Relative Efficiency of the EQ-5D, HUI2, and HUI3 Index Scores in Measuring Health Burden of Chronic Medical Conditions in a Population Health Survey in the United States

Objective: We sought to compare the ability of the EQ-5D, Health Utilities Index Mark 2 (HUI2), and HUI Mark 3 (HUI3) index scores to discriminate between respondents based on the presence or absence of chronic medical conditions in a population health survey. Methods: Secondary analyses were conducted with data from a probability sample (n = 3480, mean age: 42.5 years, male: 42.4%, Hispanic: 28.6%) of the 2001 noninstitutionalized US general adult population. F-statistic ratios were used to evaluate the relative efficiency of the EQ-5D, HUI2, and HUI3 in differentiating respondents with or without each of 18 chronic medical conditions, and differentiating respondents with low- or high-burden conditions. Results: In comparing respondents with and without chronic medical conditions, the F-statistic values of these 3 indices were not significantly different, except for EQ-5D versus HUI2 [mean F-statistic ratio: 0.79, 95% confidence interval (CI): 0.59-0.98]. In comparing respondents with a low-burden condition with those with a high-burden condition, the F-statistic values of EQ-5D and HUI2 index scores were similar, while those for EQ-5D versus HUI3 (mean: 0.79; 95% CI: 0.66-0.92) and for HUI2 versus HUI3 (mean: 0.83; 95% CI: 0.71-0.95) were significantly less than 1.0. The overall ceiling effects of the EQ-5D, HUI2, and HUI3 index scores were 48.9%, 15.4%, and 15.3%, respectively. Conclusions: Although the EQ-5D seems to be marginally less informative, the EQ-5D, HUI2, and HUI3 index scores were generally comparable in determining health burden of chronic medical conditions in this Population health survey data.