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The predictive validity of health-related quality of life measures: mortality in a longitudinal population-based study

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Abstract

Objective

This study examined the association between health-related quality of life (HRQL) and mortality risk, and compared the predictive ability of Health Utilities Index Mark 3 (HUI3) with self-rated health (SRH).

Methods

Data were from the 1994/95 Canadian National Population Health Survey, consisting of 12,375 women and men aged 18 and older. Cox proportional hazards regression models were performed to estimate mortality risk over eight years.

Results

Mortality risks for people reporting good, fair, and poor health at baseline were, respectively, 1.44 (95% confidence interval [CI] 1.04, 2.00), 1.97 (1.35, 2.88), and 3.21 (2.08, 4.95) times greater than those who reported excellent health. In a model excluding SRH, the effect of HUI3 on mortality was strong and significant (HR = 0.47; 95%, 0.33, 0.67) when adjusted for possible confounders. When HUI3 and SRH were considered simultaneously, the effect of the HUI3 on mortality was somewhat attenuated, but still significant (HR = 0.61, 0.42, 0.89) after adjusting for potential confounders.

Conclusions

Although SRH is a modestly stronger predictor of mortality than HUI3, HUI3 adds to the mortality prediction ability of SRH.

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Abbreviations

HRQL:

Health-Related Quality of Life

HUI3:

HealthUtilities Index Mark 3

SRH:

Self-Rated Health

HUI1:

Health Utilities Index Mark 1

NHEFS:

National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study

NPHS:

National Population Health Survey

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Acknowledgements

We thank Kathryn O’Grady, Daniel Schollaert, and Nathalie Huguet for their contributions to the study. We particularly thank Prof. George Wells for facilitating the collaboration with Statistics Canada. We also gratefully acknowledge the constructive comments received from two anonymous reviewers and from the Associate Editor, which have served to improve the paper. This study was supported by the National Institute on Aging (grant AG 027129) and through a Canadian Studies Grant from the Canadian Embassy in Washington DC.

Author information

Authors and Affiliations

  1. School of Community Health, Portland State University, P.O. Box 751, Portland, OR, 97207, USA

    Mark S. Kaplan

  2. Canadian Institute for Health Information, Ottawa, ON, Canada

    Jean-Marie Berthelot

  3. Institute of Health Economics, University of Alberta, Edmonton, AB, Canada

    David Feeny

  4. Kaiser Permanente Northwest Center for Health Research, Portland, OR, USA

    David Feeny

  5. Health Utilities Incorporated, Dundas, ON, Canada

    David Feeny

  6. Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA

    Bentson H. McFarland

  7. Statistics Canada, Ottawa, ON, Canada

    Saeeda Khan & Heather Orpana

Authors
  1. Mark S. Kaplan
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  2. Jean-Marie Berthelot
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  3. David Feeny
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  4. Bentson H. McFarland
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  5. Saeeda Khan
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  6. Heather Orpana
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Correspondence to Mark S. Kaplan.

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Kaplan, M.S., Berthelot, JM., Feeny, D. et al. The predictive validity of health-related quality of life measures: mortality in a longitudinal population-based study. Qual Life Res 16, 1539–1546 (2007). https://doi.org/10.1007/s11136-007-9256-7

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  • DOI: https://doi.org/10.1007/s11136-007-9256-7

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