Selecting Bolt-On Dimensions for the EQ-5D: Examining Their Contribution to Health-Related Quality of Life

Finch, Aureliano Paolo; Brazier, John; Mukuria, Clara

doi:10.1016/j.jval.2018.07.001

Cited by 35 publications

(34 citation statements)

References 19 publications

(13 reference statements)

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“…These results are supportive of the findings in recent papers by Finch et al [ 20 , 21 ] that were based on the same MIC data. However, their analytical approach was different from ours, in that they included ‘satisfaction’, as measured by a wide range of life satisfaction and subjective well-being dimensions including the SWLS dimensions, to explore their ability to predict HRQoL [ 21 ]. In our analysis, SWLS was considered a separate dependent variable, rather than an independent variable for HRQoL.…”

Section: Discussionsupporting

confidence: 93%

Filling the psycho-social gap in the EQ-5D: the empirical support for four bolt-on dimensions

Chen

Olsen

2020

Qual Life Res

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Purpose The EQ-5D is the most widely applied generic preference-based measure (GPBM) of health-related quality of life (HRQoL). Much concern has been raised that its descriptive system is lacking psycho-social dimensions. A recent paper in this journal provided theoretical support for four dimensions to fill this gap. The current paper aims to provide empirical support for these suggested bolt-on dimensions to the EQ-5D. Methods We use data from the comprehensive Multi-Instrument-Comparison (MIC) study. The four proposed bolt-on dimensions (Vitality, Sleep, Social Relationships, and Community Connectedness) were selected from the Assessment of Quality of Life (AQoL)-8D. We investigate the relative importance of these four dimensions as compared to the five EQ-5D-5L dimensions on explaining HRQoL (measured by a visual analogue scale; N = 7846) or global life satisfaction (measured by the Satisfaction With Life Scale; N = 8005), using the Shorrocks-Shapely decomposition analysis. Robustness analyses on Vitality was conducted using data from the United States National Health Measurement Study (NHMS) (N = 3812). Results All five EQ-5D-5L dimensions and four bolt-on dimensions significantly explained the variance of HRQoL. Among them, Vitality was found to be the most important dimension with regard to the HRQoL (relative contribution based on the Shorrocks-Shapely decomposition of R2: 23.0%), followed by Usual Activities (15.1%). Self-Care was the least important dimension (relative contribution: 5.4%). As a comparison, when explaining global life satisfaction, Social Relationships was the most important dimension (relative contribution: 24.0%), followed by Anxiety/Depression (23.2%), while Self-Care remained the least important (relative contribution: 1.6%). The importance of the Vitality dimension in explaining HRQoL was supported in the robustness analysis using the NHMS data (relative contribution: 23.7%). Conclusions We provide empirical support for complementing the current EQ-5D-5L descriptive system with a coherent set of four bolt-on dimensions that will fill its psycho-social gap. Such an extended health state classification system would in particular be relevant for programme evaluations within the expanding fields of mental health and community care.

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Section: Discussionsupporting

confidence: 93%

Filling the psycho-social gap in the EQ-5D: the empirical support for four bolt-on dimensions

Chen

Olsen

2020

Qual Life Res

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“…The audit data comprised 50% of UK cataract surgeries undertaken in 2017-2018. Whilst the EQ-5D-3L + VIS has not been used extensively, there is ongoing interest in the development of EQ-5D bolt-ons to fill perceived gaps in the core measures [35]. There is also considerable debate about which EQ-5D version and scoring algorithm should be used to measure self-reported health [36] and to inform decision-making [10].…”

Section: Strengths and Weaknessesmentioning

confidence: 99%

Assessing the construct validity and responsiveness of Preference-Based Measures (PBMs) in cataract surgery patients

et al. 2020

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Purpose The validity and responsiveness of the EQ-5D-3L in visual conditions has been questioned, inspiring development of a vision 'bolt-on' domain (EQ-5D-3L + VIS). Developments in preference-based measures (PBM) also includes the EQ-5D-5L and the ICECAP-O capability wellbeing measure. This study aimed to examine the construct validity and responsiveness of the EQ-5D-3L, EQ-5D-5L, EQ-5D-3L + VIS and ICECAP-O in cataract surgery patients for the first time, to inform choice of PBM for economic evaluation in this population. Methods The analyses used data from the UK Predict-CAT cataract surgery cohort study. PBMs and the Cat-PROM5 [a validated measure of cataract quality of life (QOL)] were completed before surgery and 4-8 weeks after. Construct validity was assessed using correlations and known-group differences evaluated using regression. Responsiveness was evaluated using effect sizes and analysis of variance to compare change scores between groups, defined by patient-reported and clinical outcomes. Results The sample comprised 1315 patients at baseline. No PBMs were associated with visual acuity and only the ICECAP-O (Spearman's rs = − 0.35), EQ-5D-3L + VIS (rs = − 0.42) and EQ-5D-5L (Value Set for England rs = − 0.31) correlated at least moderately with the Cat-PROM5. Effect sizes of change were consistently largest for the EQ-5D-3L + VIS (range 0.34-0.41), followed by the ICECAP-O (range 0.20-0.34). Results indicated no improvement in responsiveness using the EQ-5D-5L (range 0.13-0.16) compared to the EQ-5D-3L (range 0.17-0.20). Conclusions Whilst no PBMs comprehensively demonstrated evidence of construct validity and responsiveness in cataract surgery patients, the ICECAP-O was the most responsive generic PBM to improvements in QOL. Surprisingly the EQ-5D-5L was not more responsive than the EQ-5D-3L in this setting.

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“…As the EQ-5D was never intended to cover all dimensions of health due to a five-dimensional structure, there are some health problems that cannot be captured. For example, vision, hearing, and some mental health disorders [9,13,14] have disease-specific symptoms. This means that different types of instruments are sometimes needed [9].…”

Section: Introductionmentioning

confidence: 99%

“…This means that different types of instruments are sometimes needed [9]. Several researchers, including a working group established by the EuroQol Group (which developed the EQ-5D), are undertaking studies to examine the use of "bolt-on" dimensions [9,[13][14][15][16][17][18][19][20][21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

Factors contributing to the ceiling effect of the EQ-5D-5L: an analysis of patients with prostate cancer judged “no-problems”

et al. 2019

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Purpose The goal of the present study was to determine factors related to a ceiling effect (CE) on the EQ-5D-5L among Japanese patients with prostate cancer (PC). Methods An existent cross-sectional observational study dataset was used. Patients were ≥ 20 years of age and diagnosed with PC. For CE determinants on the EQ-5D-5L, we excluded possible "full-health" patients flagged by the EQ-VAS (score = 100) and/or FACT-P (score = 156) instruments. We then divided them into binary variables: A CE group (EQ-5D-5L score = 1) and others (< 1). The associations between CE, sociodemographic and medical characteristics, and FACT-P subscale scores were examined using a multivariate LASSO selection followed by a binomial logistic regression analysis performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Results A total of 362 patients were analyzed. The LASSO selection variables, including all obtained variables, were as follows: age, palliative treatment, FACT-P physical well-being, and PC subscale score. Statistically significant variables predicting CE were palliative treatment (OR 0.23; 95% CI 0.09-0.60), physical well-being (OR 1.54; 95% CI 1.34-1.76), and PC subscale (OR 1.08; 95% CI 1.03-1.14). Conclusions This study revealed that palliative treatment and two FACT-P physical well-being and PC subscale scores were positively related to CE on the EQ-5D-5L. To our knowledge, this is the first study to examine predictors of CE on the EQ-5D-5L. The present results may be helpful for facilitating the consideration of "bolt-on" studies from the standpoint of PC patients.

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Selecting Bolt-On Dimensions for the EQ-5D: Examining Their Contribution to Health-Related Quality of Life

Cited by 35 publications

References 19 publications

Filling the psycho-social gap in the EQ-5D: the empirical support for four bolt-on dimensions

Filling the psycho-social gap in the EQ-5D: the empirical support for four bolt-on dimensions

Assessing the construct validity and responsiveness of Preference-Based Measures (PBMs) in cataract surgery patients

Factors contributing to the ceiling effect of the EQ-5D-5L: an analysis of patients with prostate cancer judged “no-problems”

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