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. 2011 Mar-Apr;31(2):260-9.
doi: 10.1177/0272989X10380925. Epub 2010 Oct 8.

Standard error of measurement of 5 health utility indexes across the range of health for use in estimating reliability and responsiveness

Mari Palta  1 , Han-Yang Chen  2 , Robert M Kaplan  3 , David Feeny  4 , Dasha Cherepanov  3 , Dennis G Fryback  1
Affiliations

Standard error of measurement of 5 health utility indexes across the range of health for use in estimating reliability and responsiveness

Mari Palta et al. Med Decis Making. 2011 Mar-Apr.

Abstract

Background: 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.

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Figures

Figure 1
Figure 1
Bland-Altman plots of SF6D_36v2 values at 6 months minus 1 month post cataract surgery (open circles) versus mean of same values. Intervals expected to contain 95% of points (solid circles) based on adjusted SEM-S estimated from the NHMS are superimposed.
Figure2
Figure2
Bland-Altman plots of QWB-SA values at 6 months minus 1 month post cataract surgery (open circles) versus mean of same values. Intervals expected to contain 95% of points (solid circles) based on adjusted SEM-S estimated from the NHMS are superimposed.
Figure 3
Figure 3
Bland-Altman plots of EQ-5D values at 6 months minus 1 month post cataract surgery (open circles) versus mean of same values. Intervals expected to contain 95% of points (solid circles) based on adjusted SEM-S estimated from the NHMS are superimposed.
Figure 4
Figure 4
Bland-Altman plots of HUI2 values at 6 months minus 1 month post cataract surgery (open circles) versus mean of same values. Intervals expected to contain 95% of points (solid circles) based on adjusted SEM-S estimated from the NHMS are superimposed.
Figure 5
Figure 5
Bland-Altman plots of HUI3 values at 6 months minus 1 month post cataract surgery (open circles) versus mean of same values. Intervals expected to contain 95% of points (solid circles) based on adjusted SEM-S estimated from the NHMS are superimposed.
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References

    1. Terwee CB, Roorda LD, Knol DL, De Boer MR, De Vet HCW. Linking measurement error to minimal important change of patient-reported outcomes. J Clin Epidemiol. 2009;62:62–67. - PubMed
    1. Miller JD, Malthaner RA, Goldsmith CH, Goeree R, Higgins D, Cox PG, Tan L, Road JD for the Canadian Lung Volume Reduction Surgery Study. A randomized clinical trial of lung volume reduction surgery versus best medical care for patients with advanced emphysema: A two-year study from Canada. Ann Thorac Surg. 2006;81:314–21. - PubMed
    1. Ploeg J, Brazil K, Hutchison B, Kaczorowski J, Dalby DM, Goldsmith CH, Furlong W. Effect of preventive primary care outreach on health related quality of life among older adults at risk of functional decline: randomised controlled trial. BMJ. 2010;340:c1480. - PMC - PubMed
    1. Nunnally JC, Bernstein IH. Psychometric Theory. 3rd. New York: McGraw-Hill; 1994.
    1. Shrout PE, Spitzer RL, Fleiss JL. Quantification of agreement in psychiatric diagnosis revisited. Arch Gen Psychiatry. 1987;44:172–77. - PubMed

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