Researchers in Canada were not satisfied with the measurement options for health utilities in glaucoma patients—generic preference-based health-related quality-of-life (QoL) measures. The team believed in the value of disease-specific preference-based scoring systems in measuring health state changes in glaucoma patients. So they devised a valid and easy-to-use measurement of health utility, the Health Utility for Glaucoma (HUG-5).

The HUG-5 consists of five questions that assess the impact of glaucoma on visual discomfort, mobility, daily life activities, emotional well-being and social activities. Each question is accompanied with specific examples to facilitate the patient’s understanding. The team adopted a five-level response option to indicate no, slight, moderate, very much or severe impact on the patient’s health-related QoL. Pilot testing among glaucoma patients confirmed the questions as relevant, important and satisfactory in clarity and readability.

To evaluate the psychometric properties, the researchers assessed the HUG-5 for construct validity between similar and dissimilar dimensions of the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) and the EuroQol’s 5 Dimensions. In 124 glaucoma patients, the HUG-5 concurrently measured health-related QoL associated with best-eye visual field loss and was sensitive in detecting differences between patients with mild/moderate glaucoma and those with advanced disease.

The researchers understand that their new descriptive system will focus on measuring the perceived impact of these symptoms on the patient’s daily life, instead of asking patients to qualify peripheral vision or ocular pain. This measurement strategy is in line with the intended use of utility-based instruments—to inform reimbursement decision-making, which requires comparing final treatment outcomes.

Kennedy K, Podbielski D, Nanji K, et al. Disease-specific preference-based measure of glaucoma health states: HUG-5 psychometric validation. Glaucoma. May 15, 2019. [Epub ahead of print].