Validity of EQ-5D-5L in stroke

Dominik Golicki, Maciej Niewada, Julia Buczek, Anna Karlińska, Adam Kobayashi, M F Janssen, A Simon Pickard, Dominik Golicki, Maciej Niewada, Julia Buczek, Anna Karlińska, Adam Kobayashi, M F Janssen, A Simon Pickard

Abstract

Purpose: To assess EQ-5D-5L (5L) validity in patients with acute stroke, in comparison with EQ-5D-3L (3L).

Methods: Cross-sectional study of 408 patients during index hospitalization. We compared 5L and 3L in terms of feasibility, frequency of unique health states, ceiling effect and discriminatory power (informativity). We assessed construct validity in terms of known-groups validity and convergent validity of 5L dimensions with other stroke outcome measures.

Results: The overall proportion of patients with acute stroke reporting 'no problems' with 3L-6.1 % was further reduced to 5.6 % with 5L (relative reduction of 8.2 %). The highest improvement in relative discriminatory power, when moving from 3L to 5L, was noticed in pain/discomfort and anxiety/depression dimensions (Shannon Evenness Index 0.91 for both 5L dimensions; relative increase 34.4 and 29.1 %, respectively). Known-groups validity tests confirmed prior hypotheses: Health state utilities were lower in following subpopulations-females, patients with high modified Rankin Scale (mRS) score, low Barthel Index (BI) or VAS score, patients with subarachnoid hemorrhage or intracerebral hemorrhage, and when proxy respondent was used. Convergence of EQ-5D-5L dimensions with mRS, BI and EQ VAS was improved or at least the same as for 3L dimensions.

Conclusions: Results support the validity of the EQ-5D-5L descriptive system as a generic health outcome measure in patients with acute stroke, demonstrating some psychometric advantages in comparison with EQ-5D-3L.

References

    1. Brooks R. EuroQol: The current state of play. Health Policy. 1996;37(1):53–72. doi: 10.1016/0168-8510(96)00822-6.
    1. Quinn TJ, Dawson J, Walters MR, Lees KR. Functional outcome measures in contemporary stroke trials. International Journal of Stroke. 2009;4(3):200–205. doi: 10.1111/j.1747-4949.2009.00271.x.
    1. Dorman PJ, Waddell F, Slattery J, Dennis M, Sandercock P. Is the EuroQol a valid measure of health-related quality of life after stroke? Stroke. 1997;28(10):1876–1882. doi: 10.1161/01.STR.28.10.1876.
    1. Hunger M, Sabariego C, Stollenwerk B, Cieza A, Leidl R. Validity, reliability and responsiveness of the EQ-5D in German stroke patients undergoing rehabilitation. Quality of Life Research. 2012;21(7):1205–1216. doi: 10.1007/s11136-011-0024-3.
    1. Pinto EB, Maso I, Vilela RN, Santos LC, Oliveira-Filho J. Validation of the EuroQol quality of life questionnaire on stroke victims. Arquivos de Neuro-Psiquiatria. 2011;69(2b):320–323. doi: 10.1590/S0004-282X2011000300010.
    1. Pickard AS, Johnson JA, Feeny DH. Responsiveness of generic health-related quality of life measures in stroke. Quality of Life Research. 2005;14(1):207–219. doi: 10.1007/s11136-004-3928-3.
    1. Herdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L) Quality of Life Research. 2011;20(10):1727–1736. doi: 10.1007/s11136-011-9903-x.
    1. Janssen MF, Pickard AS, Golicki D, Gudex C, Niewada M, Scalone L, et al. Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups: A multi-country study. Quality of Life Research. 2013;22(7):1717–1727. doi: 10.1007/s11136-012-0322-4.
    1. Scalone L, Ciampichini R, Fagiuoli S, Gardini I, Fusco F, Gaeta L, et al. Comparing the performance of the standard EQ-5D 3L with the new version EQ-5D 5L in patients with chronic hepatic diseases. Quality of Life Research. 2013;22(7):1707–1716. doi: 10.1007/s11136-012-0318-0.
    1. Tran BX, Ohinmaa A, Nguyen LT. Quality of life profile and psychometric properties of the EQ-5D-5L in HIV/AIDS patients. Health and Quality of Life Outcomes. 2012;10:132. doi: 10.1186/1477-7525-10-132.
    1. Kim SH, Kim HJ, Lee SI, Jo MW. Comparing the psychometric properties of the EQ-5D-3L and EQ-5D-5L in cancer patients in Korea. Quality of Life Research. 2012;21(6):1065–1073. doi: 10.1007/s11136-011-0018-1.
    1. Lee CF, Luo N, Ng R, Wong NS, Yap YS, Lo SK, et al. Comparison of the measurement properties between a short and generic instrument, the 5-level EuroQoL Group’s 5-dimension (EQ-5D-5L) questionnaire, and a longer and disease-specific instrument, the Functional Assessment of Cancer Therapy-Breast (FACT-B), in Asian breast cancer patients. Quality of Life Research. 2013;22(7):1745–1751. doi: 10.1007/s11136-012-0291-7.
    1. Quinn TJ, Langhorne P, Stott DJ. Barthel index for stroke trials: Development, properties, and application. Stroke. 2011;42(4):1146–1151. doi: 10.1161/STROKEAHA.110.598540.
    1. Golicki D, Jakubczyk M, Niewada M, Wrona W, Busschbach JJ. Valuation of EQ-5D health states in Poland: First TTO-based social value set in Central and Eastern Europe. Value in Health. 2010;13(2):289–297. doi: 10.1111/j.1524-4733.2009.00596.x.
    1. van Hout B, Janssen MF, Feng YS, Kohlmann T, Busschbach J, Golicki D, et al. Interim scoring for the EQ-5D-5L: Mapping the EQ-5D-5L to EQ-5D-3L value sets. Value in Health. 2012;15(5):708–715. doi: 10.1016/j.jval.2012.02.008.
    1. Golicki D, Niewada M, van Hout B, Janssen MF, Pickard AS. Interim EQ-5D-5L value set for Poland: First crosswalk value set in Central and Eastern Europe. Value in Health Regional Issues. 2014;4C:19–23. doi: 10.1016/j.vhri.2014.06.001.
    1. Janssen MF, Birnie E, Haagsma JA, Bonsel GJ. Comparing the standard EQ-5D three-level system with a five-level version. Value in Health. 2008;11(2):275–284. doi: 10.1111/j.1524-4733.2007.00230.x.
    1. Shannon CE. A mathematical theory of communication. The Bell System Technical Journal. 1948;27:379–423. doi: 10.1002/j.1538-7305.1948.tb01338.x.
    1. Fayers PM, Machin D. Quality of life: The assessment, analysis and interpretation of patient-reported outcomes. Chichester: Wiley; 2007. Scores and measurements: validity, reliability, sensitivity; pp. 77–108.
    1. Niewada M, Kobayashi A, Sandercock PA, Kaminski B, Czlonkowska A. Influence of gender on baseline features and clinical outcomes among 17,370 patients with confirmed ischaemic stroke in the international stroke trial. Neuroepidemiology. 2005;24(3):123–128. doi: 10.1159/000082999.
    1. Juniper EF, Guyatt GH, Jaeschke R. Chapter 6: How to develop and validate a new health-related quality of life instrument. In: Spilker B, editor. Quality of life and pharmacoeconomics in clinical trials. 2. Philadelphia: Lippincott-Raven Publishers; 1996. pp. 49–56.
    1. Dorman PJ, Waddell F, Slattery J, Dennis M, Sandercock P. Are proxy assessments of health status after stroke with the EuroQol questionnaire feasible, accurate, and unbiased? Stroke. 1997;28(10):1883–1887. doi: 10.1161/01.STR.28.10.1883.
    1. Pickard AS, Johnson JA, Feeny DH, Shuaib A, Carriere KC, Nasser AM. Agreement between patient and proxy assessments of health-related quality of life after stroke using the EQ-5D and Health Utilities Index. Stroke. 2004;35(2):607–612. doi: 10.1161/.

Source: PubMed

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