Limits...
Validity and responsiveness of EuroQol-5 dimension (EQ-5D) versus Short Form-6 dimension (SF-6D) questionnaire in chronic pain.

Obradovic M, Lal A, Liedgens H - Health Qual Life Outcomes (2013)

Bottom Line: The EQ-5D showed a greater mean change from baseline to endpoint compared with the SF-6D (0.43 to 0.58 versus 0.59 to 0.64).Responsiveness was also higher with the EQ-5D and for the subgroups in which improvements in health status were expected or when WOMAC severity level was reduced the improvements with EQ-5D were higher than with SF-6D.EQ-5D seemed to have higher construct validity and responsiveness in these patients.

View Article: PubMed Central - HTML - PubMed

Affiliation: Grunenthal GmbH, Zieglerstrasse 6, Aachen 52099, Germany.

ABSTRACT

Background: Assessments of health-related quality of life and particularly utility values are important components of health economic analyses. Several instruments have been developed to measure utilities. However no consensus has emerged regarding the most appropriate instrument within a therapeutic area such as chronic pain. The study compared two instruments - EQ-5D and SF-6D - for their performance and validity in patients with chronic pain.

Methods: Pooled data from three randomised, controlled clinical trials with two active treatment groups were used. The included patients suffered from osteoarthritis knee pain or low back pain. Differences between the utility measures were compared in terms of mean values at baseline and endpoint, Bland-Altman analysis, correlation between the dimensions, construct validity, and responsiveness.

Results: The analysis included 1977 patients, most with severe pain on the Numeric Rating Scale. The EQ-5D showed a greater mean change from baseline to endpoint compared with the SF-6D (0.43 to 0.58 versus 0.59 to 0.64). Bland-Altman analysis suggested the difference between two measures depended on the health status of a patient. Spearmans rank correlation showed moderate correlation between EQ-5D and SF-6D dimensions. Construct validity showed both instruments could differentiate between patient subgroups with different severities of adverse events and analgesic efficacies but larger differences were detected with the EQ-5D. Similarly, when anchoring the measures to a disease-specific questionnaire - Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) - both questionnaires could differentiate between WOMAC severity levels but the EQ-5D showed greater differences. Responsiveness was also higher with the EQ-5D and for the subgroups in which improvements in health status were expected or when WOMAC severity level was reduced the improvements with EQ-5D were higher than with SF-6D.

Conclusions: This analysis showed that the mean EQ-5D scores were lower than mean SF-6D scores in patients with chronic pain. EQ-5D seemed to have higher construct validity and responsiveness in these patients.

Show MeSH

Related in: MedlinePlus

Bland Altman plot for EQ-5D and SF-6D scores at baseline.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3722016&req=5

Figure 1: Bland Altman plot for EQ-5D and SF-6D scores at baseline.

Mentions: The Bland–Altman plot for assessment of agreement of the two methods of measurement suggested that the differences between the two measurements depended on the health status of the individual patient. Patients with low quality of life (average utility <0.6) had lower scores on the EQ-5D and, conversely, those with high quality of life (average utility >0.8) had greater scores on the EQ-5D. However, for those patients with mid-range utility values, the EQ-5D and SF-6D were more aligned (Figure 1).


Validity and responsiveness of EuroQol-5 dimension (EQ-5D) versus Short Form-6 dimension (SF-6D) questionnaire in chronic pain.

Obradovic M, Lal A, Liedgens H - Health Qual Life Outcomes (2013)

Bland Altman plot for EQ-5D and SF-6D scores at baseline.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3722016&req=5

Figure 1: Bland Altman plot for EQ-5D and SF-6D scores at baseline.
Mentions: The Bland–Altman plot for assessment of agreement of the two methods of measurement suggested that the differences between the two measurements depended on the health status of the individual patient. Patients with low quality of life (average utility <0.6) had lower scores on the EQ-5D and, conversely, those with high quality of life (average utility >0.8) had greater scores on the EQ-5D. However, for those patients with mid-range utility values, the EQ-5D and SF-6D were more aligned (Figure 1).

Bottom Line: The EQ-5D showed a greater mean change from baseline to endpoint compared with the SF-6D (0.43 to 0.58 versus 0.59 to 0.64).Responsiveness was also higher with the EQ-5D and for the subgroups in which improvements in health status were expected or when WOMAC severity level was reduced the improvements with EQ-5D were higher than with SF-6D.EQ-5D seemed to have higher construct validity and responsiveness in these patients.

View Article: PubMed Central - HTML - PubMed

Affiliation: Grunenthal GmbH, Zieglerstrasse 6, Aachen 52099, Germany.

ABSTRACT

Background: Assessments of health-related quality of life and particularly utility values are important components of health economic analyses. Several instruments have been developed to measure utilities. However no consensus has emerged regarding the most appropriate instrument within a therapeutic area such as chronic pain. The study compared two instruments - EQ-5D and SF-6D - for their performance and validity in patients with chronic pain.

Methods: Pooled data from three randomised, controlled clinical trials with two active treatment groups were used. The included patients suffered from osteoarthritis knee pain or low back pain. Differences between the utility measures were compared in terms of mean values at baseline and endpoint, Bland-Altman analysis, correlation between the dimensions, construct validity, and responsiveness.

Results: The analysis included 1977 patients, most with severe pain on the Numeric Rating Scale. The EQ-5D showed a greater mean change from baseline to endpoint compared with the SF-6D (0.43 to 0.58 versus 0.59 to 0.64). Bland-Altman analysis suggested the difference between two measures depended on the health status of a patient. Spearmans rank correlation showed moderate correlation between EQ-5D and SF-6D dimensions. Construct validity showed both instruments could differentiate between patient subgroups with different severities of adverse events and analgesic efficacies but larger differences were detected with the EQ-5D. Similarly, when anchoring the measures to a disease-specific questionnaire - Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) - both questionnaires could differentiate between WOMAC severity levels but the EQ-5D showed greater differences. Responsiveness was also higher with the EQ-5D and for the subgroups in which improvements in health status were expected or when WOMAC severity level was reduced the improvements with EQ-5D were higher than with SF-6D.

Conclusions: This analysis showed that the mean EQ-5D scores were lower than mean SF-6D scores in patients with chronic pain. EQ-5D seemed to have higher construct validity and responsiveness in these patients.

Show MeSH
Related in: MedlinePlus