title: Comparison of the HUI3 and the EQ-5D-3L in a nursing home setting.
abstract: BACKGROUND
  Accurately assessing changes in the quality of life of older people living permanently in nursing homes is important. The multi-attribute utility instrument most commonly used and recommended to assess health-related quality of life in the nursing home population is the three-level EuroQol EQ-5D-3L. To date, there have been no studies using the Health Utilities Index Mark III (HUI3). The purpose of this study was to compare the level of agreement and sensitivity to change of the EQ-5D-3L and HUI3 in a nursing home population.
  
  
  METHODS
  EQ-5D-3L and HUI3 scores were measured as part of a cluster randomised controlled trial of nurse led care coordination in a nursing home population in Perth, Western Australia at baseline and 6-month follow up.
  
  
  RESULTS
  Both measures were completed for 199 residents at baseline and 177 at 6-month follow-up. Mean baseline utility scores for EQ-5D-3L (0.45; 95% CI 0.41-0.49) and HUI3 (0.15; 95% CI 0.10-0.20) were significantly different (Wilcoxon signed rank test, p<0.01) and agreement was poor to moderate between absolute scores from each instrument (intra-class correlation coefficient = 0.63). The EQ-5D-3L appeared more sensitive to change over the 6-month period.
  
  
  CONCLUSIONS
  Our findings show that the EQ-5D-3L and HUI3 estimate different utility scores among nursing home residents. These differences should be taken into account, particularly when considering the implications of the cost-effectiveness of particular interventions and we conclude that the HUI3 is no better suited to measuring health-related quality of life in a nursing home population when compared to the EQ-5D-3L.
authors.affiliation: The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia.|Sydney Medical School, School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Tom
authors.identifier: http://orcid.org/0000-0001-9978-6311
authors.initials: T
authors.lastname: Lung
authors.affiliation: Sydney Medical School, School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Howard
authors.affiliation: School of Medicine and Pharmacology Royal Perth Hospital Unit, The University of Western Australia, Crawley, Western Australia, Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Etherton-Beer
authors.affiliation: School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.
authors.forename: Moira
authors.initials: M
authors.lastname: Sim
authors.affiliation: School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia.
authors.forename: Gill
authors.initials: G
authors.lastname: Lewin
authors.affiliation: Emergency Medicine, School of Primary, Aboriginal and Rural Health Care, The University of Western Australia, Crawley, Western Australia, Australia.
authors.forename: Glenn
authors.initials: G
authors.lastname: Arendts
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D060825:Cognitive Dysfunction / Q000191:economics* / Q000628:therapy; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000191:economics* / Q000592:standards; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016138:Walking / Q000191:economics