Med Decis Making - Standard error of measurement of 5 health utility indexes across the range of health for use in estimating reliability and responsiveness.

Tópicos

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Resumo

CKGROUND: Standard errors of measurement (SEMs) of health-related quality of life (HRQoL) indexes are not well characterized. SEM is needed to estimate responsiveness statistics, and is a component of reliability.PURPOSE: To estimate the SEM of 5 HRQoL indexes.DESIGN: The National Health Measurement Study (NHMS) was a population-based survey. The Clinical Outcomes and Measurement of Health Study (COMHS) provided repeated measures.SUBJECTS: A total of 3844 randomly selected adults from the noninstitutionalized population aged 35 to 89 y in the contiguous United States and 265 cataract patients.MEASUREMENTS: The SF6-36v2?, QWB-SA, EQ-5D, HUI2, and HUI3 were included. An item-response theory approach captured joint variation in indexes into a composite construct of health (theta). The authors estimated 1) the test-retest standard deviation (SEM-TR) from COMHS, 2) the structural standard deviation (SEM-S) around theta from NHMS, and 3) reliability coefficients.RESULTS: SEM-TR was 0.068 (SF-6D), 0.087 (QWB-SA), 0.093 (EQ-5D), 0.100 (HUI2), and 0.134 (HUI3), whereas SEM-S was 0.071, 0.094, 0.084, 0.074, and 0.117, respectively. These yield reliability coefficients 0.66 (COMHS) and 0.71 (NHMS) for SF-6D, 0.59 and 0.64 for QWB-SA, 0.61 and 0.70 for EQ-5D, 0.64 and 0.80 for HUI2, and 0.75 and 0.77 for HUI3, respectively. The SEM varied across levels of health, especially for HUI2, HUI3, and EQ-5D, and was influenced by ceiling effects. Limitations. Repeated measures were 5 mo apart, and estimated theta contained measurement error.CONCLUSIONS: The 2 types of SEM are similar and substantial for all the indexes and vary across health.

Resumo Limpo

ckground standard error measur sem healthrel qualiti life hrqol index well character sem need estim respons statist compon reliabilitypurpos estim sem hrqol indexesdesign nation health measur studi nhms populationbas survey clinic outcom measur health studi comh provid repeat measuressubject total random select adult noninstitution popul age y contigu unit state cataract patientsmeasur sfv qwbsa eqd hui hui includ itemrespons theori approach captur joint variat index composit construct health theta author estim testretest standard deviat semtr comh structur standard deviat sem around theta nhms reliabl coefficientsresult semtr sfd qwbsa eqd hui hui wherea sem respect yield reliabl coeffici comh nhms sfd qwbsa eqd hui hui respect sem vari across level health especi hui hui eqd influenc ceil effect limit repeat measur mo apart estim theta contain measur errorconclus type sem similar substanti index vari across health

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