Using the health assessment questionnaire to estimate preference-based single indices in patients with rheumatoid arthritis.
OBJECTIVE
To estimate the relationship between preference-based measures, EuroQol (EQ-5D) and SF-6D, and the Health Assessment Questionnaire (HAQ) disability index (DI) in patients with rheumatoid arthritis (RA), and to characterize components that are predictors of health utility.


METHODS
Patients with RA participating in 2 studies in the UK (n = 151) and Canada (n = 319) completed the HAQ, EQ-5D, and Short Form 36 (SF-36). The SF-36, a generic measure of quality of life, was converted into the preference-based SF-6D. From these results we developed models of the relationship between the HAQ and SF-6D and EQ-5D using various regression analyses.


RESULTS
The optimal model developed for the EQ-5D entered levels for each item as independent variables (model 5). A root mean square error (RMSE) of 0.18 suggested relatively good predictive ability. For the SF-6D, RMSEs were lower (0.09), suggesting better predictions than for the EQ-5D, but models with more explanatory variables did not improve results (model 2 or 4 optimal). The models were able to predict actual SF-6D and EQ-5D across the range of the HAQ DI.


CONCLUSIONS
Our approach enabled calculations of quality-adjusted life years from existing trials where only the HAQ was measured. All aspects of the HAQ may not be reflected in the preference-based measures, and this method is suboptimal to direct measurement of health state utility in clinical trials. Given this limitation, our approach provides an alternative for researchers who need health-state utility values, but had not included a preference-based measure in their clinical study because of resource constraints or a desire to limit patient burden.
St. Paul's Hospital, Vancouver, British Columbia, Canada. nbansback@cheos.ubc.ca
Nick
N
Bansback
Carlo
C
Marra
Aki
A
Tsuchiya
Aslam
A
Anis
Daphne
D
Guh
Tony
T
Hammond
John
J
Brazier
D001172:Arthritis, Rheumatoid / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012044:Regression Analysis; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires