Psychology RootsHealth Utilities Index
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About Health Utilities Index
Scale Name
Health Utilities Index
Author Details
George W. Torrance and David Feeny
Translation Availability
English
Background/Description
The Health Utilities Index (HUI) is a family of multi-attribute, preference-based systems for measuring health-related quality of life (HRQoL) and producing utility scores suitable for calculating quality-adjusted life years (QALYs). It was developed in Canada at McMaster University by Torrance, Feeny, and colleagues in the mid-1980s as part of a long-term program to develop comprehensive, generic HRQoL instruments.
The HUI provides a single, preference-weighted utility score summarizing an individual’s health state across multiple attributes. It is extensively used in clinical trials, population health surveys, economic evaluations, and health policy studies.
Two principal versions exist:
- HUI Mark 2 (HUI2) (mid-1980s)
- HUI Mark 3 (HUI3) (1990 onward)
HUI3 expands the number of attributes and levels and has become the preferred version in most current research.
Administration, Scoring and Interpretation
- Format: Self-administered questionnaire or interviewer-administered survey.
- Time Required: 5–10 minutes for most respondents.
- Recall Period: Usually “today” or the past week.
- Domains Assessed:
- Procedure:
- Respondents answer a series of questions describing their level of functioning in each attribute.
- Responses define a specific health state (one out of thousands of possible combinations).
- The state is converted to a single utility score using pre-established multi-attribute utility functions based on community preference weights.
Reliability and Validity
- Reliability: Studies report high test–retest reliability (intraclass correlations 0.80–0.95) in general populations and clinical samples (Feeny et al., 2002).
- Construct Validity: HUI scores discriminate between known groups (e.g., by disease severity or age) and correlate strongly with other HRQoL measures such as the SF-36 and EQ-5D.
- Responsiveness: Sensitive to clinically meaningful changes over time, supporting its use in longitudinal studies and clinical trials.
- Preference Weights: Derived from large, representative community samples using standard gamble and other utility elicitation techniques.
Available Versions
31-Items
Reference
Torrance, G. W., Feeny, D. H., Furlong, W. J., Barr, R. D., Zhang, Y., & Wang, Q. (1996). Multiattribute utility function for a comprehensive health status classification system: Health Utilities Index Mark 2. Medical care, 34(7), 702-722.
Feeny, D., Furlong, W., Torrance, G. W., Goldsmith, C. H., Zhu, Z., DePauw, S., … & Boyle, M. (2002). Multiattribute and single-attribute utility functions for the health utilities index mark 3 system. Medical care, 40(2), 113-128.
Important Link
Scale File:
Frequently Asked Questions
Q1: What’s the difference between HUI2 and HUI3?
HUI3 adds attributes (vision, hearing, speech, dexterity) and uses a distinct preference scoring algorithm; it is generally more sensitive to differences in health states.
Q2: How are HUI scores used in QALY calculations?
Multiply the utility score by time spent in that health state (in years) to estimate quality-adjusted life years.
Q3: Can HUI be used with children?
Yes. HUI has been applied to pediatric populations, though attribute descriptions may be adapted for age.
Q4: Is the HUI comparable internationally?
Yes. Although weights were originally derived from Canadian populations, the instrument has been used in many countries. Some regions have developed local preference weights.
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