HUInc Health-Related Quality of Life Research
HEALTH UTILITIES INC

Multi-Attribute Health Status Classification System:
Health Utilities Index Mark 3 (HUI3)
 
Attribute Level Description
VISION 1 Able to see well enough to read ordinary newsprint and recognize a friend on the other side of the street, without glasses or contact lenses.
2 Able to see well enough to read ordinary newsprint and recognize a friend on the other side of the street, but with glasses.
3 Able to read ordinary newsprint with or without glasses but unable to recognize a friend on the other side of the street, even with glasses.
4 Able to recognize a friend on the other side of the street with or without glasses but unable to read ordinary newsprint, even with glasses.
5 Unable to read ordinary newsprint and unable to recognize a friend on the other side of the street, even with glasses.
6 Unable to see at all.
       
HEARING 1 Able to hear what is said in a group conversation with at least three other people, without a hearing aid.
2 Able to hear what is said in a conversation with one other person in a quiet room without a hearing aid, but requires a hearing aid to hear what is said in a group conversation with at least three other people.
3 Able to hear what is said in a conversation with one other person in a quiet room with a hearing aid, and able to hear what is said in a group conversation with at least three other people, with a hearing aid.
4 Able to hear what is said in a conversation with one other person in a quiet room, without a hearing aid, but unable to hear what is said in a group conversation with at least three other people even with a hearing aid. 
5 Able to hear what is said in a conversation with one other person in a quiet room with a hearing aid, but unable to hear what is said in a group conversation with at least three other people even with a hearing aid.
6 Unable to hear at all.
       
SPEECH 1 Able to be understood completely when speaking with strangers or friends.
2 Able to be understood partially when speaking with strangers but able to be understood completely when speaking with people who know me well.
3 Able to be understood partially when speaking with strangers or people who know me well.
4 Unable to be understood when speaking with strangers but able to be understood partially by people who know me well.
5 Unable to be understood when speaking to other people (or unable to speak at all).
       
AMBULATION 1 Able to walk around the neighbourhood without difficulty, and without walking equipment.
2 Able to walk around the neighbourhood with difficulty; but does not require walking equipment or the help of another person.
3 Able to walk around the neighbourhood with walking equipment, but without the help of another person.
4 Able to walk only short distances with walking equipment, and requires a wheelchair to get around the neighbourhood.
5 Unable to walk alone, even with walking equipment. Able to walk short distances with the help of another person, and requires a wheelchair to get around the neighbourhood.
6 Cannot walk at all.
       
DEXTERITY 1 Full use of two hands and ten fingers.
2 Limitations in the use of hands or fingers, but does not require special tools or help of another person.
3 Limitations in the use of hands or fingers, is independent with use of special tools (does not require the help of another person).
4 Limitations in the use of hands or fingers, requires the help of another person for some tasks (not independent even with use of special tools).
5 Limitations in use of hands or fingers, requires the help of another person for most tasks (not independent even with use of special tools).
6 Limitations in use of hands or fingers, requires the help of another person for all tasks (not independent even with use of special tools).
       
EMOTION 1 Happy and interested in life.
2 Somewhat happy.
3 Somewhat unhappy.
4 Very unhappy.
5 So unhappy that life is not worthwhile.
       
COGNITION 1 Able to remember most things, think clearly and solve day to day problems.
2 Able to remember most things, but have a little difficulty when trying to think and solve day to day problems.
3 Somewhat forgetful, but able to think clearly and solve day to day problems.
4 Somewhat forgetful, and have a little difficulty when trying to think or solve day to day problems.
5 Very forgetful, and have great difficulty when trying to think or solve day to day problems.
6 Unable to remember anything at all, and unable to think or solve day to day problems.
       
PAIN 1 Free of pain and discomfort.
2 Mild to moderate pain that prevents no activities.
3 Moderate pain that prevents a few activities.
4 Moderate to severe pain that prevents some activities.
5 Severe pain that prevents most activities.
       
  NOTE:  The above level descriptions are worded here
                 exactly as they were presented to interview
                 subjects in the HUI3 preference survey.

  For a pdf-formatted version of the HUI2 and HUI3 Classification Systems click here.

HUI3 Single-Attribute Utility Functions*

Level
Vision
Hearing
Speech
Ambulation
Dexterity
Emotion
Cognition
Pain
1
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
2
0.95
0.86
0.82
0.83
0.88
0.91
0.86
0.92
3
0.73
0.71
0.67
0.67
0.73
0.73
0.92
0.77
4
0.59
0.48
0.41
0.36
0.45
0.33
0.70
0.48
5
0.38
0.32
0.00
0.16
0.20
0.00
0.32
0.00
6
0.00
0.00
  
0.00
0.00
  
0.00
  
*Furlong et al. CHEPA WP#98-11, Appendix B, Table 2, page 97.
NOTE: the mean single-attribute utility score for level 3 cognition is greater than the mean single-attribute utility score for level 2 cognition.

HUI3 Multi-Attribute Utility Function*
on Dead-Healthy Scale

Vision
x1   b1
Hearing
x2   b2
Speech
x3   b3
Ambulation
x4   b4
Dexterity
x5   b5
Emotion
x6   b6
Cognition
x7   b7
Pain
x8   b8
1   1.00
1   1.00
1   1.00
1   1.00
1   1.00
1   1.00
1   1.00
1   1.00
2   0.98
2   0.95
2   0.94
2   0.93
2   0.95
2   0.95
2   0.92
2   0.96
3   0.89
3   0.89
3   0.89
3   0.86
3   0.88
3   0.85
3   0.95
3   0.90
4   0.84
4   0.80
4   0.81
4   0.73
4   0.76
4   0.64
4   0.83
4   0.77
5   0.75
5   0.74
5   0.68
5   0.65
5   0.65
5   0.46
5   0.60
5   0.55
6   0.61
6   0.61
  
6   0.58
6   0.56
  
6   0.42
  
*Furlong et al. CEHPA WP#98-11, Table 11, page 76 and Appendix B, Table 1, page 96.
Where xn is the attribute level and bn is the attribute utility score
Formula (Dead - Perfect Health scale)    u* = 1.371 (b1 * b2 * b3 * b4 * b5 * b6 * b7 * b8) - 0.371
where u* is the utility of a chronic health state1 on a utility scale where dead2 has a utility of 0.00 and healthy has a utility of 1.00.
Notes:
1. Chronic states, and healthy states, are here defined as lasting for a lifetime.
2. Dead is defined as immediate.
Example:For subject "A" whose HUI3 comprehensive health status is classified as follows:
 
VISION
HEARING
SPEECH
AMBULATION
DEXTERITY
EMOTION
COGNITION
PAIN
Level
2
1
1
2
1
2
1
3
Referring to the Multi-attribute Utility Function Table above, substitue the appropriate scores for bn for each attribute as follows:
u* = 1.371 (0.98 * 1.00 * 1.00 * 0.93 * 1.00 * 0.95 * 1.00 * 0.90) - 0.371 = 0.70,
the utility score for individual "A" on the Dead=0.00 to Perfect Health=1.00 scale.
Sources
Feeny, David, William Furlong, Michael Boyle, and George W. Torrance, "Multi-Attribute Health Status Classification Systems:  Health Utilities Index." PharmacoEconomics, Vol 7, No 6, June, 1995, pp 490-502.

Feeny, David H., George W. Torrance, and William J. Furlong, "Health Utilities Index," Chapter 26 In Bert Spilker, ed. Quality of Life and Pharmacoeconomics in Clinical Trials. Second Edition. Philadelphia: Lippincott-Raven Press, 1996, pp 239-252.

Furlong, William, David Feeny, George W. Torrance, Charles Goldsmith, Sonja DePauw, Michael Boyle, Margaret Denton, and Zenglong Zhu, "Multiplicative Multi-Attribute Utility Function for the Health Utilities Index Mark 3 (HUI3) System: A Technical Report," McMaster University Centre for Health Economics and Policy Analysis Working Paper No. 98-11.

Follow the links for detailed information on the HUI2 classification system;
Selecting a Self- or Interviewer- or Web-based administration format;
Reviewing the Table of Contents/Introduction of the HUI Self-Complete Questionnaire manual;
Completing the on-line Application Form to contact the HUI Service Centre
    with your study-particulars and allow your HUInc representative help you
    choose the HUI instrument that meets your needs.

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