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Health Utilities Index


The Health Utilities Index (HUI) is a rating scale used to measure general health status and health-related quality of life (HRQoL). HUI questionnaires are designed to map onto two classification systems, HUI-2 and HUI-3, capable of measuring 24,000 and 972,000 unique health states, respectively. HUI classifications measure a range of health domains with examples including sensation, mobility, pain, cognition, ambulation, and emotion. Health utility values are commonly produced using HUI as a component of the quality-adjusted life years (QALY) calculation used in population health and economics.

Originally developed by McMaster University in Canada, HUI has subsequently evolved and been adapted by Health Utilities Inc. The purpose of developing HUI was to create a standardized classification system using preference-based scoring. HUI was modeled using multi-attribute utility theory to assess a participants overall health-related quality of life. HUI was first used to evaluate HRQoL in very-low birth weight infants and adolescent cancer morbidity and has since been taken by thousands of respondents from hundreds of researchers.

The attribute categories were decided upon after consulting the general public to rank their order of importance. Using Von Neumann-Morganstern utility theorem to measure a participants health status, health state responses for each attribute are converted to a standardized health utility value which is discussed in detail below.

HUI-2 and HUI-3 questionnaires are proprietary and available for use from Health Utilities Inc. website. There is a licensing fee to use the questionnaire and generally costs $3,000 for a single research project use. Included in the license is a manual describing how to convert survey responses into attribute levels.

HUI-2 classification system consists of 7 attributes including sensation, mobility, emotion, cognition, self-care, pain and fertility. Fertility is not currently used in the HUI-2 questionnaire, but was included historically to account for the effects of infertility on health-related quality of life. Participants answering each attribute chooses one of three to five response items. HUI-2 is capable of identifying 24,000 unique health states. A level 1 response indicates no difficulty or interference while the highest level in each of the attributes corresponds to the lowest possible quality of life. The following table shows the number of health state levels for each attribute:


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