Health-related quality of life in Parkinson disease: correlation between Health Utilities Index III and Unified Parkinson's Disease Rating Scale (UPDRS) in U.S. male veterans.
OBJECTIVE
To apply a scaled, preference-based measure to the evaluation of health-related quality of life (HRQoL) in Parkinson's disease (PD); to evaluate the relationship between disease-specific rating scales and estimated HRQoL; and to identify predictors of diminished HRQoL.


BACKGROUND
Scaled, preference-based measures of HRQoL ("utilities") serve as indices of impact of disease, and can be used to generate quality-adjusted estimates of survival for health-economic evaluations. Evaluation of utilities for PD and their correlation with standard rating scales have been limited.


METHODS
Utilities were generated using the Health Utilities Index Mark III (HUI-III) on consecutive patients attending a PD Clinic between October 2003 and June 2006. Disease severity, medical, surgical (subthalamic nucleus deep brain stimulation (STN-DBS)), and demographic information were used as model covariates. Predictors of HUI-III utility scores were evaluated using the Wilxocon rank-sum test and linear regression models.


RESULTS
68 men with a diagnosis of PD and a mean age of 74.0 (SD 7.4) were included in the data analysis. Mean HUI-III utility at first visit was 0.45 (SD 0.33). In multivariable models, UPDRS-II score (r2 = 0.56, P < 0.001) was highly predictive of HRQoL. UPDRS-III was a weaker, but still significant, predictor of utility scores, even after adjustment for UPDRS-II (P = 0.01).


CONCLUSIONS
Poor self-care in PD reflected by worsening UPDRS-II scores is strongly correlated with low generic HRQoL. HUI-III-based health utilities display convergent validity with the UPDRS-II. These findings highlight the importance of measures of independence as determinants of HRQoL in PD, and will facilitate the utilization of existing UPDRS data into economic analyses of PD therapies.
Kleiner-Fisman
Galit
G
Department of Neurology, Baycrest Geriatric Hospital, Toronto, Ontario, Canada.
Stern
Matthew B
MB
Fisman
David N
DN
D000368:Aged; D000369:Aged, 80 and over; D046690:Deep Brain Stimulation; D018450:Disease Progression; D004522:Educational Status; D006304:Health Status; D006801:Humans; D008297:Male; D017533:Marital Status; D015999:Multivariate Analysis; D010300:Parkinson Disease / Q000503:physiopathology* / Q000628:therapy; D015143:Philadelphia; D011788:Quality of Life; D012648:Self Care / Q000592:standards; D012720:Severity of Illness Index; D020531:Subthalamic Nucleus; D014728:Veterans / Q000706:statistics & numerical data
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