Choosing the Best Instrument for Measuring Health Spillover Effect in Caregivers of Patients With Multiple Sclerosis [Editor's Choice]



To measure the health spillover effect in caregivers of patients with multiple sclerosis (MS), we aimed to select the best instrument from 2 common health-related quality of life (QoL) instruments, the 3-level EQ-5D (EQ-5D-3L) and the Health Utilities Index Mark 3 (HUI-3), by assessing them.


Using consecutive sampling, 452 primary caregivers of patients with MS were asked to fill out a Care-related QoL instrument (CarerQol-7D), EQ-5D-3L, HUI-3, and the Center for Epidemiologic Studies Depression Scale between October 2019 and May 2020. Convergent and clinical validity were assessed to measure spillover effect in caregivers of patients with MS.


A strong correlation of health-utility scores between EQ-5D-3L and HUI-3 (r = 0.914, P .001) caregivers.


We found that both, EQ-5D-3L and HUI-3, were appropriate for measuring caregivers’ QoL, although HUI-3 was a better choice because of its narrower LoA. Our findings suggest researchers should use HUI-3 to measure the quality-adjusted life-year of caregivers to aggregate with the QoL of patients in the denominator of an economic evaluation equation, such as the cost-effective ratio.


Hoda Faraji Fatemeh Soleymani Mehdi Yaseri Mohammad Ali Sahraian Akbar Abdollahiasl Azin Meftah Shekoufeh Nikfar

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