Developing the MacNew-7D Heart Disease-Specific Preference-Based Instrument


Why the research project is important

With growing, ageing populations, heart disease is becoming a health service burden, with people living longer suffering from debilitating heart complications. New health and medical technologies provide increasingly complex and expensive interventions to manage these conditions. In many developed countries, the annual heart disease-related management budgets run into billions of dollars, and this burden and strain on health resources may be worse in developing countries.

Cost-utility analysis is essential in making subsidy decisions for new health technologies to ensure value for money for limited health resources. This analysis compares cost with gains in patient benefits measured in quality-of-life changes. The cost-utility analysis measures patient benefits in Quality Adjusted Life Years (QALYs). This measure combines the length and quality of life, making it two-dimensional. The quality component of this measure is called utility, where 0 is death, and 1 is full health. All other health states have a value between 0 and 1. In most developed countries, a utility value set using a generic instrument is available, making it convenient for economic evaluations in health care.

What the research seeks to do

This research program developed a heart disease-specific instrument allowing more sensitive measurement of utility values. The QALYs produced from this instrument may produce more accurate evidence for decisions of health resource allocations.

This program produced a new heart disease classification system – The MacNew-7D, using the already available MacNew Heart Disease Health-Related Quality of Life instrument. A survey of ~800 patients with heart disease from Brisbane was used for this part of the study.

The resulting MacNew-7D instrument consists of 7 dimensions and 4 levels in each dimension. A national-level data collection using a representative general population sample of ~2000 people produced the utility value set for MacNew-7D for Australia.

What are the research outcomes/ impact

This program is near complete with a number of publications as the outcome.

Dissemination activities are ongoing to engage stakeholders.

The publications from the program are as below.

  1. Developing Australian utility value set for MacNew-7D health states – Under review
  2. Development of a preference-based heart disease-specific health state classification system using MacNew heart disease-related quality of life instrument
  3. Mapping the Minnesota living with heart failure questionnaire (MLHFQ) to EQ-5D-5L in patients with heart failure

Funding Body

This study was funded by Australian Heart Foundation Vanguard grant (2016/101407) and Heart Foundation post-doctoral fellowship for A/Prof Kularatna.

QUT Centre for Healthcare Transformation funded the DCE data collection.

Further Details

For information, contact A/Prof Sanjeewa Kularatna (