Study of observed and self-reported HRQL in older frail adults found group-level congruence and individual-level differences.
OBJECTIVE
To evaluate the consistency of self-reported health-related quality of life (HRQL) using the Health Utilities Index Mark 2 (HUI2) with observer rated HRQL using the Minimum Data Set Health-Status Index (MDS-HSI).


METHODS
Frail older home care clients in Calgary Alberta and Wayne County, Michigan responded to HUI2 questionnaires and were assessed using the Minimum Data Set Home Care tool (n=514). HRQL scores were calculated and compared for the HUI2 and the MDS-HSI. The intraclass correlation coefficient (ICC) was used to assess individual level agreement.


RESULTS
The MDS-HSI provided HRQL scores that consistently averaged 0.10 points higher than HUI2 self-reported HRQL scores overall and within client characteristics. The ICC was 0.46 in the full population but increased to 0.63 when 10% of the sample with the largest discrepant scores was removed. Pain and emotion health attributes showed the lowest level of agreement.


CONCLUSIONS
The MDS-HSI and HUI2 provide analogous group-level results but only moderate individual-level agreement. When HUI2 survey data are not available, the MDS-HSI can be used to substitute for the HUI2 in group-level comparisons but not for individual clinical evaluation comparisons.
Wodchis
Walter P
WP
Department of Health Policy, Management and Evaluation, University of Toronto, Canada. walter.wodchis@utoronto.ca
Maxwell
Colleen J
CJ
Venturini
Adriana
A
Walker
Jennifer D
JD
Zhang
Jenny
J
Hogan
David B
DB
Feeny
David F
DF
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta / Q000453:epidemiology; D001294:Attitude to Health; D002908:Chronic Disease; D003072:Cognition Disorders / Q000453:epidemiology; D005260:Female; D016330:Frail Elderly / Q000523:psychology; D006304:Health Status; D006306:Health Surveys; D006699:Home Care Services; D006801:Humans; D008297:Male; D008824:Michigan / Q000453:epidemiology; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life; D012647:Self-Assessment