Five preference-based indexes in cataract and heart failure patients were not equally responsive to change.
OBJECTIVE
To compare the responsiveness to clinical change of five widely used preference-based health-related quality-of-life indexes in two longitudinal cohorts.


METHODS
Five generic instruments were simultaneously administered to 376 adults undergoing cataract surgery and 160 adults in heart failure management programs. Patients were assessed at baseline and reevaluated after 1 and 6 months. The measures were the Short Form (SF)-6D (based on responses scored from SF-36v2), Self-Administered Quality of Well-being Scale (QWB-SA), the EuroQol-5D developed by the EuroQol Group, the Health Utilities Indexes Mark 2 (HUI2) and Mark 3 (HUI3). Cataract patients completed the National Eye Institute Visual Functioning Questionnaire-25, and heart failure patients completed the Minnesota Living with Heart Failure Questionnaire. Responsiveness was estimated by the standardized response mean.


RESULTS
For cataract patients, mean changes between baseline and 1-month follow-up for the generic indices ranged from 0.00 (SF-6D) to 0.052 (HUI3) and were statistically significant for all indexes except the SF-6D. For heart failure patients, only the SF-6D showed significant change from baseline to 1 month, whereas only the QWB-SA change was significant between 1 and 6 months.


CONCLUSIONS
Preference-based methods for measuring health outcomes are not equally responsive to change.
Kaplan
Robert M
RM
Department of Health Services, School of Public Health, University of California, Los Angeles, CA 90095, USA. rmkaplan@ucla.edu
Tally
Steven
S
Hays
Ron D
RD
Feeny
David
D
Ganiats
Theodore G
TG
Palta
Mari
M
Fryback
Dennis G
DG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods; D018579:Patient Selection; D011594:Psychometrics; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires