Generic quality of life utility measures in health-care research: Conceptual issues highlighted for the most commonly used utility measures

Abstract

Purpose. Effectiveness of health interventions is often measured by means of generic utility measures (e.g., EQ-5D). These measures focus on aspects of QoL that can be expected to be affected by health-care interventions. We argue that traditional health-related utility measures are based on a relatively narrow focus on the concept of QoL. Therefore, to better judge the effectiveness of health interventions, measures need to go beyond traditional health-related QoL utility measures.

Methods. We conducted an analysis of the definitions and questions of the five most commonly used generic utility measures: the EQ-5D, SF-6D, QWB-SA, HUI2 and HUI3.

Results. Traditional health-related QoL utility measures are based on a relatively narrow focus on the concept of health and health-related QoL. We illustrate this narrow focus by zooming in on two issues: a) the focus on a too selective number of domains; and b) the use of a narrow interpretation of the features that can be part of domains.

Conclusions.We believe that using insights from different backgrounds and research fields (i.e., the subjective wellbeing approach and capabilities approach) will result in a more complete operationalization of health and health-related QoL and hence will ultimately facilitate the allocation of health-care resources to interventions that are most effective in increasing people’s (health-related) QoL.