title: Comparison of three societally derived health-state classification values among older African Americans with depressive symptoms.
abstract: OBJECTIVE
  To compare societal values across three health-state classification systems in older African Americans with depression and to describe the association of these instruments to depression severity.
  
  
  METHODS
  We summarized baseline values for EQ-5D (US weights) and HUI2/3 (Canadian weights) and their subscales for 118 older African American participants enrolled in a randomized depression treatment trial and calculated correlations between the different instruments. We evaluated ceiling and floor effects for each instrument by comparing the proportion at the highest and lowest possible score for each tool. Also, utility scores were assessed by level of depression severity (mild, moderate, moderate severe, severe) scores as measured by the Patient Health Questionnaire (PHQ-9).
  
  
  RESULTS
  Mean utility values were 0.58 (SD = 0.21) for EQ-5D, 0.52 (SD = 0.21) for HUI2, and 0.36 (SD = 0.31) for HUI3. For the EQ-5D, 72 % of participants reported having some problems on the anxiety/depression domain. On the emotion domain for the HUI2, 23 % reported the highest level of impairment compared to only 3 % on the HUI3. No participant scored at the floor for the EQ-5D, HUI2, or HUI3 index; one participant scored at the ceiling value on the HUI3 index. Correlations ranged from 0.63 to 0.82 (all of which were significant at an alpha level of 0.05). In general, utility scores trended inversely with depression level.
  
  
  CONCLUSIONS
  Small differences in the three preference-weighted health-state classification systems were evident for this sample of older African Americans with depressive symptoms, with HUI scores lower than EQ-5D. For this sample, utility scores were lower (i.e., poorer) than the general United States population with depression on each utility measure.
authors.affiliation: Department of Health Policy and Management, University of Minnesota School of Public Health, 420 Delaware Street SE, Minneapolis, MN 55455, USA. Jutko001@umn.edu
authors.forename: Eric
authors.initials: E
authors.lastname: Jutkowitz
authors.forename: Laura
authors.initials: L
authors.lastname: Pizzi
authors.forename: Edward
authors.initials: E
authors.lastname: Hess
authors.forename: Dong-Churl
authors.initials: DC
authors.lastname: Suh
authors.forename: Laura N
authors.initials: LN
authors.lastname: Gitlin
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000704:Analysis of Variance; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003863:Depression / Q000191:economics / Q000208:ethnology / Q000523:psychology* / Q000628:therapy; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods / Q000592:standards*; D011594:Psychometrics / Q000295:instrumentation*; D011788:Quality of Life; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States