The EQ-5D-5L health status questionnaire in COPD: validity, responsiveness and minimum important difference

Abstract

BackgroundThe EQ-5D, a generic health status questionnaire that is widely used in health economic evaluation, was recently expanded to the EQ-5D-5L to address criticisms of unresponsiveness and ceiling effect.AimsTo describe the validity, responsiveness and minimum important difference of the EQ-5D-5L in COPD.MethodsStudy 1: The validity of the EQ-5D-5L utility index and visual analogue scale (EQ-VAS) was compared with four established disease-specific health status questionnaires and other measures of disease severity in 616 stable outpatients with COPD. Study 2: The EQ-5D-5L utility index and EQ-VAS were measured in 324 patients with COPD before and after 8 weeks of pulmonary rehabilitation. Distribution and anchor-based approaches were used to estimate the minimum important difference.ResultsThere were moderate-to-strong correlations between utility index and EQ-VAS with disease-specific questionnaires (Pearson's r=0.47–0.72). A ceiling effect was seen in 7% and 2.6% of utility index and EQ-VAS. Utility index decreased (worsening health status) with indices of worsening disease severity. With rehabilitation, mean (95% CI) changes in utility index and EQ-VAS were 0.065 (0.047 to 0.083) and 8.6 (6.5 to 10.7), respectively, with standardised response means of 0.39 and 0.44. The mean (range) anchor estimates of the minimum important difference for utility index and EQ-VAS were 0.051 (0.037 to 0.063) and 6.9 (6.5 to 8.0), respectively.ConclusionsThe EQ-5D-5L is a valid and responsive measure of health status in COPD and may provide useful additional cost-effectiveness data in clinical trials.

An Experience-Based Value Set for the EQ-5D-5L in Germany

“…A major issue for use in patient management is whether or not estimates of patient valuations are accurate enough for a clinical assessment, at least at a group level. Further analysis is needed here: Compared with minimal clinically important differences (MCIDs) for using the EQ-5D-5L and VAS valuation, MAEs were found to be somewhat below the MCIDs reported for patients who had experienced stroke [32] but slightly above the MCIDsalthough within confidence intervals-reported for patients with chronic obstructive pulmonary disease [33]. Accordingly, it has to be considered, by clinical application, whether or not accuracy is considered sufficient to properly reflect effectiveness.…”

Improvement in health‐related quality of life after renal sympathetic denervation in real‐world hypertensive patients: 12‐month outcomes in the Global SYMPLICITY Registry

“…To the best of our knowledge for the EQ‐5D visual analog scale score, no minimally important difference is defined in hypertensive patients. However, empirical work on the minimally important difference for the EQ‐5D‐3L score on the visual analog scale has been done for several other diseases, such as stroke, Crohn′s disease, lower back pain, and cancer, and the minimally important difference has ranged from 4.2 to 14.8 . The reported change in hypertensive patients lies within this range and thus can be carefully assumed as clinically meaningful.…”

“…Crohn′s disease, lower back pain, and cancer, and the minimally important difference has ranged from 4.2 to 14.8 [32][33][34][35][36][37]. The reported change in hypertensive patients lies within this range and thus can be carefully assumed as clinically meaningful.Since quality of life can vary among countries and by socioeconomic status, we performed a subanalysis of scores by geographic region.…”

Quality of Life, Clinical and Biochemical Parameters in Hypertensive Patients With Comorbid Conditions

“…При-кладная ценность и достоверность опросника EQ-5D для изучения качества жизни именно больных с ХОБЛ была доказана сравнительно недавно по результатам 2-х исследований с включением порядка 1000 амбу-латорных пациентов со стабильным течением заболе-вания. Авторы заключают, что этот опросник полностью соответствует цели изучения прогноза больных с ХОБЛ, отличается удобством и может применяться в качестве оценки фармакоэкономической эффективности кли-нических исследований [13].…”