The Health and Activities Limitation Index in patients with acute myocardial infarction

Utility assessment is required to estimate quality-adjusted life years, but is often avoided due to the cumbersome nature of elicitation techniques. T he Health Activities and Limitations Index (HALex) offers a method of utili ty assessment using existing values from the National Health Interview Surv ey (NHIS) and a utility algorithm to derive preferences. The authors assess ed the construct validity of the HALex by comparing derived values with dir ectly assessed HALex utilities in patients post acute myocardial infarction (AMI). OLS regression was used to model the relationship between utilities and patient demographics, comorbidities, and treatment. The mean and media n utility for patients (n = 160) was .57 (SD = 22) and .55 respectively, an d was not statistically different from the mean [.57 (SD = .30)] and median (.58) for similar NHIS respondents (n = 46). Patients with a comorbidity i ndex of three or less had mean utilities .13 higher than the mean utility f or patients with an index of four or more. No relationship was found betwee n patients' age, race, and income and their utilities. The HALex scoring al gorithm is a promising means to obtain utilities, and provides a methodolog y to easily estimate utilities for patients, but is not without limitations . (C) 2000 Elsevier Science Inc. All rights reserved.