Appendix.

Multiattribute Health Status Classification System: Health Utilities Index Mark 3

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 neighborhood without difficulty, and without walking equipment
	2. Able to walk around the neighborhood with difficulty; but does not require walking equipment or the help of another person
	3. Able to walk around the neighborhood 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 neighborhood
	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 neighborhood
	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

Source: Feeny et al., 2002 (11).