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Are indirect utility measures reliable and responsive in rheumatoid arthritis patients?

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Abstract

Background: Preference-based, generic measures are increasingly being used to measure quality of life and as sources for quality weights in the estimation of Quality Adjusted Life Years (QALYs) in rheumatoid arthritis (RA). However, among the most commonly used instruments (the Health Utilities Index 2 and 3 [HUI2 and HUI3], the EuroQoL-5D [EQ-5D], and the Short Form-6D [SF-6D], there has been little comparative research. Therefore, we examined the reliability and responsiveness of these measures and the Rheumatoid Arthritis Quality of Life (RAQoL) and the Health Assessment Questionnaire (HAQ) in a sample of RA patients. Major findings: Test–retest reliability was acceptable for all of the instruments with the exception of the EQ-5D. Using two external criteria to define change (a patient transition question and categories of the patient global assessment of disease activity VAS), the RAQoL was the most responsive of the instruments. For the indirect utility instruments, the HUI3 and the SF-6D were the most responsive for measuring positive change. On average, for patients whose RA improved, the absolute change was highest for the HUI3. Conclusions: The HUI3 and the SF-6D appear to be the most responsive of the preference-based instruments in RA. However, differences in the magnitude of the absolute change scores have important implications for cost-effectiveness analyses.

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References

  1. American College of Rheumatology Subcommittee on Rheumatoid Arthritis Guidelines for the Management of Rheumatoid Arthritis: 2002 Update. Arthritis Rheum 2002; 46: 326–348.

    Google Scholar 

  2. PE Lipsky DM Heijde Particlevan der EW. St Clair et al. (2000) ArticleTitleInfliximab and methotrexate in the treatment of rheumatoid arthritis Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group N Eng J Med 343 1594–1602 Occurrence Handle1:CAS:528:DC%2BD3cXovVeltLk%3D Occurrence Handle10.1056/NEJM200011303432202

    Article  CAS  Google Scholar 

  3. B Blumenauer A Cranney J Clinch P. Tugwell (2003) ArticleTitleQuality of life in patients with rheumatoid arthritis: Which drugs might make a difference? Pharmacoeconomics 21 927–940 Occurrence Handle10.2165/00019053-200321130-00002 Occurrence Handle12959625

    Article  PubMed  Google Scholar 

  4. DL. Scott (1999) ArticleTitleLeflunomide improves quality of life in rheumatoid arthritis Scand J Rheumatol Suppl 112 23–29 Occurrence Handle1:STN:280:DC%2BD3c7jtlOjsQ%3D%3D Occurrence Handle10.1080/030097499750042254-1 Occurrence Handle10668524

    Article  CAS  PubMed  Google Scholar 

  5. SZ Zhao JI Fiechtner EA. Tindall et al. (2000) ArticleTitleEvaluation of health-related quality of life of rheumatoid arthritis patients treated with celecoxib Arthritis Care Res 13 112–121 Occurrence Handle1:STN:280:DC%2BD3srlsF2qtw%3D%3D Occurrence Handle10.1002/1529-0131(200004)13:2<112::AID-ANR5>3.0.CO;2-L Occurrence Handle14635284

    Article  CAS  PubMed  Google Scholar 

  6. A Hammond A Young R. Kidao (2004) ArticleTitleA randomised controlled trial of occupational therapy for people with early rheumatoid arthritis Ann Rheum Dis 63 23–30 Occurrence Handle1:STN:280:DC%2BD3srptFarsQ%3D%3D Occurrence Handle10.1136/ard.2002.001511 Occurrence Handle14672887 Occurrence Handle1754722

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. K Eberhardt S Duckberg BM Larsson PM Johnson K. Nived (2002) ArticleTitleMeasuring health related quality of life in patients with rheumatoid arthritis – reliability, validity, and responsiveness of a Swedish version of RAQoL Scand J Rheumatol 31 6–12 Occurrence Handle10.1080/030097402317255291 Occurrence Handle11922201

    Article  PubMed  Google Scholar 

  8. MF Drummond B O’Brien GL Stoddart GW. Torrance (Eds) (1997) Methods for the Economic Evaluation of Health Care Programmes EditionNumber2 Oxford Medical Publications Oxford

    Google Scholar 

  9. NP Hurst P Kind D Ruta M Hunter A. Stubbings (1997) ArticleTitleMeasuring health-related quality of life in rheumatoid arthritis: Validity, responsiveness and reliability of EuroQol (EQ-5D) Br J Rheumatol 36 551–559 Occurrence Handle1:STN:280:DyaK2szjt1yqtw%3D%3D Occurrence Handle10.1093/rheumatology/36.5.551 Occurrence Handle9189057

    Article  CAS  PubMed  Google Scholar 

  10. SJ Walters JE. Brazier (2003) ArticleTitleWhat is the relationship between the minimally important difference and health state utility values? The case of the SF-6D Health Qual Life Outcomes 11 4–12 Occurrence Handle10.1186/1477-7525-1-4

    Article  Google Scholar 

  11. B Conner-Spady ME. Surez-Almazor (2003) ArticleTitleVariation in the estimation of quality-adjusted life-years by different preference-based instruments Med Care 41 791–801 Occurrence Handle10.1097/00005650-200307000-00003 Occurrence Handle12835603

    Article  PubMed  Google Scholar 

  12. C Blanchard D Feeny JL. Mahon et al. (2003) ArticleTitleIs the Health Utilities Index responsive in total hip arthroplasty patients? J Clin Epidemiol 56 1046–1054 Occurrence Handle10.1016/S0895-4356(03)00203-8 Occurrence Handle14614995

    Article  PubMed  Google Scholar 

  13. CB Terwee FW Dekker Wiersinga MF Prummel PMM. Bossuyt (2003) ArticleTitleOn assessing the responsiveness of health-related quality of life instruments: Guidelines for instrument evaluation Qual Life Res 12 349–362 Occurrence Handle1:STN:280:DC%2BD3s3ntFCjsw%3D%3D Occurrence Handle10.1023/A:1023499322593 Occurrence Handle12797708

    Article  CAS  PubMed  Google Scholar 

  14. MH Liang RA Lew G Stucki PR Fortin L. Daltroy (2002) ArticleTitleMeasuring clinically important changes with patient-oriented questionnaires Med Care 40 IssueIDSuppl II-45–II-51

    Google Scholar 

  15. FC Arnett SM Edworthy DA. Bloch et al. (1988) ArticleTitleThe American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis Arthritis Rheum 31 315–324 Occurrence Handle1:STN:280:DyaL1c7pt1Ohsg%3D%3D Occurrence Handle10.1002/art.1780310302 Occurrence Handle3358796

    Article  CAS  PubMed  Google Scholar 

  16. AL Wong WK Wong J. Harker et al. (1999) ArticleTitlePatient self-report tender and swollen joint counts in early rheumatoid arthritis Western Consortium of Practicing Rheumatologists J Rheumatol 26 2551–2561 Occurrence Handle1:STN:280:DC%2BD3c%2Fnt1ekug%3D%3D Occurrence Handle10606362

    CAS  PubMed  Google Scholar 

  17. PR Fortin Abrahomowicz AE. Clarke et al. (2000) ArticleTitleDo lupus disease activity measures detect clinically important changes? J Rheumatol 27 1421–1428 Occurrence Handle1:STN:280:DC%2BD3cvotlGjtQ%3D%3D Occurrence Handle10852264

    CAS  PubMed  Google Scholar 

  18. DA Redelmeier K. Lorig (1993) ArticleTitleAssessing the clinical importance of symptomatic improvements – an illustration in rheumatology Arch Intern Med 153 1337–1342 Occurrence Handle1:STN:280:DyaK3s3ot1OnsA%3D%3D Occurrence Handle10.1001/archinte.1993.00410110045008 Occurrence Handle8507124

    Article  CAS  PubMed  Google Scholar 

  19. GA Wells P Tugwell GR Kraag PR Baker J Groh DA. Redelmeier (1993) ArticleTitleMinimum important difference between patients with rheumatoid arthritis: The patient’s perspective J Rheumatol 20 557–560 Occurrence Handle1:STN:280:DyaK3s3ktVCmtA%3D%3D Occurrence Handle8478873

    CAS  PubMed  Google Scholar 

  20. Marra CA, Woolcott JC, Shojania K, et al. (1999). An assessment of the construct validity of four indirect utility measures in rheumatoid arthritis. Social Science and Medicine (in press).

  21. JA Kopec KD. Willison (2003) ArticleTitleA comparative review of four preference-weighted measures of health-related quality of life J Clin Epidemiol 56 317–325 Occurrence Handle10.1016/S0895-4356(02)00609-1 Occurrence Handle12767408

    Article  PubMed  Google Scholar 

  22. P Grootendorst D Feeny W. Furlong (2000) ArticleTitleHealth Utilities Index Mark 3: Evidence of construct validity for stroke and arthritis in a population health survey Med Care 38 290–299 Occurrence Handle1:STN:280:DC%2BD3c7otFarsA%3D%3D Occurrence Handle10.1097/00005650-200003000-00006 Occurrence Handle10718354

    Article  CAS  PubMed  Google Scholar 

  23. G Samsa D Edelman M Rothman GR Williams J Lipscomb D. Matchar (1999) ArticleTitleDetermining clinically important differences in health status measures A general approach with illustrations to the Health Utilities Index Mark II Pharmacoeconomics 15 141–155 Occurrence Handle1:STN:280:DyaK1M3isFyitg%3D%3D Occurrence Handle10.2165/00019053-199915020-00003 Occurrence Handle10351188

    Article  CAS  PubMed  Google Scholar 

  24. Horsman J, Furlong W, Feeny D, Torrance G. The Health Utilities Index (HUI®): Concepts, measurement properties and applications. Health and Quality of Life Outcomes 2003; 1: 54 (http://hqlo.com/content/1/1/54).

  25. GR Norman FG Wridhar GH Guyatt SD. Walter (2001) ArticleTitleRelation of distribution- and anchor-based approaches in interpretation of changes in health-related quality of life Med Care 39 1039–1047 Occurrence Handle1:STN:280:DC%2BD3MritVSksQ%3D%3D Occurrence Handle10.1097/00005650-200110000-00002 Occurrence Handle11567167

    Article  CAS  PubMed  Google Scholar 

  26. GR Norman JA Sloan KW. Wyrwich (2003) ArticleTitleInterpretation of changes in health-related quality of life The remarkable universality of half a standard deviation Med Care 41 582–592 Occurrence Handle12719681

    PubMed  Google Scholar 

  27. J. Cohen (1992) ArticleTitleA power primer Psychol Bull 112 155–159 Occurrence Handle1:STN:280:DC%2BD1MvlsV2mug%3D%3D Occurrence Handle10.1037/0033-2909.112.1.155 Occurrence Handle19565683

    Article  CAS  PubMed  Google Scholar 

  28. RA Deyo P Diehr DL. Patrick (1991) ArticleTitleReproducibility and responsiveness of health status measures Statistics and strategies for evaluation. Control Clin Trials 12 142S–158S Occurrence Handle1:STN:280:DyaK387js1yitw%3D%3D Occurrence Handle10.1016/S0197-2456(05)80019-4 Occurrence Handle1663851

    Article  CAS  PubMed  Google Scholar 

  29. J. Cohen (1988) Statistical Power Analysis for the Behavioural Sciences EditionNumber2 Lawrence Erlbaum Assoc Hillsdale, (NJ)

    Google Scholar 

  30. S Wiebe G Guyatt B Weaver S Matijevic C. Sidwell (2003) ArticleTitleComparative responsiveness of generic and specific quality-of-life instruments J Clin Epidemiol 56 52–60 Occurrence Handle10.1016/S0895-4356(02)00537-1 Occurrence Handle12589870

    Article  PubMed  Google Scholar 

  31. E Chang M Abrahamowicz D Ferland PR. Fortin (2002) ArticleTitleCaNIOS Investigators Comparison of the responsiveness of lupus disease activity measures to changes in systemic lupus erythematosus activity relevant to patients and physicians J Clin Epidemiol 55 488–497 Occurrence Handle10.1016/S0895-4356(01)00509-1 Occurrence Handle12007552

    Article  PubMed  Google Scholar 

  32. M Abrahamowicz JO. Ramsay (1992) ArticleTitleMulticategorical spline model for item response theory Psychometrika 57 5–27 Occurrence Handle10.1007/BF02294656

    Article  Google Scholar 

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Authors and Affiliations

  1. Faculty of Pharmaceutical Sciences, University of British Columbia, Canada

    Carlo A. Marra

  2. Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada

    Carlo A. Marra

  3. Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, Vancouver, Canada

    Amir A. Rashidi & Daphne Guh

  4. Department of Health Care and Epidemiology, Faculty of Medicine, University of British Columbia, 620-1081 Burrard Street, Vancouver, B.C., Canada, V6Z 1Y6

    Jacek A. Kopec & Aslam H. Anis

  5. Arthritis Research Centre of Canada, Vancouver, Canada

    Jacek A. Kopec & John M. Esdaile

  6. Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada

    Michal Abrahamowicz

  7. Division of Rheumatology, Faculty of Medicine, University of British Columbia, UK

    John M. Esdaile

  8. Sheffield Health Economics Group, School of Health & Related Research, University of Sheffield, Sheffield, UK

    John E. Brazier

  9. Division of Rheumatology, Toronto Western Hospital, University of Toronto, Toronto, Canada

    Paul R. Fortin

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  1. Carlo A. Marra
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Correspondence to Aslam H. Anis.

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Marra, C.A., Rashidi, A.A., Guh, D. et al. Are indirect utility measures reliable and responsive in rheumatoid arthritis patients?. Qual Life Res 14, 1333–1344 (2005). https://doi.org/10.1007/s11136-004-6012-0

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