EuroQol (EQ-5D-5L) Validity in Assessing the Quality of Life in Adults With Asthma: Cross-Sectional Study (original) (raw)
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BACKGROUND The EuroQol-5 Dimension (EQ-5D), developed in 1990, is a most widely used generic tool to measure the health-related quality of life (HRQoL) and considered suitable for patients with asthma. In 2009, the EuroQol Group developed a new EQ-5D version to overcome limitations related to its consistently reported high ceiling effect. To enhance the sensitivity for assessing the HRQoL in further patient populations, the number of responses of EQ-5D was increased from 3 to 5 levels (EQ-5D-5L). Moreover, the availability of well-defined requirements for its Web-based administration allows EQ-5D-5L use to monitor the HRQoL in electronic health (eHealth) programs. No study has evaluated the metric properties of the new EQ-5D-5L in patients with asthma yet. OBJECTIVE This study aims to examine the distribution, construct validity, and reliability of the new EQ-5D-5L questionnaire administered online to adults with asthma. METHODS We evaluated patients with asthma (age: 18-40 years) f...
Health and quality of life outcomes, 2018
The increasing emphasis on patient-reported outcomes in health care decision making has prompted greater rigor in the evidence to support the instruments used. Acceptability and content validity are important properties of any measure to ensure it assesses the relevant aspects of the target concept. The purpose of this study was to evaluate the acceptability and content validity of the EQ-5D 5-Level (EQ-5D-5L) to assess the impact of asthma on patients' lives. Qualitative interviews were conducted with 40 adults with asthma in the United Kingdom. The first 25 interviews used cognitive-debriefing methods to assess the relevance and acceptability of the EQ-5D-5L and two asthma-specific measures for comparison: an asthma-specific, preference-based measure (the Asthma Quality of Life Utility Index-5 Dimensions) and an Asthma Symptom Diary. The final 15 interviews combined concept elicitation to identify patient-perceived asthma impact, and cognitive debriefing to assess relevance an...
Quality-of-life and asthma-severity in general population asthmatics: results of the ECRHS II study
Allergy, 2008
Many studies conducted both in clinical and populationbased samples show that the quality-of-life is impaired in asthmatic patients (1-3). One of the major goals in the management of asthma is to improve the health-related quality-of-life (HRQL) of patients. Standardized questionnaires, either generic applied over all diseases or specific for asthma, have been developed in tandem with clinical criteria to measure the impact of the disease on daily life in clinical trials (4, 5). Results from Juniper et al. (6) indicated that HRQL measures add complementary information to conventionally-used clinical outcomes. There are few data on HRQL in asthmatics selected from community-based samples and determinants of HRQL remain poorly addressed. Although the quality-of-life decreased with the degree of asthma-severity (7, 8), HRQL is not simply a further index of severity, as the degree to which disease is perceived to affect daily life may vary between patients with the same asthma-severity.
Does health-related quality of life in asthma patients correlate with the clinical indices?
South African Family Practice, 2014
Background: Assessment of health-related quality of life (HRQOL) has been shown to be more relevant to patients who have chronic diseases such as asthma, as achieving the best possible quality of life is the paramount objective in the management of such patients. This study assessed the quality of life of asthma patients and correlated it with the various clinical indices of asthma, such as age, sex, the duration of the asthma, medication used and its severity. Design: The study was a cross-sectional, analytical, case-control design, involving three approaches, i.e. quality of life, clinical assessment and lung function assessment. The patients who participated in this study completed the Asthma Quality of Life Questionnaire (AQLQ) and Asthma Control Questionnaire (ACQ). Statistical analysis was performed using Epi Info ™ version 6.04.
European Respiratory Journal, 2001
With interest in health economics growing, there is a demand for valid methods for measuring health-related quality of life (HRQL) in asthma using utilities. The aims of this study were to develop disease-specific versions of the standard gamble and rating scale, to compare their measurement properties with those of the Asthma Quality of Life Questionnaire (AQLQ) and the Medical Outcomes Survey Short-Form 36 (SF-36), as well as to determine their validity for assessing asthma-specific quality of life. Forty adults with symptomatic asthma participated in a 9-week observational study. Participants completed the standard gamble, rating scale, AQLQ, SF-36 and other measures of clinical asthma status at baseline and after 1, 5 and 9 weeks. In patients whose asthma was stable between assessments, reliability was good for the rating scale (intraclass correlation coefficient (ICC)~0.89) and the AQLQ (ICC~0.95) but more modest for the SF-36 mental score (ICC~0.68), SF-36 physical score (ICC0 .65) and standard gamble (ICC~0.59). The responsiveness index was highest in the AQLQ (1.35), followed by the rating scale (0.74), the physical score of the SF-36 (0.61) and the standard gamble (0.31). Construct validity (correlation with other indices of health status) was strongest for the AQLQ and the rating scale. In conclusion, both the disease-specific rating scale and the Asthma Quality of Life Questionnaire have strong measurement properties for measuring asthma-specific quality of life; the Short-Form 36 health survey physical summary score has more modest properties. Although the disease-specific standard gamble has acceptable discriminative properties, its evaluative properties are too inadequate for it to be used in cost/utility analyses. Poor correlation between the standard gamble and the rating scale indicates that utilities cannot be derived from rating scale data.
Journal of Asthma, 2005
Introduction: Quality-of-life questionnaires have been recognized as an important tool to measure the impact of asthma in the patient's life and has become a main outcome in clinical research. To be effective, questionnaires should be adapted to reflect the needs of the target population. Objective: To assess the reliability, responsiveness, and cross-sectional validity of a simplified quality-of-life questionnaire (QQL-EPM) as a tool specially developed for a socioeconomically deprived target population of asthmatic patients. Method: Thirty-five asthma patients were followed in a prospective open study over a period of 9 weeks. Clinical visits were performed monthly with pulmonary function assessment and the patients filled out a diary card regarding symptom scores, use of rescue medication, and PEF. At each visit, FEV1 and FVC were measured and two healthrelated quality-of-life questionnaires were applied: general quality of life (SF-36) and specific quality of life (QQL-EPM). The condition of patient regarding asthma control was assessed at each visit to the clinic, with treatment optimization and medication adjustment as needed. At the end of the study, each period was analyzed across the trial period and classified as stable or noncontrolled asthma. Results: QQL-EPM was able to correlate changes in quality of life in patients with alterations in their asthma control condition (global = 0.0001) and to differentiate these patients from those whose condition remained stable (global = 0.0001). The reliability of QQL-EPM was 0.68-0.90, and correlation with other clinical measurements and generic quality of life was moderate.
Measuring asthma-specific quality of life: structured review
Allergy, 2011
Measuring quality of life (QoL) has become an increasingly important dimension of assessing patient well-being and drug efficacy. As there are now several asthma QoL questionnaires to choose from, it is important to appreciate their strengths and weaknesses. To assist in this choice, we have reviewed the existing questionnaires in a structured way. Information relating to the conceptual and measurement model, reliability, validity, interpretability, burden, administration format and translations was extracted from the published literature. The instruments differ in almost all criteria considered, and therefore it cannot be assumed that they measure the same thing. We recommend the selection of questionnaires that are designed only for asthma and that do not assess symptoms as part of QoL. Only two of the questionnaires reviewed fulfill these requirements: the Sydney Asthma QoL Questionnaire (AQLQ-S) and the Living with Asthma Questionnaire (LWAQ). However, for multinational studies, it may be convenient or practical to use questionnaires that have been linguistically validated in many languages (AQLQ-J, SGRQ). It remains unclear which of these questionnaires best reflects patient perceptions of QoL. Our review did not involve patients, so for the time being choosing from existing questionnaires requires a compromise based on the rigor of the development process and the target patient group.
European Respiratory Journal, 1996
Asthma is a chronic disease, which affects patients' daily lives. The goal of this study was the development of a disease-specific scale to evaluate quality of life in asthmatic patients in France: The Asthma Impact Record Index (AIR Index). The study was conducted with the participation of 486 asthmatic patients using the following steps: 1) selection of dichotomous items; 2) reduction of the number of items; 3) study of reproducibility of the questionnaire; 4) weighting of items; 5) study of the reliability and validity of the final version of the AIR Index. The final version of the AIR Index contains 63 unweighted items. The items were classified into subscales representing the main dimensions of quality of life: 1) physical, which was itself split into two subscales: a) physical activities; and b) symptoms; 2) psychological; and 3) social or relational. The internal consistency, measured by Cronbach's alpha coefficients, was found to be high, for the global scale and all subscales (range 0.79-0.94). The concurrent validity, evaluated by studying the relationship between the score values on the global scale and the subscales, and the parameters reflecting disease severity, was also high. We conclude that the AIR Index might represent a useful evaluative and discriminant instrument in studying quality of life in asthma in French populations.
Validation of the asthma impact survey, a brief asthma-specific quality of life tool
Quality of Life Research, 2007
Background: The Asthma Impact Survey (AIS-6) is a new six question asthma outcome tool for which information on validity has not been published. Objective: To provide validation for the AIS-6 as a brief asthma-specific quality of life tool. Methods: Surveys were sent to a random sample of members of a large managed care organization who were at least 35 years of age and in the two-year period preceding the survey had either (1) at least one documented asthma-related medical encounter, or (2) at least a 6 months supply of asthma medication dispensed. In addition to the AIS-6, the survey included a validated quality of life tool [the mini-Asthma Quality of Life Questionnaire (AQLQ)]; a validated asthma control questionnaire [the Asthma Therapy Assessment Questionnaire TM (ATAQ)]; a validated symptom severity scale (AOMS); and information regarding demographics, co-morbidities, asthma severity, and asthma management. The results of the AIS-6 were compared to the results of the other tools by means of correlation and factor analysis. Independent predictors of AIS-6 and AQLQ scores were determined by multiple stepwise linear regression analyses. Results: AIS-6 scores were significantly related to female sex, educational level, income, smoking, body mass index (BMI), COPD, steroid use, and hospitalization history in bivariate analyses. The AIS-6 score significantly correlated (r = ) 0.84, p < 0.0001) with the AQLQ total score and loaded on the three factors (activity, symptoms, and concern/ bother) reflected by the survey information and on which the AQLQ also loaded. Significant but somewhat smaller correlations were found between the AIS-6 and the ATAQ (r = 0.70, p < 0.0001) and the AOMS (r = 0.55, p < 0.0001). Independent predictors were the same for the AIS-6 and AQLQ and included oral steroid use, COPD history, BMI, female sex, educational level, and hospitalization in the past year. Conclusion: These data support the validity of the short six-question AIS-6 as an asthmaspecific quality of life tool.