Alva Maria, Dolman Sarahfaye, Sikirica Slaven, Kolm Paul, Andrade Katherine, Zhang Zugui, Weintraub William S
Department of Health Management and Policy, Georgetown University, Washington, DC, USA.
MedStar Health Research Institute, Washington, DC, USA.
Health Qual Life Outcomes. 2025 May 30;23(1):53. doi: 10.1186/s12955-025-02372-0.
Individuals with heart failure (HF) experience various symptoms making both diagnosis and disease burden estimates challenging. While HF-specific patient-reported outcome measures (PROMs) are widely used, their focus on clinical cohorts limits their generalizability. Preference-based measures like the EQ-5D enable standardized health-related quality of life (HRQoL) comparisons across conditions, supporting resource allocation decisions. The CDC's Healthy Days (HD) Survey-a simple two-question tool that can be mapped to the EQ-5D-offers a broader approach to tracking HRQoL but remains underutilized in HF populations.
Using a nationally representative U.S. sample, we mapped HD Survey responses to EQ-5D utility scores to compare HRQoL between individuals with and without HF and examined changes in HRQoL over time. We assessed whether HD-derived scores align with HF-specific utility measures to support population-level health monitoring.
Individuals with HF report significantly more physically unhealthy days (8.46 vs. 3.42) and mentally unhealthy days (5.42 vs. 3.86) compared to those without HF. HF respondents are, on average, 20 years older than those without HF, consistent with HF's prevalence in older adults. The likelihood of an HF diagnosis is similar for men and women but higher among non-Hispanic whites and blacks than Hispanics and other races. Those with HF are more likely to have health insurance. Adjusting for age, sex, race, and insurance, mean EQ-5D utility scores for individuals with and without HF are 0.785 (95% CI: 0.714-0.825) and 0.840 (95% CI: 0.827-0.851), respectively. Utility scores for HF patients remain significantly lower than those without HF up to 10 years post-diagnosis.
HF reduces HRQoL by 6.55%, surpassing the clinically significant threshold of a 1-2% decrement. These findings highlight the potential of the HD Survey to inform public health monitoring and underscore the need for tailored interventions to address HRQoL deficits in HF populations.
心力衰竭（HF）患者会经历各种症状，这使得诊断和疾病负担评估都具有挑战性。虽然特定于HF的患者报告结局指标（PROMs）被广泛使用，但它们对临床队列的关注限制了其普遍性。像EQ-5D这样基于偏好的指标能够对不同疾病的健康相关生活质量（HRQoL）进行标准化比较，为资源分配决策提供支持。美国疾病控制与预防中心（CDC）的健康日（HD）调查——一种可映射到EQ-5D的简单双问题工具——提供了一种更广泛的跟踪HRQoL的方法，但在HF人群中仍未得到充分利用。
我们使用具有全国代表性的美国样本，将HD调查的回答映射到EQ-5D效用得分，以比较有HF和无HF个体之间的HRQoL，并研究HRQoL随时间的变化。我们评估了源自HD的得分是否与特定于HF的效用指标一致，以支持人群水平的健康监测。
与无HF的个体相比，有HF的个体报告的身体不健康天数（8.46天对3.42天）和精神不健康天数（5.42天对3.86天）明显更多。HF受访者的平均年龄比无HF的个体大20岁，这与HF在老年人中的患病率一致。HF诊断的可能性在男性和女性中相似，但在非西班牙裔白人和黑人中高于西班牙裔和其他种族。患有HF的人更有可能拥有医疗保险。在调整年龄、性别、种族和保险因素后，有HF和无HF个体的平均EQ-5D效用得分分别为0.785（95%CI：0.714 - 0.825）和0.840（95%CI：0.827 - 0.851）。在诊断后长达10年的时间里，HF患者的效用得分仍显著低于无HF的患者。
HF使HRQoL降低了6.55%，超过了临床上有显著意义的1 - 2%的下降阈值。这些发现凸显了HD调查在为公共卫生监测提供信息方面的潜力，并强调了针对HF人群的HRQoL缺陷进行量身定制干预措施的必要性。
