Responsiveness of health state utility values in knee osteoarthritis

J Rheumatol. 2013 Dec;40(12):2075-82. doi: 10.3899/jrheum.130176. Epub 2013 Nov 1.

Abstract

Objective: Adaptive tests are increasingly being used to assess health-related quality of life in patients with a variety of medical conditions, including osteoarthritis (OA) of the knee. This approach has recently been used to assess health state utility valuations (HSUV) for use in quality-adjusted life-year calculations. To accurately assess incremental value for money, these tools must be responsive. Therefore, we examined the responsiveness of the Health Utilities Index mark 3 (HUI3) and Paper Adaptive Test-5D (PAT-5DQOL) in a group of patients with knee OA.

Methods: We used patient-level data from a randomized controlled trial evaluating a pharmacist-initiated multidisciplinary intervention in newly diagnosed patients with knee OA. The mean change for utility scores from baseline to 6 months was calculated, as well as effect size (ES) and standardized response mean (SRM) for the HUI3 and PAT-5DQOL, and generalized additive model plots, using the Western Ontario and McMaster Osteoarthritis index as a reference standard.

Results: When patients were assessed based on whether their condition had improved, remained unchanged, or worsened over time, the PAT-5DQOL showed greater responsiveness in patients whose condition had either improved or worsened. ES and SRM were generally small for both instruments.

Conclusion: The PAT-5DQOL is more responsive to change over time than the HUI3 in patients with knee OA.

Keywords: ADAPTIVE TESTS; HEALTH CARE EVALUATION MECHANISMS; HEALTH-RELATED QUALITY OF LIFE; KNEE OSTEOARTHRITIS; QUALITY-ADJUSTED LIFE-YEARS.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Female
  • Health Status Indicators*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Models, Statistical
  • Osteoarthritis, Knee / epidemiology*
  • Osteoarthritis, Knee / physiopathology*
  • Osteoarthritis, Knee / therapy
  • Pain Measurement
  • Quality of Life*
  • Quality-Adjusted Life Years
  • Severity of Illness Index*
  • Treatment Outcome