Comparing preference-based quality-of-life measures: results from rehabilitation patients with musculoskeletal, cardiovascular, or psychosomatic disorders
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To compare the EQ-5D, 15D, HUI 2, HUI 3, SF-6D, and QWB-SA in terms of their descriptive statistics, score distribution, agreement and responsiveness in a sample of German rehabilitation inpatients.
Patients with musculoskeletal (N = 106), cardiovascular (N = 88), and psychosomatic (N = 70) disorders completed questionnaires at the beginning (baseline) and end (follow-up) of their inpatient treatment. Comparisons addressed the proportion of missing data, distributional properties, agreement, and responsiveness. Intraclass correlation coefficients (ICC), paired t-tests, and standardized response means (SRM) were computed.
Mean index scores at baseline ranged from 0.48 (HUI 3; psychosomatic) to 0.86 (15D; cardiovascular). At baseline, ceiling effects across all patient groups ranged from zero (SF-6D; cardiovascular and psychosomatic) to 21.6% (EQ-5D; cardiovascular). ICCs ranged from 0.26 (EQ-5D–QWB-SA; cardiovascular) to 0.80 (HUI 2–HUI 3; musculoskeletal). Substantial differences in responsiveness were observed between measures.
Results obtained with different preference-based quality-of-life measures in a sample of patients with mild to moderate disease severity are not equivalent. As differences between measures may have considerable effects in health economic evaluation studies, careful selection of instruments for a given study is essential.
KeywordsPreference-based HRQoL Head-to-head comparison EQ-5D HUI 2 HUI 3 SF-6D 15D QWB-SA
Our thanks go to HUI Inc. and John Horsman for permitting this project and to John Brazier for providing the SF-6D weights and Harri Sintonen for providing the 15D weights. We would also like to thank our cooperation partners Dr Klaus Drüner and Dr Detlev Besch and their colleagues at the rehabilitation clinic Göhren/Germany, and Dr Martin Grunze and Dr Helmhold Seidlein of the rehabilitation clinic Trassenheide/Germany. Further thanks go to Kathrin Bezold for her assistance with data collection. We gratefully acknowledge the constructive comments and suggestions received from John Brazier and the anonymous referees. This project was funded by a grant (no. 01GD0106) from the German Federal Ministry of Education and Research within the North German Network for Rehabilitation Research (NVRF).
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