Choosing between measures: comparison of EQ-5D, HUI2 and HUI3 in persons with hearing complaints.
OBJECTIVE
To generate insight into the differences between utility measures EuroQol 5D (EQ-5D), Health Utilities Index Mark II (HUI2) and Mark III (HUI3) and their impact on the incremental cost-effectiveness ratio (ICER) for hearing aid fitting


METHODS
Persons with hearing complaints completed EQ-5D, HUI2 and HUI3 at baseline and, when applicable, after hearing aid fitting. Practicality, construct validity, agreement, responsiveness and impact on the ICER were examined.


RESULTS
All measures had high completion rates. HUI3 was capable of discriminating between clinically distinctive groups. Utility scores (n = 315) for EQ-5D UK and Dutch tariff (0.83; 0.86), HUI2 (0.77) and HUI3 (0.61) were significantly different, agreement was low to moderate. Change after hearing aid fitting (n = 70) for HUI2 (0.07) and HUI3 (0.12) was statistically significant, unlike the EQ-5D UK (0.01) and Dutch (0.00) tariff. ICERs varied from 647,209 euros/QALY for the EQ-5D Dutch tariff to 15,811 euros/QALY for HUI3.


CONCLUSIONS
Utility scores, utility gain and ICERs heavily depend on the measure that is used to elicit them. This study indicates HUI3 as the instrument of first choice when measuring utility in a population with hearing complaints, but emphasizes the importance of a clear notion of what constitutes utility with regard to economic analyses.
Grutters
Janneke P C
JP
Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands. janneke.grutters@maastro.nl
Joore
Manuela A
MA
van der Horst
Frans
F
Verschuure
Hans
H
Dreschler
Wouter A
WA
Anteunis
Lucien J C
LJ
D003362:Cost-Benefit Analysis; D006304:Health Status; D006305:Health Status Indicators; D006309:Hearing; D006311:Hearing Disorders / Q000191:economics / Q000523:psychology; D034381:Hearing Loss / Q000191:economics / Q000523:psychology*; D006801:Humans; D017063:Outcome Assessment, Health Care; D011581:Psychological Tests; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D019057:Quality-Adjusted Life Years; D011795:Surveys and Questionnaires