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BACKGROUND: The 6-dimensional health state short form (SF-6D) is a health preference measure used in economic evaluations of many treatments. OBJECTIVES: To compare the results provided by the SF-6D index, when applied to a representative sample of the Brazilian population, using Brazilian and UK preference weights. METHODS: Five thousand individuals were assessed in the 5 regions of Brazil. Preference measures in healthcare were assessed using the SF-6D Brazil, version 2002. To calculate the single utility score, 2 preference weights were used: one established for the Brazilian population (SF-6D Brazil) and the other for the UK population (SF-6D UK). Agreement between the SF-6D Brazil and the SF-6D UK was assessed using the intraclass correlation coefficient, the Wilcoxon signed rank test, confidence intervals (CIs), and the Bland-Altman method. RESULTS: The mean values of the SF-6D Brazil and the SF-6D UK were 0.83 ± 0.15 and 0.84 ± 0.15, respectively. The intraclass correlation coefficient was 0.952 (CI 0.942-0.960; P<.010). The Wilcoxon signed rank test and CI showed a statistically significant difference between the 2 measures; this difference was, however, very small and considered clinically irrelevant (CI 0.011-0.013; P<.010). Using the Bland-Altman method resulted in a mean difference of 0.012 and the limits of agreement were between -0.077 and 0.101. CONCLUSIONS: The present study identified very small quantitative differences between UK- and Brazilian-derived SF-6D scores. Tests of agreement, however, showed that the impact of using different sets of preference weights in the construction of quality-adjusted life-year might be considered irrelevant.

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OBJECTIVES: To investigate the internal consistency of the SF-6D as a health status index in the Brazilian urban population. STUDY DESIGN: Cross-sectional population based study. METHODS: Five thousand individuals, older than the age of 15, were assessed in the five regions of the country. Two different methods of scoring the SF-6D where compared: "weighting the items" of the questionnaire through the Brazilian official weight coefficients, and "unweighting the items" through a parallel non preference scoring rule solely based on patients' answers to SF-6D health classification system (SF-6DHSI). Principal component factor analysis was used for the development of the SF-6DHSI. Pearson's, Spearman's, and intraclass correlation coefficients were used to assess the psychometric properties. RESULTS: The SF-6DHSI scoring formula summarized the pattern of factor loadings and the item-internal consistency (Cronbach's α = 0.858). The scale showed good item-internal consistency, exceeding the 0.70 standard. The association between weighted and unweighted (SF-6DHSI) scores was extremely high (Spearman's ρ = 0.971). The correlations of the SF-6DHSI with the Physical Component of the 12-Item Short-Form Health Survey (SF-12) and the Health Assessment Questionnaire was moderate to strong. The intraclass correlation coefficient obtained (0.917) also suggested that the concordance between the weighted and unweighted score distributions was prominent. CONCLUSIONS: A nonweighted approach to score the SF-6D provides a reliable global measure of health status. The SF-6D health classification system is useful for assessing quality of life in a large and representative sample of the Brazilian population.

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OBJECTIVE: This study describes the utility scores of the SF-6D, standardized for the Brazilian urban population. METHODS: Five thousand individuals, over the age of 15, were assessed in the five regions of the country, in 16 capitals. The sample consisted of representative quotas of the Brazilian population. The selection of households was random. Face-to-face approach was applied in the household interviews. The SF-6D questionnaire was used to assess the measure of utility. Sociodemographics, household income and work status were also evaluated. RESULTS: The mean score of utility assessed by the SF-6D for the study population was 0.82 (015). The scores were lower for females (0.79), and as age increases, the utility scores progressively decrease. Individuals who reported health problems affecting their work activities presented the lowest scores (0.64). CONCLUSIONS: This study describes the utility scores using the SF-6D, standardized for the Brazilian urban population. These values will be useful for understanding the impact of interventions on health and quality of life in the population, assisting decision-making in the health sector.

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Race differences in health have been extensively analyzed and documented in the literature, especially between African Americans or blacks and whites in the United States. Despite the vast literature in the area, the majority of studies that explore the relationship between race and health use outcomes such as self-rated health, mortality or morbidity, and disability, but very few use Health-Related Quality of Life (HRQoL) measures and their domains or dimensions. This narrative review aims to provide a better understanding of the relationship between race and health domains that are commonly used in preference-based HRQoL measures. We investigated the literature on race, physical health, mental health, pain and discomfort, cognition, neurologic spectrum domains, dexterity, ambulation, vitality and social functioning domains. We conducted a literature search and review using the key words race and the health domain of interest, using medical and social sciences databases, such as MEDLINE/Pubmed, Web of Science, and the Google Scholar portal.The majority of the studies identified in the literature show that African Americans or blacks in the United States tend to have lower scores than whites throughout a variety of health domains found in preference-based HRQoL measures. This review also emphasizes the scarcity of studies that investigate some health domains, such as social functioning, dexterity, vitality and neurologic spectrum domains, and therefore we identify the need for more studies focusing on race and measures that address such domains.

A literatura sobre raça nos Estados Unidos está repleta de estudos que documentam diferenças na saúde entre negros e brancos. Entretanto, a maioria dos trabalhos que exploram a relação entre raça e saúde utiliza medidas com saúde autorrelatada, mortalidade e morbidade, mas poucos empregam medidas de qualidade de vida relacionada à saúde e seus domínios específicos. Este artigo revisa a literatura sobre raça e qualidade de vida relacionada à saúde, especificamente examinando os domínios que constituem as principais medidas baseadas na teoria da utilidade: saúde física; saúde mental; dor e desconforto; cognição; domínios neurológicos; destreza; locomoção; vitalidade; e funcionamento social. Conduziu-se uma revisão da literatura usando as palavras-chave raça e o domínio da qualidade de vida de interesse nos Estados Unidos. Foram consultadas as bases de dados Medline/Pubmed, Web of Science e o portal Google Scholar. A maioria dos estudos sobre diversos domínios das medidas de qualidade de vida investigados sugere que negros têm pior qualidade de vida do que brancos nos Estados Unidos. A revisão salienta a escassez de estudos que exploram a relação entre raça e alguns domínios, como, por exemplo, funcionamento social, destreza, vitalidade e domínios de escopo neurológico, e, portanto, mostra a necessidade de que futuros estudos examinem a relação entre raça e estes domínios.

La literatura sobre raza en los Estados Unidos está repleta de estudios que documentan diferencias en la salud entre negros y blancos. No obstante, la mayoría de los trabajos que explotan la relación entre raza y salud utiliza medidas con salud autorrelatada, mortalidad y morbilidad, pero pocos emplean medidas de calidad de vida relacionada con la salud y sus dominios específicos. Este artículo revisa la literatura sobre raza y calidad de vida relacionada con la salud, específicamente, examinando los dominios que constituyen las principales medidas basadas en la teoría de la utilidad: salud física; salud mental; dolor y molestias; cognición; dominios neurológicos; agilidad; locomoción; vitalidad; y funcionamiento social. Se realizó una revisión de la literatura usando las palabras-clave raza y el dominio de la calidad de vida de interés en los Estados Unidos. Se consultaron las bases de datos Medline/Pubmed, Web of Science y el portal Google Scholar. La mayoría de los estudios sobre diversos dominios de las medidas de calidad de vida investigados sugiere que los negros tienen peor calidad de vida que los blancos en los Estados Unidos. La revisión resalta la escasez de estudios que explotan la relación entre raza y algunos dominios, como, por ejemplo, funcionamiento social, agilidad, vitalidad y dominios de objetivo neurológico, y, por tanto, muestra la necesidad de que futuros estudios examinen la relación entre raza y estos dominios.

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