Department of Health Policy and Management, University of Minnesota School of Public Health, 420 Delaware Street SE, Minneapolis, MN 55455, USA.
Qual Life Res. 2013 Aug;22(6):1491-8. doi: 10.1007/s11136-012-0263-y. Epub 2012 Sep 13.
To compare societal values across three health-state classification systems in older African Americans with depression and to describe the association of these instruments to depression severity.
We summarized baseline values for EQ-5D (US weights) and HUI2/3 (Canadian weights) and their subscales for 118 older African American participants enrolled in a randomized depression treatment trial and calculated correlations between the different instruments. We evaluated ceiling and floor effects for each instrument by comparing the proportion at the highest and lowest possible score for each tool. Also, utility scores were assessed by level of depression severity (mild, moderate, moderate severe, severe) scores as measured by the Patient Health Questionnaire (PHQ-9).
Mean utility values were 0.58 (SD = 0.21) for EQ-5D, 0.52 (SD = 0.21) for HUI2, and 0.36 (SD = 0.31) for HUI3. For the EQ-5D, 72 % of participants reported having some problems on the anxiety/depression domain. On the emotion domain for the HUI2, 23 % reported the highest level of impairment compared to only 3 % on the HUI3. No participant scored at the floor for the EQ-5D, HUI2, or HUI3 index; one participant scored at the ceiling value on the HUI3 index. Correlations ranged from 0.63 to 0.82 (all of which were significant at an alpha level of 0.05). In general, utility scores trended inversely with depression level.
Small differences in the three preference-weighted health-state classification systems were evident for this sample of older African Americans with depressive symptoms, with HUI scores lower than EQ-5D. For this sample, utility scores were lower (i.e., poorer) than the general United States population with depression on each utility measure.
比较三个健康状态分类系统在有抑郁症状的老年非裔美国人中的社会价值观，并描述这些工具与抑郁严重程度的关联。
我们总结了 118 名参加抑郁症随机治疗试验的老年非裔美国人的 EQ-5D（美国权重）和 HUI2/3（加拿大权重）及其子量表的基线值，并计算了不同工具之间的相关性。我们通过比较每个工具的最高和最低可能得分来评估每个工具的天花板和地板效应。此外，还根据患者健康问卷（PHQ-9）的抑郁严重程度（轻度、中度、中度严重、重度）评分评估了效用评分。
EQ-5D 的平均效用值为 0.58（SD=0.21），HUI2 为 0.52（SD=0.21），HUI3 为 0.36（SD=0.31）。对于 EQ-5D，72%的参与者报告在焦虑/抑郁领域存在一些问题。在 HUI2 的情绪领域，23%的人报告了最高程度的障碍，而在 HUI3 中只有 3%的人报告了最高程度的障碍。没有参与者在 EQ-5D、HUI2 或 HUI3 指数的地板值得分，只有一名参与者在 HUI3 指数的天花板值得分。相关性范围从 0.63 到 0.82（所有相关性在 alpha 水平为 0.05 时均具有统计学意义）。一般来说，效用评分与抑郁程度呈负相关。
在这个有抑郁症状的老年非裔美国人样本中，三种偏好加权健康状态分类系统之间存在微小差异，HUI 评分低于 EQ-5D。对于这个样本，在每个效用衡量标准上，效用评分（即较差）都低于美国一般有抑郁症状的人群。
