Comparison of three societally derived health-state classification values among older African Americans with depressive
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Comparison of three societally derived health-state classification values among older African Americans with depressive symptoms Eric Jutkowitz • Laura Pizzi • Edward Hess Dong-Churl Suh • Laura N. Gitlin
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Accepted: 30 August 2012 / Published online: 13 September 2012 Ó Springer Science+Business Media B.V. 2012
Abstract Purpose To compare societal values across three healthstate classification systems in older African Americans with depression and to describe the association of these instruments to depression severity. Methods 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). Results 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. Conclusion Small differences in the three preferenceweighted 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.
E. Jutkowitz (&) Department of Health Policy and Management, University of Minnesota School of Public Health, 420 Delaware Street SE, Minneapolis, MN 55455, USA e-mail: [email protected]
D.-C. Suh College of Pharmacy, Chung-Ang University, 221 Heukseok-dong, Dongjak-gu, Seoul, South Korea e-mail: [email protected]
L. Pizzi Department of Pharmacy Practice, Jefferson School of Pharmacy, 130 South 9th Street, Suite 1540, Philadelphia, PA 19107, USA e-mail: [email protected]
Keywords Utility Quality of life EQ-5D HUI3 Cost-effectiveness analysis
L. N. Gitlin (&) Johns Hopkins University School of Nursing Center for Innovative Care in Aging, Johns Hopkins University, 525 Wolfe Street, Suite 316, Baltimore, MD 21205, USA e-mail: [email protected]
E. Hess School of Medicine, Johns Hopkins University, 511 N. Washington Street, Baltimore, MD 21205, USA e-mail: [email protected]
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Introduction Depression is the leading cause of disabi
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