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(Stroke. 1997;28:1888-1894.)
© 1997 American Heart Association, Inc.

Articles

Use of the Health Utilities Index With Stroke Patients and Their Caregivers

Susan D. Mathias, MPH; Molly M. Bates, BA; David J. Pasta, MS; Miriam G. Cisternas, MA; David Feeny, PhD; Donald L. Patrick, PhD, MSPH

From Technology Assessment Group, San Francisco, Calif (S.D.M., M.M.B., D.J.P., M.G.C.); the Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario (D.F.); and the Department of Health Services, University of Washington, Seattle, Wash (D.L.P.).

Correspondence to Susan D. Mathias, MPH, Director of Quality-of-Life Research, Technology Assessment Group, 490 Second St, Suite 201, San Francisco, CA 94107. E-mail smathias{at}tagsf.com

Background and Purpose Few studies currently assess the health-related quality of life of individuals following a stroke. One of the major challenges of assessing quality of life is the high likelihood that after a stroke a patient will not be able to complete such an assessment. One practical solution is to have a family caregiver complete the assessment on behalf of these individuals. This current pilot study examined the interrater reliability of having family caregivers complete the Health Utilities Index (HUI) on behalf of stroke patients.

Methods A total of 74 patients who experienced an ischemic stroke and 37 family caregivers completed the interviewer-administered HUI (data were available for 33 pairs). The HUI is designed to produce a single summary measure of health-related quality of life, the global multiattribute utility score, as well as descriptive information on each of its attributes. Interrater reliability was measured by evaluating the percent agreement, Cohen's statistics, intraclass correlation coefficients (ICCs), Pearson's R correlations, and paired t tests between the patient and caregiver responses.

Results In most instances interrater reliability was acceptable, with values suggesting moderate to high agreement. The mean global multiattribute utility scores for the HUI 2 were identical for patients and caregivers (0.64±0.29), with an ICC of .72. A preponderance of patients reported decrements in several attributes of the HUI.

Conclusions These data indicate a substantial decrement in functioning in stroke patients and suggest that family caregivers can complete the HUI reliably when patients are unable to do so.

Key Words: caregivers • cerebrovascular disorders • health status • quality of life • questionnaires

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