EuroQol (EQ-5D-5L) Validity in Assessing the Quality of Life in Adults With Asthma: Cross-Sectional Study (original) (raw)

Abstract

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) from a primary care setting in France and England, who self-completed the EQ-5D-5L questionnaire online. The inclusion criteria were persistent asthma defined as >6 months of prescribed inhaled corticosteroids and long-acting beta-agonists or inhaled corticosteroids alone during the 12 months prior to inclusion. The EQ-5D index was obtained by applying the English preference value set for the new EQ-5D-5L and the French 3L-5L crosswalk value set. Both value sets produced single preference-based indices ranging from 1 (best health state) to negative values (health states valued as worse than death), where 0=death, allowing the calculation of quality-adjusted life years. Responses to dimensions and index distribution, including ceiling and floor effects, were examined. The construct validity was assessed by comparing the means of known groups by analyses of variance and calculation of effect sizes. Results: Of 312 patients answering the baseline Web-based survey, 290 completed the EQ-5D-5L (93%). The floor effect was null, and the ceiling effect was 26.5% (74/279). The mean EQ-5D-5L index was 0.88 (SD 0.14) with the English value set and 0.83 (SD 0.19) with the French 3L-5L crosswalk value set. In both indices, large effect sizes were observed for known groups defined by the Asthma Control Questionnaire (1.06 and 1.04, P<.001). Differences between extreme groups defined by chronic

Loading...

Loading Preview

Sorry, preview is currently unavailable. You can download the paper by clicking the button above.

References (54)

  1. Carranza RJR, Edwards L, Lincourt W, Dorinsky P, ZuWallack RL. The relationship between health-related quality of life, lung function and daily symptoms in patients with persistent asthma. Respir Med 2004 Dec;98(12):1157-1165. [Medline: 15588035]
  2. McKenna SP. Measuring patient-reported outcomes: moving beyond misplaced common sense to hard science. BMC Med 2011 Jul 14;9:86 [FREE Full text] [doi: 10.1186/1741-7015-9-86] [Medline: 21756344]
  3. Global Initiative for Asthma. 2018. Global Strategy for Asthma Management and Prevention URL: https://ginasthma.org [accessed 2018-09-26] [WebCite Cache ID 72j3Zhq3B]
  4. Stucky BD, Sherbourne CD, Edelen MO, Eberhart NK. Understanding asthma-specific quality of life: moving beyond asthma symptoms and severity. Eur Respir J 2015 Sep;46(3):680-687 [FREE Full text] [doi: 10.1183/09031936.00225014] [Medline: 25882804]
  5. Chen H, Gould MK, Blanc PD, Miller DP, Kamath TV, Lee JH, TENOR Study Group. Asthma control, severity, and quality of life: quantifying the effect of uncontrolled disease. J Allergy Clin Immunol 2007 Aug;120(2):396-402. [doi: 10.1016/j.jaci.2007.04.040] [Medline: 17561244]
  6. Schatz M, Mosen DM, Kosinski M, Vollmer WM, Magid DJ, O'Connor E, et al. The relationship between asthma-specific quality of life and asthma control. J Asthma 2007 Jun;44(5):391-395. [doi: 10.1080/02770900701364296] [Medline: 17613636]
  7. Hunger M, Sabariego C, Stollenwerk B, Cieza A, Leidl R. Validity, reliability and responsiveness of the EQ-5D in German stroke patients undergoing rehabilitation. Qual Life Res 2012 Sep;21(7):1205-1216. [doi: 10.1007/s11136-011-0024-3] [Medline: 21971874]
  8. König H, Born A, Günther O, Matschinger H, Heinrich S, Riedel-Heller SG, et al. Validity and responsiveness of the EQ-5D in assessing and valuing health status in patients with anxiety disorders. Health Qual Life Outcomes 2010 May 05;8:47 [FREE Full text] [doi: 10.1186/1477-7525-8-47] [Medline: 20444251]
  9. Hung M, Lu W, Chen S, Hou W, Hsieh C, Wang J. Validation of the EQ-5D in Patients with Traumatic Limb Injury. J Occup Rehabil 2015 Jun;25(2):387-393. [doi: 10.1007/s10926-014-9547-0] [Medline: 25261389]
  10. EQ-5D. EQ-5D User Guides URL: https://euroqol.org/publications/user-guides [accessed 2018-09-26] [WebCite Cache ID 72j34C3U7]
  11. Gibbons E, Fitzpatrick R. Patient Reported Outcome Measurement Group, Oxford. The University of Oxford: Oxford, UK; 2009. A structured review of patient-reported outcome measures (PROMs) for asthma URL: http://phi.uhce.ox.ac.uk/pdf/ PROMs_Oxford_Asthma_17092010 [accessed 2018-09-26] [WebCite Cache ID 72j5h8ddn]
  12. Räsänen P, Roine E, Sintonen H, Semberg-Konttinen V, Ryynänen O, Roine R. Use of quality-adjusted life years for the estimation of effectiveness of health care: A systematic literature review. Int J Technol Assess Health Care 2006;22(2):235-241. [doi: 10.1017/S0266462306051051] [Medline: 16571199]
  13. Richardson J, McKie J, Bariola E. Multi attribute utility instruments and their use. In: Culyer AJ, editor. Encyclopedia of health economics. San Diego: Elsevier Science; 2014:341-357.
  14. Fauteux V, Poder T. État des lieux sur les méthodes d'élicitation du QALY Overview of QALY elicitation methods. Int J Health Pref Research 2017;1:001-014. [doi: 10.21965/IJHPR.2017.001]
  15. Oga T, Nishimura K, Tsukino M, Sato S, Hajiro T, Mishima M. A comparison of the responsiveness of different generic health status measures in patients with asthma. Qual Life Res 2003 Aug;12(5):555-563. [Medline: 13677500]
  16. Garratt AM, Hutchinson A, Russell I. Patient-assessed measures of health outcome in asthma: a comparison of four approaches. Respir Med 2000 Jun;94(6):597-606 [FREE Full text] [doi: 10.1053/rmed.2000.0787] [Medline: 10921766]
  17. McTaggart-Cowan HM, Marra CA, Yang Y, Brazier JE, Kopec JA, FitzGerald JM, et al. The validity of generic and condition-specific preference-based instruments: the ability to discriminate asthma control status. Qual Life Res 2008 Apr;17(3):453-462. [doi: 10.1007/s11136-008-9309-6] [Medline: 18274882]
  18. Brazier J, Roberts J, Tsuchiya A, Busschbach J. A comparison of the EQ-5D and SF-6D across seven patient groups. Health Econ 2004 Sep;13(9):873-884. [doi: 10.1002/hec.866] [Medline: 15362179]
  19. Janssen MF, Lubetkin EI, Sekhobo JP, Pickard AS. The use of the EQ-5D preference-based health status measure in adults with Type 2 diabetes mellitus. Diabet Med 2011 Apr;28(4):395-413. [doi: 10.1111/j.1464-5491.2010.03136.x] [Medline: 21392061]
  20. van Stel HF, Buskens E. Comparison of the SF-6D and the EQ-5D in patients with coronary heart disease. Health Qual Life Outcomes 2006 Mar 25;4:20 [FREE Full text] [doi: 10.1186/1477-7525-4-20] [Medline: 16563170]
  21. Feeny D, Furlong W, Torrance GW, Goldsmith CH, Zhu Z, DePauw S, et al. Multiattribute and single-attribute utility functions for the health utilities index mark 3 system. Med Care 2002 Feb;40(2):113-128. [Medline: 11802084]
  22. Brazier J, Roberts J, Deverill M. The estimation of a preference-based measure of health from the SF-36. J Health Econ 2002 Mar;21(2):271-292. [Medline: 11939242]
  23. Oppe M, Devlin NJ, van Hout B, Krabbe PFM, De Leon MC. A program of methodological research to arrive at the new international EQ-5D-5L valuation protocol. Value Health 2014 Jun;17(4):445-453 [FREE Full text] [doi: 10.1016/j.jval.2014.04.002] [Medline: 24969006]
  24. Pickard AS, De Leon MC, Kohlmann T, Cella D, Rosenbloom S. Psychometric comparison of the standard EQ-5D to a 5 level version in cancer patients. Med Care 2007 Mar;45(3):259-263. [doi: 10.1097/01.mlr.0000254515.63841.81] [Medline: 17304084]
  25. Kim SH, Kim HJ, Lee S, Jo M. Comparing the psychometric properties of the EQ-5D-3L and EQ-5D-5L in cancer patients in Korea. Qual Life Res 2012 Aug;21(6):1065-1073. [doi: 10.1007/s11136-011-0018-1] [Medline: 21947656]
  26. Jia YX, Cui FQ, Li L, Zhang DL, Zhang GM, Wang FZ, et al. Comparison between the EQ-5D-5L and the EQ-5D-3L in patients with hepatitis B. Qual Life Res 2014 Oct;23(8):2355-2363. [doi: 10.1007/s11136-014-0670-3] [Medline: 24627090]
  27. Van Ganse E, Texier N, Dima AL, Laforest L, Ferrer M, Hernandez G, ASTRO-LAB group. Assessment of the safety of long-acting β2-agonists in routine asthma care: the ASTRO-LAB protocol. NPJ Prim Care Respir Med 2015 Jun 18;25:15040 [FREE Full text] [doi: 10.1038/npjpcrm.2015.40] [Medline: 26086323]
  28. Schatz M, Zeiger RS, Yang ST, Chen W, Crawford WW, Sajjan SG, et al. Relationship of asthma control to asthma exacerbations using surrogate markers within a managed care database. Am J Manag Care 2010 May;16(5):327-333 [FREE Full text] [Medline: 20469953]
  29. van Hout B, Janssen MF, Feng Y, 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 Health 2012;15(5):708-715 [FREE Full text] [doi: 10.1016/j.jval.2012.02.008] [Medline: 22867780]
  30. Devlin NJ, Shah KK, Feng Y, Mulhern B, van Hout B. Valuing health-related quality of life: An EQ-5D-5L value set for England. Health Econ 2018 Jan;27(1):7-22. [doi: 10.1002/hec.3564] [Medline: 28833869]
  31. McClure NS, Sayah FA, Xie F, Luo N, Johnson JA. Instrument-Defined Estimates of the Minimally Important Difference for EQ-5D-5L Index Scores. Value Health 2017 Apr;20(4):644-650. [doi: 10.1016/j.jval.2016.11.015] [Medline: 28408007]
  32. Reddel HK, Taylor DR, Bateman ED, Boulet L, Boushey HA, Busse WW, American Thoracic Society/European Respiratory Society Task Force on Asthma Control and Exacerbations. An official American Thoracic Society/European Respiratory Society statement: asthma control and exacerbations: standardizing endpoints for clinical asthma trials and clinical practice. Am J Respir Crit Care Med 2009 Jul 1;180(1):59-99. [doi: 10.1164/rccm.200801-060ST] [Medline: 19535666]
  33. Taylor DR, Bateman ED, Boulet L, Boushey HA, Busse WW, Casale TB, et al. A new perspective on concepts of asthma severity and control. Eur Respir J 2008 Sep;32(3):545-554 [FREE Full text] [doi: 10.1183/09031936.00155307] [Medline: 18757695]
  34. Juniper EF, Svensson K, Mörk A, Ståhl E. Measurement properties and interpretation of three shortened versions of the asthma control questionnaire. Respir Med 2005 May;99(5):553-558 [FREE Full text] [doi: 10.1016/j.rmed.2004.10.008] [Medline: 15823451]
  35. Juniper EF, Bousquet J, Abetz L, Bateman ED. Identifying 'well-controlled' and 'not well-controlled' asthma using the Asthma Control Questionnaire. Respir Med 2006 Apr;100(4):616-621 [FREE Full text] [doi: 10.1016/j.rmed.2005.08.012] [Medline: 16226443]
  36. Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 2007 Jan;60(1):34-42. [doi: 10.1016/j.jclinepi.2006.03.012] [Medline: 17161752]
  37. Aaronson N, Alonso J, Burnam A, Lohr KN, Patrick DL, Perrin E, et al. Assessing health status and quality-of-life instruments: attributes and review criteria. Qual Life Res 2002 May;11(3):193-205. [Medline: 12074258]
  38. Chen W, Lynd LD, FitzGerald JM, Marra CA, Rousseau R, Sadatsafavi M. The added effect of comorbidity on health-related quality of life in patients with asthma. Qual Life Res 2015 Oct;24(10):2507-2517. [doi: 10.1007/s11136-015-0995-6] [Medline: 26038225]
  39. Moy ML, Fuhlbrigge AL, Blumenschein K, Chapman RH, Zillich AJ, Kuntz KM, et al. Association between preference-based health-related quality of life and asthma severity. Ann Allergy Asthma Immunol 2004 Mar;92(3):329-334. [doi: 10.1016/S1081-1206(10)61570-0] [Medline: 15049396]
  40. Cohen J. Statistical Power Analysis for the Behavioral Sciences. New York: Taylor & Francis, Inc; 1988.
  41. Kongsved SM, Basnov M, Holm-Christensen K, Hjollund NH. Response rate and completeness of questionnaires: a randomized study of Internet versus paper-and-pencil versions. J Med Internet Res 2007;9(3):e25 [FREE Full text] [doi: 10.2196/jmir.9.3.e25] [Medline: 17942387]
  42. Ritter P, Lorig K, Laurent D, Matthews K. Internet versus mailed questionnaires: a randomized comparison. J Med Internet Res 2004 Sep 15;6(3):e29 [FREE Full text] [doi: 10.2196/jmir.6.3.e29] [Medline: 15471755]
  43. Scott A, Jeon S, Joyce CM, Humphreys JS, Kalb G, Witt J, et al. A randomised trial and economic evaluation of the effect of response mode on response rate, response bias, and item non-response in a survey of doctors. BMC Med Res Methodol 2011;11:126 [FREE Full text] [doi: 10.1186/1471-2288-11-126] [Medline: 21888678]
  44. Fouladi RT, McCarthy CJ, Moller NP. Paper-and-pencil or online? Evaluating mode effects on measures of emotional functioning and attachment. Assessment 2002 Jun;9(2):204-215. [doi: 10.1177/10791102009002011] [Medline: 12066835]
  45. Ekman A, Dickman PW, Klint A, Weiderpass E, Litton J. Feasibility of using web-based questionnaires in large population-based epidemiological studies. Eur J Epidemiol 2006;21(2):103-111. [doi: 10.1007/s10654-005-6030-4] [Medline: 16518678]
  46. Hohwü L, Lyshol H, Gissler M, Jonsson SH, Petzold M, Obel C. Web-based versus traditional paper questionnaires: a mixed-mode survey with a Nordic perspective. J Med Internet Res 2013;15(8):e173 [FREE Full text] [doi: 10.2196/jmir.2595] [Medline: 23978658]
  47. Augustovski F, Rey-Ares L, Irazola V, Garay OU, Gianneo O, Fernández G, et al. An EQ-5D-5L value set based on Uruguayan population preferences. Qual Life Res 2016 Feb;25(2):323-333. [doi: 10.1007/s11136-015-1086-4] [Medline: 26242249]
  48. Xie F, Pullenayegum E, Gaebel K, Bansback N, Bryan S, Ohinmaa A, et al. A Time Trade-off-derived Value Set of the EQ-5D-5L for Canada. Med Care 2016 Jan;54(1):98-105 [FREE Full text] [doi: 10.1097/MLR.0000000000000447] [Medline: 26492214]
  49. Kim S, Ahn J, Ock M, Shin S, Park J, Luo N, et al. The EQ-5D-5L valuation study in Korea. Qual Life Res 2016 Dec;25(7):1845-1852. [doi: 10.1007/s11136-015-1205-2] [Medline: 26961008]
  50. Xie F, Pullenayegum E, Gaebel K, Oppe M, Krabbe PFM. Eliciting preferences to the EQ-5D-5L health states: discrete choice experiment or multiprofile case of best-worst scaling? Eur J Health Econ 2013 Apr 4;15(3):281-288. [doi: 10.1007/s10198-013-0474-3]
  51. Versteegh MM, Vermeulen KM, Evers SMAA, de Wit GA, Prenger R, Stolk EA. Dutch Tariff for the Five-Level Version of EQ-5D. Value Health 2016 Dec;19(4):343-352 [FREE Full text] [doi: 10.1016/j.jval.2016.01.003] [Medline: 27325326]
  52. Chevalier J, de Pouvourville G. Valuing EQ-5D using time trade-off in France. Eur J Health Econ 2013 Feb;14(1):57-66. [doi: 10.1007/s10198-011-0351-x] [Medline: 21935715]
  53. King MT, Kenny PM, Marks GB. Measures of asthma control and quality of life: longitudinal data provide practical insights into their relative usefulness in different research contexts. Qual Life Res 2009 Apr;18(3):301-312. [doi: 10.1007/s11136-009-9448-4] [Medline: 19225906]
  54. Worth A, Hammersley V, Knibb R, Flokstra-de-Blok B, DunnGalvin A, Walker S, et al. Patient-reported outcome measures for asthma: a systematic review. NPJ Prim Care Respir Med 2014 Jun 26;24:14020 [FREE Full text] [doi: 10.1038/npjpcrm.2014.20] [Medline: 24964767]