Health utilities in patients with HIV/AIDS in Thailand.
OBJECTIVE
We measured health utility (HU) in Thai HIV/AIDS patients using visual analog scale (VAS), EuroQOL (EQ-5D), and standard gamble (SG), determine the relationships between these HU measures and health-related quality of life (HRQOL) measures of HIV and patient characteristics, and assess the feasibility of the HU methods.


METHODS
A sample of 120 HIV/AIDS patients was identified at Bamrasnaradura Infectious Disease Institute, Thailand, during September to December, 2004. Face-to-face interviews included VAS, SG, and EQ-5D, HRQOL assessment using the Thai abbreviated version of the World Health Organization quality of life (WHOQOL-BREF THAI) and HIV-related symptom instruments, questions about ease of understanding HU approaches and sociodemographic items. Data were analyzed with repeated-measures ANOVA, followed by Dunn-Bonferroni t-test, intraclass coefficients (ICC), Spearman's rank correlation, and multiple linear regressions.


RESULTS
The mean (95% confidence interval) HUs were as follows: VAS, 0.79 (0.76-0.82); EQ-5D, 0.80 (0.77-0.84); and SG, 0.65 (0.60-0.70). A significant difference in HU by method was found (P < 0.001). Agreement by ICC was 0.71 for VAS versus EQ-5D, 0.41 for VAS versus SG, and 0.38 for EQ-5D and SG. The regression models showed that WHOQOL-BREF THAI, frequency of HIV symptoms, and patient characteristics could explain approximately 50% of the variation in the VAS and the EQ-5D and 20% in the SG(2). Among these three HU methods, the SG was the most difficult task.


CONCLUSIONS
VAS, EQ-5D and SG yielded different HUs for this sample. VAS and EQ-5D showed stronger construct validity with other health measures than SG. From a feasibility perspective, the SG was the least satisfactory of the three approaches.
Sakthong
Phantipa
P
Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand. phantipa_sakthong@yahoo.com
Schommer
Jon C
JC
Gross
Cynthia R
CR
Prasithsirikul
Wisit
W
Sakulbumrungsil
Rungpetch
R
D000328:Adult; D000704:Analysis of Variance; D016001:Confidence Intervals; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010147:Pain Measurement; D011788:Quality of Life / Q000523:psychology; D012044:Regression Analysis; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D018709:Statistics, Nonparametric; D013785:Thailand / Q000453:epidemiology