Maddigan Sheri L, Feeny David H, Majumdar Sumit R, Farris Karen B, Johnson Jeffrey A
Department of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada.
J Clin Epidemiol. 2006 May;59(5):472-7. doi: 10.1016/j.jclinepi.2005.09.010. Epub 2006 Mar 14.
To assess the cross-sectional construct validity of the Health Utilities Index mark 3 (HUI3) in type 2 diabetes using population health survey data.
Data used were from 5,134 adult respondents of Cycle 1.1 (2000-2001) of the Canadian Community Health Survey (CCHS) with type 2 diabetes. Analyses of covariance models were used to assess differences in overall and single-attribute HUI3 scores between groups hypothesized a priori to differ in HRQL. The association between health-care resource use (i.e., hospitalizations and physician and emergency room visits) and overall HUI3 scores was assessed using logistic regression models.
For overall HUI3 scores, clinically important and statistically significant differences were observed between all groups expected to differ in HRQL. Depression was the comorbidity associated with the largest deficit (-0.17; 95% confidence interval CI=-0.22, -0.12), followed by stroke (-0.15; 95% CI=-0.21, -0.10) and heart disease (-0.08; 95% CI=-0.11, -0.05). Insulin use and comorbidities were associated with clinically important deficits in pain. Overall HUI3 scores were significantly predictive of all three categories of health-care resource use.
Observed differences between groups contribute further evidence of the construct validity of the HUI3 in type 2 diabetes.
利用人群健康调查数据评估健康效用指数3级（HUI3）在2型糖尿病中的横断面结构效度。
所使用的数据来自加拿大社区健康调查（CCHS）第1.1轮（2000 - 2001年）的5134名患有2型糖尿病的成年受访者。采用协方差分析模型评估在健康相关生活质量（HRQL）方面预先假设存在差异的组间HUI3总分及单属性得分的差异。使用逻辑回归模型评估医疗资源利用（即住院、看医生和急诊就诊）与HUI3总分之间的关联。
对于HUI3总分，在所有预期HRQL存在差异的组间观察到了具有临床意义且具有统计学显著性的差异。抑郁症是与最大健康效用损失相关的合并症（-0.17；95%置信区间CI = -0.22，-0.12），其次是中风（-0.15；95% CI = -0.21，-0.10）和心脏病（-0.08；95% CI = -0.11，-0.05）。使用胰岛素和合并症与疼痛方面具有临床意义的健康效用损失相关。HUI3总分对所有三类医疗资源利用均具有显著预测性。
组间观察到的差异为HUI3在2型糖尿病中的结构效度提供了进一步证据。
