Estimation of health-related-quality of life depends on which utility measure is selected for patients with carpal tunnel syndrome

Goris Nazari; Joy C MacDermid; James Bain; Carolyn M Levis; Achilleas Thoma

doi:10.1016/j.jht.2016.11.001

Estimation of health-related-quality of life depends on which utility measure is selected for patients with carpal tunnel syndrome

J Hand Ther. 2017 Jul-Sep;30(3):299-306. doi: 10.1016/j.jht.2016.11.001. Epub 2016 Dec 14.

Authors

Goris Nazari¹, Joy C MacDermid², James Bain³, Carolyn M Levis⁴, Achilleas Thoma⁵

Affiliations

¹ School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada. Electronic address: [email protected].
² School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.
³ Division of Plastic Surgery, MacHANd, McMaster Medical Centre/Hamilton Health Sciences, Hamilton, Ontario, Canada.
⁴ Division of Plastic Surgery, St. Joseph's Healthcare, Hamilton, Ontario, Canada.
⁵ Division of Plastic Surgery, MacHANd, Hamilton, Ontario, Canada.

PMID: 27988154
DOI: 10.1016/j.jht.2016.11.001

Abstract

Study design: Cross-sectional.

Introduction: Carpal tunnel syndrome (CTS) refers to the compression neuropathy of the median nerve at the wrist.

Purpose of the study: To establish the interinstrument reliability, convergent construct validity, and the levels of agreement of health utility indexes 2 and 3 (HUI-2 and HUI-3), EuroQol 5-dimensions (EQ-5D), EuroQol-visual analog scale (EQ-VAS) and to determine the difference of these utility measures based on age and gender in patients with carpal tunnel syndrome.

Methods: Seventy-four patients with a confirmed diagnosis of carpal tunnel syndrome completed the 3 questionnaires and EQ-VAS a month before surgery. Demographic characteristics were reported. Intraclass correlation coefficients were used to assess relative interinstrument reliability. Pearson correlation coefficients (r) were used to establish convergent construct validity. Bland-Altman plots and t tests were used to describe the levels of agreement between the 4 utility measures. A 2-way analysis of variance was performed to determine the effect of age and gender on the utility measures; HUI-2, HUI-3, and EQ-5D.

Results: The intraclass correlation coefficients were 0.85 for HUI-3 vs HUI-2 and 0.80 for HUI-2 vs EQ-VAS. Pearson correlation coefficients ranged from 0.60 to 0.89; HUI-3 vs HUI-2: 0.89, and HUI-3 vs EQ-5D: 0.60. One-sample t test demonstrated significant differences between HUI-3 vs HUI-2, HUI-3 vs EQ-5D, and HUI-3 vs EQ-VAS measures, with mean differences of -0.12, -0.15, and -0.14, respectively. A 2-way analysis of variance test controlling for age and gender indicated neither as predictors of outcome scores.

Conclusions: The HUI-3 vs HUI-2 and HUI-2 vs EQ-VAS demonstrated excellent interinstrument relative reliability measures. The HUI-3 vs HUI-2 displayed very strong convergent construct validity measures, and strong validity measures were established between the remaining utility measures. In addition, the pair-wise utility comparisons demonstrated minimal bias between HUI-2 vs EQ-5D, HUI-2 vs EQ-VAS, and EQ-VAS vs EQ-5D measures.

Discussion: N/A.

Level of evidence: N/A.

Keywords: Carpal tunnel syndrome; Euro-Qol; Health utility indexes; Health-related quality of life.