disability such as patients with CKD. It remains to be determined whether these differences will remain when one compares within-instrument differences in preference scores over time.