Measurement properties of EQ-5D-3L and EQ-5D-5L in recording self-reported health status in older patients with substantial multimorbidity and polypharmacy
Open Access
- 29 September 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Health and Quality of Life Outcomes
- Vol. 18 (1), 1-17
- https://doi.org/10.1186/s12955-020-01564-0
Abstract
The EQ-5D-3L and EQ-5D-5L are two generic health-related quality of life measures, which may be used in clinical and health economic research. They measure impairment in 5 aspects of health: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. The aim of this study was to assess the performance of the EQ-5D-3L and EQ-5D-5L in measuring the self-reported health status of older patients with substantial multimorbidity and associated polypharmacy. Between 2017 and 2019, we administered EQ-5D-3L and EQ-5D-5L to a subset of patients participating in the OPERAM trial at 6 months and 12 months after enrolment. The OPERAM trial is a two-arm multinational cluster randomised controlled trial of structured medication review assisted by a software-based decision support system versus usual pharmaceutical care, for older people (aged ≥ 70 years) with multimorbidity and polypharmacy. In the psychometric analyses, we only included participants who completed the measures in full at 6 and 12 months. We assessed whether responses to the measures were consistent by assessing the proportion of EQ-5D-5L responses, which were 2 or more levels away from that person’s EQ-5D-3L response. We also compared the measures in terms of informativity, and discriminant validity and responsiveness relative to the Barthel Index, which measures independence in activities of daily living. 224 patients (mean age of 77 years; 56% male) were included in the psychometric analyses. Ceiling effects reported with the EQ-5D-5L (22%) were lower than with the EQ-5D-3L (29%). For the mobility item, the EQ-5D-5L demonstrated better informativity (Shannon’s evenness index score of 0.86) than the EQ-5D-3L (Shannon’s evenness index score of 0.69). Both the 3L and 5L versions of EQ-5D demonstrated good performance in terms of discriminant validity, i.e. (out of all items of the EQ-5D-3L and EQ-5D-5L, the pain/discomfort and anxiety/depression items had the weakest correlation with the Barthel Index. Both the 3L and 5L versions of EQ-5D demonstrated good responsiveness to changes in the Barthel Index. Both EQ-5D-3L and EQ-5D-5L demonstrated validity and responsiveness when administered to older adults with substantial multimorbidity and polypharmacy who were able to complete the measures.Keywords
Funding Information
- Universität Basel
- Horizon 2020 (6342388)
- Staatssekretariat für Bildung, Forschung und Innovation (15.0137)
This publication has 45 references indexed in Scilit:
- EQ-5D Versus SF-12 in Coronary Patients: Are They Interchangeable?Value in Health, 2014
- Using Effect Size—or Why the P Value Is Not EnoughJournal of Graduate Medical Education, 2012
- Interim Scoring for the EQ-5D-5L: Mapping the EQ-5D-5L to EQ-5D-3L Value SetsValue in Health, 2012
- Methods for interpreting change over time in patient-reported outcome measuresQuality of Life Research, 2012
- Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)Quality of Life Research, 2011
- Establishing the Minimal Clinically Important Difference of the Barthel Index in Stroke PatientsNeurorehabilitation and Neural Repair, 2007
- Psychometric Comparison of the Standard EQ-5D to a 5 Level Version in Cancer PatientsMedical Care, 2007
- Evaluating the discriminatory power of EQ-5D, HUI2 and HUI3 in a US general population survey using Shannon’s indicesQuality of Life Research, 2007
- “Order Effects” in Survey Research: Activation and Information Functions of Preceding QuestionsPublished by Springer Science and Business Media LLC ,1992
- The Barthel ADL Index: A standard measure of physical disability?International Disability Studies, 1988