Psychometric validation of the EuroQoL 5-Dimension 5-Level (EQ-5D-5L) in Chinese patients with adolescent idiopathic scoliosis

Prudence Wing Hang Cheung, Carlos King Ho Wong, Dino Samartzis, Keith Dip Kei Luk, Cindy Lo Kuen Lam, Kenneth Man Chee Cheung, Jason Pui Yin Cheung, Prudence Wing Hang Cheung, Carlos King Ho Wong, Dino Samartzis, Keith Dip Kei Luk, Cindy Lo Kuen Lam, Kenneth Man Chee Cheung, Jason Pui Yin Cheung

Abstract

Background: Scoliosis is a common spinal deformity that occurs often during adolescence. Previous studies suggested that adolescent idiopathic scoliosis (AIS) patients can have various aspects of their lives being affected, due to disease presentation and/or treatment received. It is important to define a reliable instrument based on which the affected patients' health-related quality of life can be assessed. This study aims to assess the validity, reliability and sensitivity of the EuroQoL 5-dimension 5-level (EQ-5D-5L) in Chinese patients with AIS.

Methods: Adolescent idiopathic scoliosis patients of Chinese descent were prospectively recruited to complete both the traditional Chinese versions of the EQ-5D-5L and the refined Scoliosis Research Society-22 (SRS-22r) questionnaires. Patients' demographic profiles and corresponding clinical parameters including treatment modalities, spinal curve pattern and magnitude, and duration of bracing were recorded. Telephone interviews were then conducted at least two weeks later for the assessment of test-retest reliability. Statistical analysis was performed: construct validity of the EQ-5D-5L domains were assessed using Spearman's correlation test against the SRS-22r; whereas intra-class correlation coefficient (ICC) was used to assess the test-retest reliability, and agreement over the test-retest period was expressed in percentages. Also, the sensitivity of the EQ-5D-5L in differentiating various clinical known groups was determined by effect size, independent t-test and analysis of variance.

Results: A total of 227 AIS patients were recruited. Scores of domains of the EQ-5D-5L correlated significantly (r: 0.57-0.74) with the scores of the SRS-22r domains that were intended to measure similar constructs, supporting construct validity. The EQ-5D-5L domain responses and utility scores showed good test-retest reliability (ICC: 0.777; agreement: 76.4 -98.1 %). Internal consistency was good (Cronbach's α: 0.78) for the EQ-5D-5L utility score. The EQ-5D-5L utility score was sensitive in detecting differences between subjects who had different treatment modalities and bracing duration, but not for curve pattern and its magnitude.

Conclusions: The EQ-5D-5L is found to be a valid, reliable and sensitive measure to assess the health-related quality of life in Chinese AIS patients. This potentiates the possibility of utilizing the EQ-5D-5L to estimate AIS patients' health-related quality of life, based on which the outcome of various treatment options can eventually be evaluated.

Keywords: Adolescent idiopathic scoliosis; Chinese; EQ-5D-5L; Psychometrics; Quality of life; Reliability; Validity.

References

    1. Burwell RG, Dangerfield PH, Moulton A, Grivas TB, Cheng JC. Whither the etiopathogenesis (and scoliogeny) of adolescent idiopathic scoliosis? Incorporating presentations on scoliogeny at the 2012 IRSSD and SRS meetings. Scoliosis. 2013;8(1):4. doi: 10.1186/1748-7161-8-4.
    1. Reamy BV, Slakey JB. Adolescent idiopathic scoliosis: review and current concepts. Am. Fam. Physician. 2001;64(1):111–116.
    1. Weinstein SL, Ponseti IV. Curve progression in idiopathic scoliosis. J. Bone Joint Surg. Am. 1983;65(4):447–455.
    1. Tan KJ, Moe MM, Vaithinathan R, Wong HK. Curve progression in idiopathic scoliosis: follow-up study to skeletal maturity. Spine. 2009;34(7):697–700. doi: 10.1097/BRS.0b013e31819c9431.
    1. Weinstein SL, Dolan LA, Wright JG, Dobbs MB. Effects of bracing in adolescents with idiopathic scoliosis. N. Engl. J. Med. 2013;369(16):1512–1521. doi: 10.1056/NEJMoa1307337.
    1. Tones M, Moss N, Polly DW., Jr A review of quality of life and psychosocial issues in scoliosis. Spine. 2006;31(26):3027–3038. doi: 10.1097/01.brs.0000249555.87601.fc.
    1. Matsunaga S, Hayashi K, Naruo T, Nozoe S, Komiya S. Psychologic management of brace therapy for patients with idiopathic scoliosis. Spine. 2005;30(5):547–550. doi: 10.1097/01.brs.0000154648.53535.52.
    1. Sapountzi-Krepia D, Psychogiou M, Peterson D, Zafiri V, Iordanopoulou E, Michailidou F, Christodoulou A. The experience of brace treatment in children/adolescents with scoliosis. Scoliosis. 2006;1:8. doi: 10.1186/1748-7161-1-8.
    1. Pham VM, Houlliez A, Carpentier A, Herbaux B, Schill A, Thevenon A. Determination of the influence of the Cheneau brace on quality of life for adolescent with idiopathic scoliosis. Annales de readaptation et de medecine physique: revue scientifique de la Societe francaise de reeducation fonctionnelle de readaptation et de medecine physique. 2008;51(1):3–8. doi: 10.1016/j.annrmp.2007.08.008.
    1. Danielsson AJ, Hasserius R, Ohlin A, Nachemson AL. Body appearance and quality of life in adult patients with adolescent idiopathic scoliosis treated with a brace or under observation alone during adolescence. Spine. 2012;37(9):755–762. doi: 10.1097/BRS.0b013e318231493c.
    1. Danielsson AJ, Hasserius R, Ohlin A, Nachemson AL. Health-related quality of life in untreated versus brace-treated patients with adolescent idiopathic scoliosis: a long-term follow-up. Spine. 2010;35(2):199–205. doi: 10.1097/BRS.0b013e3181c89f4a.
    1. Simony A, Hansen EJ, Carreon LY, Christensen SB, Andersen MO. Health-related quality-of-life in adolescent idiopathic scoliosis patients 25 years after treatment. Scoliosis. 2015;10:22. doi: 10.1186/s13013-015-0045-8.
    1. Schwieger T, Campo S, Weinstein SL, Dolan LA, Ashida S, Steuber KR. Body Image and Quality-of-Life in Untreated Versus Brace-Treated Females with Adolescent Idiopathic Scoliosis. Spine. 2016;41(4):311–319. doi: 10.1097/BRS.0000000000001210.
    1. Hurwitz S. Evidence-based medicine in orthopaedic surgery--a way to the future. Iowa Orthop. J. 2003;23:61–65.
    1. Alakarppa A, Alho OP. Patient-recorded outcomes and quality of life in evidence-based medicine databases on most common ear, throat and nose procedures: a systematic review. Clin Otolaryngol. 2012;37(6):436–445. doi: 10.1111/coa.12048.
    1. Fitzpatrick R, Davey C, Buxton MJ, Jones DR. Evaluating patient-based outcome measures for use in clinical trials. Health Technol. Assess. (Winchester, England) 1998;2(14):i-iv.
    1. Cutler HS, Guzman JZ, Connolly J, Maaieh MA, Allen AK, Cho SK. Patient-reported outcome instruments in pediatric deformity surgery: a bibliometric analysis. Spine Deformity. 2015;3(2):136–143. doi: 10.1016/j.jspd.2014.08.009.
    1. Paulus MC, Kalantar SB, Radcliff K. Cost and value of spinal deformity surgery. Spine. 2014;39(5):388–393. doi: 10.1097/BRS.0000000000000150.
    1. Patrick DL, Deyo RA. Generic and disease-specific measures in assessing health status and quality of life. Med. Care. 1989;27(3 Suppl):S217–232. doi: 10.1097/00005650-198903001-00018.
    1. Cox DR, Fitzpatrick R, Fletcher AE, Gore SM, Spiegelhalter DJ, Jones DR. Quality-of-life assessment: can we keep it simple? J R Statist Soc. 1992;155:353–393. doi: 10.2307/2982889.
    1. Fletcher A, Gore S, Jones D, Fitzpatrick R, Spiegelhalter D, Cox D. Quality of life measures in health care. II: Design, analysis, and interpretation. BMJ (Clinical research ed) 1992;305(6862):1145–1148. doi: 10.1136/bmj.305.6862.1145.
    1. Revicki DA, Leidy NK, Brennan-Diemer F, Sorensen S, Togias A. Integrating patient preferences into health outcomes assessment: the multiattribute asthma symptom utility index. Chest. 1998;114(4):998–1007. doi: 10.1378/chest.114.4.998.
    1. Cairns J. Measuring health outcomes. BMJ (Clinical research ed) 1996;313(7048):6. doi: 10.1136/bmj.313.7048.6.
    1. Read JL. The new era of quality of life assessment. In: Walker SR RR, editor. Quality of life assessment. Key issues in the 1990’s. Dordrecht: Kluwer Academic Publishers; 1993. pp. 3–10.
    1. U.S. Department of Health and Human Services FDA Center for Drug Evaluation and Research, U.S. Department of Health and Human Services FDA Center for Biologics Evaluation and Research, U.S. Department of Health and Human Services FDA Center for Devices and Radiological Health. Guidance for industry: patient-reported outcome measures: use in medical product development to support labeling claims: draft guidance. Health and quality of life outcomes. 2006;4:79.
    1. Adobor RD, Rimeslatten S, Keller A, Brox JI. Repeatability, reliability, and concurrent validity of the scoliosis research society-22 questionnaire and EuroQol in patients with adolescent idiopathic scoliosis. Spine. 2010;35(2):206–209. doi: 10.1097/BRS.0b013e3181b43bdf.
    1. Lai SM, Asher M, Burton D. Estimating SRS-22 quality of life measures with SF-36: application in idiopathic scoliosis. Spine. 2006;31(4):473–478. doi: 10.1097/01.brs.0000200049.94329.f4.
    1. Cobb J. Outline for the study of scoliosis. In: Blount WP, Banks SW, editors. The American Academy of Orthopaedic Surgeons Instructional Course Lectures. 5. Ann Arbor, MI: JW Edwards; 1948. pp. 261–275.
    1. Sanders JO, Browne RH, McConnell SJ, Margraf SA, Cooney TE, Finegold DN. Maturity assessment and curve progression in girls with idiopathic scoliosis. J. Bone Joint Surg. Am. 2007;89(1):64–73. doi: 10.2106/JBJS.F.00067.
    1. EuroQol Group. EuroQol-- A new facility for the measurement of health-related quality of life. Health policy (Amsterdam, Netherlands). 1990;16(3):199–208.
    1. Torrance GW. Measurement of health state utilities for economic appraisal. J. Health Econ. 1986;5(1):1–30. doi: 10.1016/0167-6296(86)90020-2.
    1. Patrick DL. Constructing social metrics for health status indexes. Int J Health Serv. 1976;6(3):443–453. doi: 10.2190/C26P-BKVG-WM5Q-UDKU.
    1. McNeil BJ, Pauker SG, Sox HC, Jr, Tversky A. On the elicitation of preferences for alternative therapies. N. Engl. J. Med. 1982;306(21):1259–1262. doi: 10.1056/NEJM198205273062103.
    1. Pan CW, Sun HP, Wang X, Ma Q, Xu Y, Luo N, Wang P. The EQ-5D-5L index score is more discriminative than the EQ-5D-3L index score in diabetes patients. Qual. Life Res. Int. J. Qual. Life Asp. Treat. Care Rehab. 2015;24(7):1767–1774. doi: 10.1007/s11136-014-0902-6.
    1. van Hout B, Janssen MF, Feng YS, Kohlmann T, Busschbach J, Golicki D, Lloyd A, Scalone L, Kind P, Pickard AS. Interim scoring for the EQ-5D-5L: mapping the EQ-5D-5L to EQ-5D-3L value sets. Value Health. 2012;15(5):708–715. doi: 10.1016/j.jval.2012.02.008.
    1. Liu GG, Wu H, Li M, Gao C, Luo N. Chinese time trade-off values for EQ-5D health states. Value Health. 2014;17(5):597–604. doi: 10.1016/j.jval.2014.05.007.
    1. Asher M, Min Lai S, Burton D, Manna B. The reliability and concurrent validity of the scoliosis research society-22 patient questionnaire for idiopathic scoliosis. Spine. 2003;28(1):63–69. doi: 10.1097/00007632-200301010-00015.
    1. Asher MA, Lai SM, Glattes RC, Burton DC, Alanay A, Bago J. Refinement of the SRS-22 Health-Related Quality of Life questionnaire Function domain. Spine. 2006;31(5):593–597. doi: 10.1097/01.brs.0000201331.50597.ea.
    1. Cheung KM, Senkoylu A, Alanay A, Genc Y, Lau S, Luk KD. Reliability and concurrent validity of the adapted Chinese version of Scoliosis Research Society-22 (SRS-22) questionnaire. Spine. 2007;32(10):1141–1145. doi: 10.1097/01.brs.0000261562.48888.e3.
    1. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, Bouter LM, de Vet HC. Quality criteria were proposed for measurement properties of health status questionnaires. J. Clin. Epidemiol. 2007;60(1):34–42. doi: 10.1016/j.jclinepi.2006.03.012.
    1. Nunnally JC. Psychometric theory. University of Michigan, USA: McGraw-Hill; 1978.
    1. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–174. doi: 10.2307/2529310.
    1. Altaf F, Gibson A, Dannawi Z, Noordeen H. Adolescent idiopathic scoliosis. BMJ (Clinical research ed) 2013;346:f2508.
    1. Dayer R, Haumont T, Belaieff W, Lascombes P. Idiopathic scoliosis: etiological concepts and hypotheses. J. Child. Orthop. 2013;7(1):11–16. doi: 10.1007/s11832-012-0458-3.
    1. Oppenlander ME, Maulucci CM, Ghobrial GM, Harrop JS. Research in spinal surgery: Evaluation and practice of evidence-based medicine. World J. Orthod. 2014;5(2):89–93. doi: 10.5312/wjo.v5.i2.89.
    1. Ersberg A, Gerdhem P. Pre- and postoperative quality of life in patients treated for scoliosis. Acta Orthop. 2013;84(6):537–543. doi: 10.3109/17453674.2013.854667.
    1. Cheung KM, Cheng EY, Chan SC, Yeung KW, Luk KD. Outcome assessment of bracing in adolescent idiopathic scoliosis by the use of the SRS-22 questionnaire. Int. Orthop. 2007;31(4):507–511. doi: 10.1007/s00264-006-0209-5.
    1. Lange JE, Steen H, Gunderson R, Brox JI. Long-term results after Boston brace treatment in late-onset juvenile and adolescent idiopathic scoliosis. Scoliosis. 2011;6:18. doi: 10.1186/1748-7161-6-18.
    1. van den Hout WB, Goekoop-Ruiterman YP, Allaart CF, de Vries-Bouwstra JK, Hazes JM, Kerstens PJ, van Zeben D, Hulsmans HM, de Jonge-Bok JM, de Sonnaville PB, et al. Cost-utility analysis of treatment strategies in patients with recent-onset rheumatoid arthritis. Arthritis and Rheum. 2009;61(3):291–299. doi: 10.1002/art.24169.
    1. Epps H, Ginnelly L, Utley M, Southwood T, Gallivan S, Sculpher M, Woo P. Is hydrotherapy cost-effective? A randomised controlled trial of combined hydrotherapy programmes compared with physiotherapy land techniques in children with juvenile idiopathic arthritis. Health Technol. Assess. (Winchester, England) 2005;9(39):iii–iv.
    1. Crichton N. Visual analogue scale (VAS). J Clin Nurs. 2001;10(5):706–6.
    1. Brazier J, Deverill M, Green C, Harper R, Booth A. A review of the use of health status measures in economic evaluation. Health technology assessment (Winchester, England) 1999;3(9):i–iv.
    1. Loomes G, Lee MJ, Robinson A. What do visual analogue scales actually mean? Newcastle: Paper presented to HESG Conference; 1994.
    1. Wang H, Kindig DA, Mullahy J. Variation in Chinese population health related quality of life: results from a EuroQol study in Beijing, China. Qual. Life Res. Int. J. Qual. Life Asp. Treat. Care Rehab. 2005;14(1):119–132. doi: 10.1007/s11136-004-0612-6.
    1. Wu J, Han Y, Zhao FL, Zhou J, Chen Z, Sun H. Validation and comparison of EuroQoL-5 dimension (EQ-5D) and Short Form-6 dimension (SF-6D) among stable angina patients. Health Qual. Life Outcomes . 2014;12:156. doi: 10.1186/s12955-014-0156-6.
    1. Chen J, Wong CK, McGhee SM, Pang PK, Yu WC. A comparison between the EQ-5D and the SF-6D in patients with chronic obstructive pulmonary disease (COPD) PloS One. 2014;9(11):e112389. doi: 10.1371/journal.pone.0112389.
    1. Zhao FL, Yue M, Yang H, Wang T, Wu JH, Li SC. Validation and comparison of EuroQol and short form 6D in chronic prostatitis patients. Value Health. 2010;13(5):649–656. doi: 10.1111/j.1524-4733.2010.00728.x.

Source: PubMed

Patrocinadores e Colaboradores

Condições médicas

Intervenções de drogas

3
Se inscrever