Quality of Life Research

, Volume 14, Issue 5, pp 1401–1406 | Cite as

Cross-cultural adaptation and validation of the Korean version of the EQ-5D in patients with rheumatic diseases

  • Myoung-Hee Kim
  • Young-Shin Cho
  • Wan-Sik Uhm
  • Sehyun Kim
  • Sang-Cheol Bae


Objectives: This study aimed to determine the cross-cultural adaptation and validation of the Korean version of the EQ-5D in rheumatic conditions. Methods: Translation, back-translation and cognitive debriefing were performed according to the EuroQol group’s guidelines. For validity, 508 patients were recruited and administered the EQ-5D, Short-Form 36 and condition-specific measures. Construct validity and sensitivity were evaluated by testing a-priori hypotheses. For reliability, another 57 patients repeated the EQ-5D at 1-week interval, and intra-class correlations (ICC) and kappa statistics were estimated. For responsiveness, another 60 patients repeated it at 12-week interval within the context of clinical trial, and standardized response mean(SRM) were calculated. Results: The cross-cultural adaptation produced no major modifications in the scale. The associations of the EQ-5D with the generic- and condition-specific measures were observed as expected in hypotheses the higher: EQ-5D index and EQ-5D VAS scores, the better health status by generic- or condition-specific measures, and the better functional class. The ICCs were 0.751 and 0.767, respectively, and kappa ranged from 0.455 to 0.772. The SRM were 0.649 and 0.410, respectively. Conclusion: The Korean EQ-5D exhibits good validity and sensitivity in various rheumatic conditions. Although its reliability and responsiveness were not excellent, it seems acceptable if condition-specific measures are applied together.


Quality of life Reliability and validity Rheumatic disease 



ankylosing spondylitis


fibromyalgia syndrome


Health Survey Short-Form 36




rheumatoid arthritis


standardized response mean


systemic lupus erythematosus


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  1. 1.
    Rabin, R, Charro, F. 2001EQ-5D: A measure of health status from the EuroQol GroupAnn Med33337343CrossRefPubMedGoogle Scholar
  2. 2.
    Wolfe, F, Smythe, HA, Yunus, MB. 1990The American College of Rheumatology 1990 criteria for the classification of fibromyalgiaReport of the multicenter criteria committee. Arthritis Rheum33160172CrossRefPubMedGoogle Scholar
  3. 3.
    Altman, R, Asch, E, Bloch, D. 1986Development of criteria for the classification and reporting of osteoarthritisClassification of osteoarthritis of the knee. Diagnostic and therapeutic criteria committee of the American rheumatism association. Arthritis Rheum2910391049PubMedGoogle Scholar
  4. 4.
    Arnett, FC, Edworthy, SM, Bloch, DA. 1988The American rheumatism association 1987 revised criteria for the classification of rheumatoid arthritisArthritis Rheum31315324CrossRefPubMedGoogle Scholar
  5. 5.
    Hochberg, MC. 1997Updating the American college of rheumatology revised criteria for the classification of systemic lupus erythematosusArthritis Rheum401725CrossRefPubMedGoogle Scholar
  6. 6.
    Linden, S, Valkenburg, HA, Cats, A. 1984Evaluation of diagnostic criteria for ankylosing spondylitisA proposal for modification of the New York criteria. Arthritis Rheum27361368PubMedGoogle Scholar
  7. 7.
    Calin, A, Garrett, S, Whitelock, H. 1994A new approach to defining functional ability in ankylosing spondylitis: The development of the Bath Ankylosing Spondylitis Functional IndexJ Rheumatol2122812285PubMedGoogle Scholar
  8. 8.
    Bae, SC, Lee, JH. 2004Cross-cultural adaptation and validation of the Korean fibromyalgia impact questionnaire in women patients with fibromyalgia for clinical researchQual Life Res13857861CrossRefPubMedGoogle Scholar
  9. 9.
    Bae, SC, Lee, HS, Yun, HR. 2001Cross-cultural adaptation and validation of Korean western Ontario and McMaster universities (WOMAC) and Lequesne osteoarthritis indices for clinical researchOsteoarthritis Cartilage9746750CrossRefPubMedGoogle Scholar
  10. 10.
    Bae, SC, Cook, EF, Kim, SY. 1998Psychometric evaluation of a Korean health assessment questionnaire for clinical researchJ Rheumatol2519751979PubMedGoogle Scholar
  11. 11.
    Bombardier, C, Gladman, DD, Urowitz, MB, Caron, D, Chang, CH. 1992Derivation of the SLEDAIA disease activity index for lupus patients. The committee on prognosis studies in SLE. Arthritis Rheum35630640Google Scholar
  12. 12.
    Gladman, D, Ginzler, E, Goldsmith, C. 1992Systemic lupus international collaborative clinics: Development of a damage index in systemic lupus erythematosusJ Rheumatol1918201821PubMedGoogle Scholar
  13. 13.
    Maurice, J, Staquet, RDH, Peter, MF. 1998Quality of Life Assessment in Clinical Trials: Methods and PracticeOxford University PressNew YorkGoogle Scholar
  14. 14.
    Fleiss, JL. 1981Statistical Methods for Rates and ProportionsJohn Wiley & Sons, IncNew YorkGoogle Scholar
  15. 15.
    Husted, JA, Cook, RJ, Farewell, VT, Gladman, DD. 2000Methods for assessing responsiveness: A critical review and recommendationsJ Clin Epidemiol53459468CrossRefPubMedGoogle Scholar
  16. 16.
    Hurst, NP, Kind, P, Ruta, D, Hunter, M, Stubbings, A. 1997Measuring health-related quality of life in rheumatoid arthritis: validity, responsiveness and reliability of EuroQol (EQ-5D)Br J Rheumatol36551559CrossRefPubMedGoogle Scholar
  17. 17.
    Haywood, KL, Garratt, AM, Dziedzic, K, Dawes, PT. 2002Generic measures of health-related quality of life in ankylosing spondylitis: Reliability, validity and responsivenessRheumatology (Oxford)4113801387CrossRefGoogle Scholar
  18. 18.
    Wang, C, Mayo, NE, Fortin, PR. 2001The relationship between health related quality of life and disease activity and damage in systemic lupus erythematosusJ Rheumatol28525532PubMedGoogle Scholar
  19. 19.
    Luo, N, Chew, LH, Fong, KY. 2003Validity and reliability of the EQ-5D self-report questionnaire in English-speaking Asian patients with rheumatic diseases in SingaporeQual Life Res128792CrossRefPubMedGoogle Scholar
  20. 20.
    Fransen, M, Edmonds, J. 1999Reliability and validity of the EuroQol in patients with osteoarthritis of the kneeRheumatology (Oxford)38807813CrossRefGoogle Scholar
  21. 21.
    Brazier, JE, Harper, R, Munro, J, Walters, SJ, Snaith, ML. 1999Generic and condition-specific outcome measures for people with osteoarthritis of the kneeRheumatology (Oxford)38870877CrossRefGoogle Scholar
  22. 22.
    Kind, P. 1996The EuroQol Instrument:an index of health-related quality of life.Spilker, B eds. Quality of Life and Pharmacoeconomics in Clinical TrialsLippincott-Raven PublishersPhiladelphia191201Google Scholar
  23. 23.
    Badia, X, Roset, M, Herdman, M, Kind, P. 2001A comparison of United Kingdom and Spanish general population time trade-off values for EQ-5D health statesMed Decis Making21716CrossRefPubMedGoogle Scholar
  24. 24.
    Tsuchiya, A, Ikeda, S, Ikegami, N. 2002Estimating an EQ-5D population value set: The case of JapanHealth Econ11341353CrossRefPubMedGoogle Scholar
  25. 25.
    Suarez-Almazor, ME, Conner-Spady, B. 2001Rating of arthritis health states by patients, physicians, and the general public Implications for cost-utility analysesJ Rheumatol28648656PubMedGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Myoung-Hee Kim
    • 1
  • Young-Shin Cho
    • 2
  • Wan-Sik Uhm
    • 3
  • Sehyun Kim
    • 4
  • Sang-Cheol Bae
    • 3
  1. 1.Department of Preventive MedicineEulji University School of MedicineDaejeonRepublic of Korea
  2. 2.Department of Internal Medicine, Division of RheumatologyChosun UniversityGwangjooRepublic of Korea
  3. 3.Department of Internal Medicine, Division of Rheumatology, The Hospital for Rheumatic DiseasesHanyang UniversitySeoulRepublic of Korea
  4. 4.Department of Preventive MedicinePochon CHA UniversityKyonggiRepublic of Korea

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