The construct validity of the Health Utilities Index Mark 3 in assessing mental health in population health surveys

Purpose  To examine the construct validity of the Health Utilities Index Mark 3 (HUI3) by exploring relationships among several well-recognized measures of mental health, the K6 and the Composite International Diagnostic Interview (CIDI), and the HUI3 in a large, nationally representative sample of community-dwelling subjects. Known-group comparisons were also included in the validation process. Methods  We specified a priori hypotheses about the expected degree of association between the measures. Correlation coefficients of <0.1 were defined as negligible, 0.1 to <0.3 as small, 0.3 to <0.5 as medium, and ≥0.5 as large. Data from the Statistics Canada National Population Health Survey (NPHS) Cycle 2 (1996/97) for respondents 20 years of age or older (n = 66,435) were used to test the a priori hypotheses. Results  In 58.1% of cases, predictions of association were correct. Predictions were off by one category in 38.9% of cases and a priori predictions were off by two categories in 3.0% of cases. Conclusions  Our results provide evidence supporting the cross-sectional construct validity of the HUI3 emotion and HUI3 in a nationally representative sample of the community-dwelling population. The results also provide further evidence of the cross-sectional construct validity of the HUI3 in assessing population health. An erratum to this article can be found at