GENERIC VERSUS HIV-SPECIFIC HEALTH-RELATED QUALITY-OF-LIFE MEASURES: A COMPARATIVE ASSESSMENT OF EQ-5D-5L AND MOS-HIV IN A HIGH HIV PREVALENCE POPULATION IN UGANDA
Author(s)
Elly Nuwamanya, MSc.
Health Economist, Infectious Diseases Institute, Kampala, Uganda.
Health Economist, Infectious Diseases Institute, Kampala, Uganda.
OBJECTIVES: Health-related quality of life (HRQoL) has emerged as a critical patient-centered outcome metric for people living with HIV, underscoring the need for accurate and sensitive measurement tools. Using disease-specific MOS-HIV as a reference, we assessed whether the other two generic tools (EQ-5D and VAS) could detect changes in HRQoL.
METHODS: Baseline data were drawn from a cluster randomized trial of adults living with HIV in Kalangala District, Uganda, enrolled in a study evaluating drone-based antiretroviral therapy delivery. HRQoL was measured using MOS-HIV, EQ-5D, and EQ-VAS. EQ-5D-5L utility scores were derived via a Uganda-specific crosswalk algorithm. Validity, responsiveness, and relative precision were assessed by each tool's ability to correlate with the intended HRQoL construct, detect meaningful changes in health status related to comorbidity, and discriminate HRQoL differences between individuals with and without comorbidity, respectively.
RESULTS: A total of 1,082 participants were interviewed, predominantly male (54%), with a mean age of 44. Mean baseline EQ-5D index and VAS scores were 0.95 and 76, with 42% and 16% at maximum values. MOSH-HIV scores ranged from 18 (body pain) to 96 (social functioning), with mean physical (PHS) and mental health summaries (MHS) of 75 and 66, respectively. MOS-HIV PHS and MHS correlated with EQ-5D index at 0.21 and 0.32, and with EQ-VAS at 0.11 and 0.17, respectively. Responsiveness to current comorbidity was highest for MOS-HIV physical functioning, EQ-5D, and VAS (Effect sizes = -1, -0.94, and -0.55). EQ-5D index showed greater relative precision for current comorbidity (1.81) than EQ-VAS (1.14).
CONCLUSIONS: No single instrument fully captures HRQoL in people living with HIV. The EQ-5D enables general-population benchmarking and economic comparisons; the MOS-HIV detects the HIV-specific burden that the EQ-5D misses. Pairing generic and disease-specific measures yields the most complete, clinically meaningful assessment of HRQoL in this population.
METHODS: Baseline data were drawn from a cluster randomized trial of adults living with HIV in Kalangala District, Uganda, enrolled in a study evaluating drone-based antiretroviral therapy delivery. HRQoL was measured using MOS-HIV, EQ-5D, and EQ-VAS. EQ-5D-5L utility scores were derived via a Uganda-specific crosswalk algorithm. Validity, responsiveness, and relative precision were assessed by each tool's ability to correlate with the intended HRQoL construct, detect meaningful changes in health status related to comorbidity, and discriminate HRQoL differences between individuals with and without comorbidity, respectively.
RESULTS: A total of 1,082 participants were interviewed, predominantly male (54%), with a mean age of 44. Mean baseline EQ-5D index and VAS scores were 0.95 and 76, with 42% and 16% at maximum values. MOSH-HIV scores ranged from 18 (body pain) to 96 (social functioning), with mean physical (PHS) and mental health summaries (MHS) of 75 and 66, respectively. MOS-HIV PHS and MHS correlated with EQ-5D index at 0.21 and 0.32, and with EQ-VAS at 0.11 and 0.17, respectively. Responsiveness to current comorbidity was highest for MOS-HIV physical functioning, EQ-5D, and VAS (Effect sizes = -1, -0.94, and -0.55). EQ-5D index showed greater relative precision for current comorbidity (1.81) than EQ-VAS (1.14).
CONCLUSIONS: No single instrument fully captures HRQoL in people living with HIV. The EQ-5D enables general-population benchmarking and economic comparisons; the MOS-HIV detects the HIV-specific burden that the EQ-5D misses. Pairing generic and disease-specific measures yields the most complete, clinically meaningful assessment of HRQoL in this population.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
PCR166
Topic
Methodological & Statistical Research, Patient-Centered Research
Topic Subcategory
Instrument Development, Validation, & Translation, Patient-reported Outcomes & Quality of Life Outcomes
Disease
Infectious Disease (non-vaccine)