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Quality of Life Research

, Volume 14, Issue 1, pp 207–219 | Cite as

Responsiveness of generic health-related quality of life measures in stroke

  • A. Simon Pickard
  • Jeffrey A. Johnson
  • David H. Feeny
Article

Abstract

Objective: To compare five preference-based generic measures of health-related quality of life (HRQOL) in terms of change scores, correlations among change scores, responsiveness, and quality adjusted life-years (QALYs) gained. Design: Observational longitudinal cohort study where clinical measures and self-assessed HRQOL measures were administered to stroke patients at baseline and at 6 months. Patients were categorized as ‘stable’, ‘some improvement’ and ‘large improvement’ using the Barthel Index, Modified Rankin Scale (MRS), and Center for Epidemiologic Studies Depression Scale (CES-D). For each group, paired t -tests and variants of effect size were used to compare the responsiveness of preference-based HRQOL summary scores, including the EQ-5D VAS and index-based score, SF-6D, and Health Utilities Index (HUI) Mark 2 (HUI2) and Mark 3 (HUI3) overall utility scores. Results: Ninety-eight of 124 (79%) patients completed the 6-month follow-up. Change scores of the EQ-Index, HUI2, and HUI3 were strongly correlated with changes in the Barthel Index and MRS, while the EQ-5D VAS had higher correlation with CES-D change scores than the other measures. The SF-6D, HUI3, and EQ-Index were generally more responsive than the HUI2 and EQ-5D Visual analogue scale (EQ-VAS). QALY estimates based on the EQ-5D index and HUI3 were twice as large as estimates based on the SF-6D and HUI2. Conclusions : The results of this study may assist in informing the selection of a preference-based generic HRQOL measure, although choice will also depend on study goals and context. We would caution against the generalization of the study results on responsiveness to conditions when more subtle change is expected.

Keywords

Cerebrovascular disease Health-related quality of life Health status indicators Longitudinal studies 

Abbreviations

CES-D

Center for Epidemiologic Studies Depression Scale

EQ-VAS

EQ-5D visual analogue scale

HRQOL

health-related quality of life

HUI

Health Utilities Index

MRS

Modified Rankin Scale

QALYs

quality-adjusted life years

SF-36

Medical Outcomes Study (MOS) short-form health survey

SRM

standardized response mean

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Copyright information

© Springer 2005

Authors and Affiliations

  • A. Simon Pickard
    • 1
  • Jeffrey A. Johnson
    • 2
    • 3
  • David H. Feeny
    • 2
    • 3
    • 4
    • 5
  1. 1.College of PharmacyUniversity of Illinois at ChicagoChicagoUSA
  2. 2.Department of Public Health Sciences, Faculty of Medicine and DentistryUniversity of AlbertaUSA
  3. 3.Institute of Health EconomicsUSA
  4. 4.Faculty of Pharmacy and Pharmaceutical SciencesUniversity of AlbertaEdmonton
  5. 5.Health Utilities Inc.DundasCanada

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