title: Comparison of contemporaneous responses for EQ-5D-3L and Minnesota Living with Heart Failure; a case for disease specific multiattribute utility instrument in cardiovascular conditions.
abstract: BACKGROUND
  The EQ-5D-3L, a generic multi-attribute utility instrument (MAUI), is widely employed to assist in economic evaluations in health care. The EQ-5D-3L lacks sensitivity when used in conditions such as cardiovascular disease (CVD). Although there are number of CVD specific quality of life instruments, currently, there are no CVD specific MAUIs. The aim of this study is to investigate the discriminative ability and responsiveness of the EQ-5D-3L and the Minnesota Living with Heart Failure Questionnaire (MLHF), a CVD specific quality of life instrument in a group of heart failure patients.
  
  
  METHODS
  The psychometric performance of the EQ-5D-3L and the MLHF was assessed using data from a randomised trial for a heart failure management intervention. The two instruments were compared for discrimination, responsiveness and agreement. The severity groups were defined using New York Heart Association functional classes.
  
  
  RESULTS
  The effect sizes for severe classes were generally similar showing good discrimination. The MLHF recorded better responsiveness between the time points than the EQ-5D-3L which was indicated by higher effect sizes and standardised response means. The change in MLHF summary scores between the time points was significant (p<0.005; paired t-test). The overall agreement between the two measures was low.
  
  
  CONCLUSIONS
  The low correlation indicates that the two classification systems cover different aspects of health space. Comparison of CVD specific instruments with other generic MAUIs such as EQ-5D-3L and AQOL-8D is recommended for further research.
authors.affiliation: Centre for Applied Health Economics, School of Medicine, Griffith University, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Queensland, Australia; Centre for Research Excellence to Reduce Inequality in Heart Disease, Australia. Electronic address: s.kularatna@griffith.edu.au.
authors.forename: Sanjeewa
authors.initials: S
authors.lastname: Kularatna
authors.affiliation: Centre for Applied Health Economics, School of Medicine, Griffith University, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Queensland, Australia; Centre for Research Excellence to Reduce Inequality in Heart Disease, Australia.
authors.forename: Joshua
authors.initials: J
authors.lastname: Byrnes
authors.affiliation: Centre for Research Excellence to Reduce Inequality in Heart Disease, Australia; Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
authors.forename: Yih Kai
authors.initials: YK
authors.lastname: Chan
authors.affiliation: Centre for Research Excellence to Reduce Inequality in Heart Disease, Australia; Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
authors.forename: Melinda J
authors.initials: MJ
authors.lastname: Carrington
authors.affiliation: Centre for Research Excellence to Reduce Inequality in Heart Disease, Australia; Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
authors.forename: Simon
authors.initials: S
authors.lastname: Stewart
authors.affiliation: Centre for Applied Health Economics, School of Medicine, Griffith University, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Scuffham
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000145:classification / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D009517:New South Wales; D011594:Psychometrics; D011788:Quality of Life; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012737:Sex Factors; D016019:Survival Analysis; D055815:Young Adult
keywords: EQ-5D; MLHF; QALY; Quality of life; Utility