Advertisement

Intensive Care Medicine

, Volume 30, Issue 12, pp 2245–2252 | Cite as

Performance of two measures of general health-related quality of life, the EQ-5D and the RAND-36 among critically ill patients

  • Anne Kaarlola
  • Ville Pettilä
  • Pertti Kekki
Original

Abstract

Objective

To compare two health-related quality of life measures, the preference-based EQ-5D with five questions and the profile-based RAND-36 with 36 questions, in previous critically ill patients.

Design

Prospective observational study.

Setting

A ten-bed medical-surgical intensive care unit (ICU) in a tertiary care university hospital.

Patients

Of the 2,709 critically ill patients, treated during the years 1995–2000, the 1,099 patients of the 1,443 still alive who returned both mailed measures were included in the study.

Interventions

None.

Measurements and main results

The EQ-5D and the RAND-36 correlated well (P <.001). Ceiling effect was more obvious with the EQ-5D; the values of the RAND-36 varied usually from 0 to 100 in all the three levels of the corresponding EQ-5D question, and the weakest statistically significant differences were between the EQ levels 2 and 3. In particular, the RAND-36 proved to differentiate better the levels of mobility, self-care, and poor outcome.

Conclusions

The EQ-5D and the RAND-36 correlated well, but when more precisely stated information is needed, especially regarding mobility, self-care, or low quality of life levels of previous critically ill patients, the profile-based RAND-36 may discriminate better.

Keywords

Outcome Quality of life EQ-5D RAND-36 ICU Adults 

Notes

Acknowledgement

We are very thankful to S. Sarna for statistical advice

Supplementary material

supp.pdf (58 kb)
(PDF 59 KB)

References

  1. 1.
    Angus DC, Carlet J (2003) Surviving intensive care: a report from the 2002 Brussels Roundtable. Intensive Care Med 29:368–377PubMedGoogle Scholar
  2. 2.
    Black NA, Jenkinson C, Hayes JA, Young D, Vella K, Rowan KW, Daly K, Ridley S (2001) Review of outcome measures used in adult critical care. Crit Care Med 29:2119–2124CrossRefPubMedGoogle Scholar
  3. 3.
    Bowling A (1997) Evaluating health services: multidisciplinary collaboration. In: Research methods in health care. Open University, Buckingham Philadelphia, pp 6–15Google Scholar
  4. 4.
    Garrett A, Schmidt L, Macintosh A, Fitzpatric R (2002) Quality of life measurement: bibliographic study of patients assessed health outcome measure. BMJ 324:1417CrossRefPubMedGoogle Scholar
  5. 5.
    Jones I (1997) Costing health services: health economics. In: Bowling A (ed) Research methods in health care. Open University, Buckingham Philadelphia, pp 79–97Google Scholar
  6. 6.
    Kutsogiannis DJ, Noseworthy T (2001) Health-related quality of life; during and following critical care. In: Sibbald JW, Bion JF (eds) Evaluating critical care. Springer, Berlin Heidelberg New York, pp 86–103Google Scholar
  7. 7.
    Kerridge RK, Glasziou PP, Hillman KM (1995) The use of “quality-adjusted life years” (QALYs) to evaluate treatment in intensive care. Anaesth Intens Care 23:322–331Google Scholar
  8. 8.
    Heyland DK, Guyatt G, Cook DJ, Meade M, Juniper E, Cronin L, Gafni A (1998) Frequency and methodological rigor of quality of life assessments in the critical care literature. Crit Care Med 26:591–598PubMedGoogle Scholar
  9. 9.
    Patrick DL, Danis M, Southerland LI, Hong G (1988) Quality of life following intensive care. J Gen Intern Med 3:218–223PubMedGoogle Scholar
  10. 10.
    Bergner M, Robbitt RA, Kressel S, Pollard WE, Gibson BS, Morris JR (1981) The sickness impact profile. Development and final version of health status measure. Med Care 19:787–805PubMedGoogle Scholar
  11. 11.
    Hunt SM, McKenna SP, McEwen J, Williams J, Papp E (1981) The Nottingham health profile: subjective health status and medical consultations. Soc Sci Med 15:221–229Google Scholar
  12. 12.
    Ware MK, Snow KK, Kosinski M, Gandek B (1993) SF-36 Health survey: manual and interpretation guide. The Health Institute, New England Medical Centre, BostonGoogle Scholar
  13. 13.
    Kind P, Rosser RM, Williams A (1982) Valuation of quality of life; some psychometric evidence. In: Jones-Lee MW (ed) The value of life and safety. Elsevier, AmsterdamGoogle Scholar
  14. 14.
    Spitzer WO, Dobson AJ, Hall J, Chesterman E, Levi J, Shepherd R, Battista RN, Catchlove BR (1981) Measuring the quality of life of cancer patients: a concise Quality of Life Index for use by physicians. J Chronic Dis 34:585–597CrossRefPubMedGoogle Scholar
  15. 15.
    Hays RD, Sherbourne CD, Mazel R (1993) The RAND 36-item HEALTH survey 1.0. Health Econ 2:217–277PubMedGoogle Scholar
  16. 16.
    Brooks R (1996) EuroQol; the current state of Play. Health Policy 37:53–72CrossRefPubMedGoogle Scholar
  17. 17.
    Bowling A (1997) The principles of research. In: Research methods in health care. Open University, Buckingham Philadelphia, pp 130–138Google Scholar
  18. 18.
    Johnson JA, Ohinmaa A, Murti B, Sintonen H, Coons SJ (2000) Comparison of Finnish and U.S-based Visual Analog Scale Valuations of the EQ-5D measure. Med Decis Making 20:281–289PubMedGoogle Scholar
  19. 19.
    Ohinmaa A, Sintonen H (1996) Quality of life of Finnish population measures by EuroQol. In: Badia X, Herdman M, Segura A (eds) EuroQol, Plenary Meeting. Barcelona 1995, 3–5 October. Discussion papers, Catalan Institute of Public Health, Barcelona, pp 161–172Google Scholar
  20. 20.
    Aalto A, Aro S, Aro AR, Mähönen M (1999) RAND 36-item Survey 1.0. Finnish version. STAKES (National Research and Development Centre for Welfare and Health), HelsinkiGoogle Scholar
  21. 21.
    Coons SJ, Rao S, Keininger DL, Hays RD (2000) A comparative review of generic quality-of-life instruments. Pharmacoeconomics 17:13–35PubMedGoogle Scholar
  22. 22.
    Ware JE, Kosinski M, Keller SD (1994) SF-36 Physical and mental health summary scales. A user’s manual. Health Assessment Lab, Boston MAGoogle Scholar
  23. 23.
    Knaus WA, Wagner DP, Draper EA, Zimmerman JE (1985) APACHE II severity of disease classification system. Crit Care Med 13:818–829PubMedGoogle Scholar
  24. 24.
    Myers C, Wilks D (1999) Comparison of Euroqol EQ-5D and SF-36 in patients with chronic fatigue syndrome. Qual Life Res 8:9–16CrossRefPubMedGoogle Scholar
  25. 25.
    Brazier J, Jones N, Kind P (1993) Testing the validity of the Euroqol and comparing it with the SF-36 health survey questionnaire. Qual Life Res 2:169–180PubMedGoogle Scholar
  26. 26.
    Bosch JL, Hunink MG (2000) Comparison of the Health Utilities index Mark 3 (HUI3) and the EuroQol EQ-5D in patients treated for intermittent claudication. Qual Life Res 9:591–601CrossRefPubMedGoogle Scholar
  27. 27.
    McHorney CA, Taylor AR (1995) Individual patient monitoring in clinical practice: are available health status surveys adequate? Qual Life Res 4:293–307PubMedGoogle Scholar
  28. 28.
    Badia X, Diaz-Prieto A, Gorriz MT, Herdman R, Torrado H, Farrero E, Cavanilles JM (2001) Using EuroQol-5D to measure changes in quality of life 12 months after discharge from an intensive care unit. Intensive Care Med 27:1901–1907CrossRefPubMedGoogle Scholar
  29. 29.
    Jenkinson C, Stradling J, Petersen S (1998) How should we evaluate health status? A comparison of three methods in patients presenting with obstructive sleep apnea. Qual Life Res 7:95–100CrossRefPubMedGoogle Scholar
  30. 30.
    Johnson JA, Coons SJ (1998) Comparison of the EQ-5D and SF-12 in adult US sample. Qual Life Res 7:155–166CrossRefPubMedGoogle Scholar
  31. 31.
    Granja C, Teixeira-Pinto A, Costa-Pereira A (2002) Quality of life after intensive care - evaluation with EQ-5D questionnaire. Intensive Care Med 28:898–907CrossRefPubMedGoogle Scholar
  32. 32.
    Kaarlola A, Pettilä V, Kekki P (2003) Quality of life six years after intensive care. Intensive Care Med 29:1294–1299CrossRefPubMedGoogle Scholar
  33. 33.
    Bosch JL, van der Graaf J, Hunink MGM (1999) Health-related quality of life after angioplasty and stent placement in patients with iliac artery disease; results of the randomised controlled clinical trial. Circulation 99:3155–3160PubMedGoogle Scholar
  34. 34.
    Herridge MS, Cheung AM, Tansey CM, Matte-Martyn A, Diaz-Granados N, Al-Saidi F, Cooper AB, Guest CB, Mazer CD, Mehta S, Stewart TE, Barr A, Cook D, Slutsky AS (2003) One-year outcome in survivors of the acute respiratory distress syndrome. N Engl J Med 348:683–693CrossRefPubMedGoogle Scholar
  35. 35.
    Schelling G, Richter M, Roozendaal B, Rothenhäusler HB, Krauseneck T, Stoll C, Nollert G, Schmidt M, Kapfhammer HP (2003) Exposure to high stress in the intensive care unit may have negative effects on health-related quality-of-life outcome after cardiac surgery. Crit Care Med 31:1971–1980CrossRefPubMedGoogle Scholar
  36. 36.
    Cornock MA (1998) Stress and the intensive care patient: perceptions of patients and nurses. J Adv Nurs 27:518–527CrossRefPubMedGoogle Scholar
  37. 37.
    Scragg P, Jones A, Fauvel N (2001) Psychological problems following ICU treatment. Anaesthesia 56:9–14CrossRefPubMedGoogle Scholar
  38. 38.
    Schelling G, Stoll C, Haller M, Briegel J, Manert W, Hummel T, Lenhart A, Heyduck M, Polasek J, Meier M, Preuss U, Bullinger M, Schuffel W, Peter K (1998) Health-related quality of life and posttraumatic stress disorder in survivors of the acute respiratory distress syndrome. Crit Care Med 26:651–659CrossRefPubMedGoogle Scholar
  39. 39.
    Skogstad W (2000) Working in the world of bodies. A medical ward. In: Hinshelwood RD, Skogstad W (eds) Observing organisations. Anxiety, defence and culture in health care. Routledge, London, pp 101–121Google Scholar
  40. 40.
    Bion WR (1961) Experiences in groups. Routledge, Bristol, pp 59–75Google Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  1. 1.Department of Anaesthesiology and Intensive Care Medicine, Meilahti HospitalHelsinki University Central HospitalFinland
  2. 2.Department of General Practice and Primary Health CareUniversity of HelsinkiHelsinkiFinland

Personalised recommendations