Validity of the Eq-5d-5l in Stroke Patients

Abstract

objeCtives: To assess EQ-5D-5L validity in patients with acute stroke, in comparison to EQ-5D-3L, EQ VAS, modified Rankin Scale (mRS) and Barthel Index (BI). Methods: Cross-sectional study of 408 patients (51.5% males; mean age 69 years), after median 8 days from stroke onset. We assessed: construct validity in terms of known-groups validity, convergent validity of EQ-5D-5L dimensions with other stroke outcome measures, and criterion-related validity in terms of concurrent validity, with mRS as a gold standard. Results: A total of 2.9% EQ-5D-5L and 3.7% EQ-5D-3L questionnaires had at least one missing answer, indicating good feasibility of both instruments in patients with stroke. The proportion of patients reporting 'no problems' was 38.2% for BI, 6.1% for EQ-5D-3L, 5.6% for EQ-5D-5L, 5.0% for mRS and 2.5% for EQ VAS. Results of the known-groups validity tests confirmed prior hypotheses: health state utilities were lower in females, patients with high mRS score, low BI or VAS score, patients with subarachnoid hemorrhage or intracerebral hemorrhage, and when proxy respondent was used. Convergence of EQ-5D-5L dimensions with mRS, BI and EQ VAS was improved or at least the same as EQ-5D-3L dimensions. For predicting outcome in patients with stroke, the sum of mRS related EQ-5D-5L dimensions (Mobility, Self-care, Usual activities), gave 1% of false positive and 0% of false negative results. ConClusions: Results support the validity of the EQ-5D-5L descriptive system as a generic measure assessed by self-report and proxy in patients with acute stroke, demonstrating some psychometric advantages in comparison to EQ-5D-3L and substantially lower ceiling effect in comparison to Barthel Index.

Health related quality of life and satisfaction with care of stroke patients in Budapest: A substudy of the EuroHOPE project

“…EQ-5D addresses 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/ depression, grading these on 5 levels and a visual analog scale. The overall HRQoL described by the EQ-5D can be used to derive health state utility values, and has been found to be a valid descriptive system as a generic health outcome measure in patients with acute stroke [27]. The 15D is a comprehensive, self-administered health-related QoL instrument, which consists of 15 dimensions: breathing, mental function, speech, vision, mobility, usual activity, vitality, hearing, eating, elimination, sleeping, distress, discomfort and symptoms, depression and sexual activity.…”

MORe PREcISE: A Multicenter Prospective Cohort of Patient Reported Outcome Measures in Stroke

“…PROMs such as the PROMIS 10 offers a clinically feasible way to measure patient reported quality of life. In the future, comparison to other generic instruments, such HL-QoL and other generic measures that have been utilised in stroke to acess patient quality of life, such as the SF-36 34 and EQ-5D 35 , is needed.…”

“…Thus, utilising PROMs in clinical practice would allow greater understanding and reaction to patient perceptions and needs. In the future, comparison to other generic instruments, such HL-QoL and other generic measures that have been utilised in stroke to assess patient quality of life, such as the SF-36 34 and EQ-5D 35 , is needed.…”

Long-Term Outcomes in Patients with Stroke after in-Hospital Treatment—Study Protocol of the Prospective Stroke Cohort Augsburg (SCHANA Study)

“…Three and 12 months after hospital discharge, all study participants will receive postal questionnaires or telephone interviews. The postal questionnaires will include questions on disease symptoms, complications, disabilities and comorbidities; behavioral and clinical risk factors (smoking, alcohol consumption, body weight, height); physical activity (German-PAQ-50+) [ 18 ]; health-related quality of life (Stroke Impact Scale) [ 19 , 20 , 21 ] and EQ-5D [ 22 , 23 ]; fatigue and headache (Rostock Headache Questionnaire) [ 24 ]; vertigo and depression (PHQ-9) [ 25 , 26 ]; recurrent events, bleeding outcomes, and healthcare utilization (readmissions, visits to physicians, clinics, and emergency departments); and data on current medication. An overview of the data collected at baseline and follow-up is given in Table 1 , and a study flow-chart with enrollment and follow-up is depicted in Figure 1 .…”