Study of observed and self-reported HRQL in older frail adults found group-level congruence and individual-level differences

ObjectiveTo evaluate the consistency of self-reported health-related quality of life (HRQL) using the Health Utilities Index Mark 2 (HUI2) with observer rated HRQL using the Minimum Data Set Health-Status Index (MDS-HSI).Study Design and SettingFrail older home care clients in Calgary Alberta and Wayne County, Michigan responded to HUI2 questionnaires and were assessed using the Minimum Data Set Home Care tool (n = 514). HRQL scores were calculated and compared for the HUI2 and the MDS-HSI. The intraclass correlation coefficient (ICC) was used to assess individual level agreement.ResultsThe MDS-HSI provided HRQL scores that consistently averaged 0.10 points higher than HUI2 self-reported HRQL scores overall and within client characteristics. The ICC was 0.46 in the full population but increased to 0.63 when 10% of the sample with the largest discrepant scores was removed. Pain and emotion health attributes showed the lowest level of agreement.ConclusionThe MDS-HSI and HUI2 provide analogous group-level results but only moderate individual-level agreement. When HUI2 survey data are not available, the MDS-HSI can be used to substitute for the HUI2 in group-level comparisons but not for individual clinical evaluation comparisons.