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Comparison of Preference-Based Utilities of the Short-Form 36 Health Survey and Health Utilities Index before and after Treatment of Patients with Intermittent Claudication

Decision Analysis and Technology Assessment Group, Department of Radiology, Harvard School of Public Health, Boston, MA, Department of Epidemiology and Biostatistics, Erasmus University Medical Center, Rotterdam, the Netherlands

Elkan F. Halpern, PhD

Decision Analysis and Technology Assessment Group, Department of Radiology, Harvard School of Public Health, Boston, MA

G. Scott Gazelle, MD, PhD, MPH

Decision Analysis and Technology Assessment Group, Department of Radiology, Harvard School of Public Health, Boston, MA, Massachusetts General Hospital, Harvard Medical School, and the Department of Health Policy and Management

The authors compared SF-36 utilities with Health Utilities Index (HUI) utilities (HUI2 and HUI3) assessed in patients with intermittent claudication. A total of 87 patients with intermittent claudication completed the SF-36 and HUI before and 1, 3, and 12 months after revascularization. Utilities were estimated using SF-36 and HUI published algorithms (i.e., both algorithms were based on standard-gamble utilities assessed in random samples of the general population). The utilities were compared using repeated-measures multivariate analysis of variance, paired t tests, and univariate linear regression analyses. Before treatment, the mean SF-36 and HUI3 utilities were the same (0.66 vs. 0.66, P = 0.92) and less than the mean HUI2 utility (0.70, P = 0.02). After treatment, all utilities showed improvement from before treatment (P < 0.05); the gain in utilities from treatment was lowest when using the SF-36 (e.g., 0.74, 0.80, 0.77 at 3 months for the SF-36, HUI2, and HUI3, respectively). The correlations of changes over time of the SF-36 with HUI2 utilities and of the SF-36 with HUI3 utilities were 0.39 and 0.49, respectively. The relationships between the SF-36 and HUI2 or HUI3 utilities were moderate to good (i.e., range-adjusted R² = 31% to 72%). The results suggest that SF-36 data can be transformed to preference-based utilities and be used for economic evaluation in health care. The gain in utilities from treatment, however, was less for SF-36 utilities than for HUI utilities.

Key Words: health status • utilities • quality of life • Short-Form 36 Health Survey • Health Utilities Index • intermittent claudication • peripheral vascular disease

Medical Decision Making, Vol. 22, No. 5, 403-409 (2002)
DOI: 10.1177/027298902236928


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