Quality of Life Research

, Volume 26, Issue 1, pp 1–23 | Cite as

Assessment of the construct validity and responsiveness of preference-based quality of life measures in people with Parkinson’s: a systematic review

  • Yiqiao Xin
  • Emma McIntosh



Generic preference-based quality of life (PbQoL) measures are sometimes criticized for being insensitive or failing to capture important aspects of quality of life (QoL) in specific populations. The objective of this study was to systematically review and assess the construct validity and responsiveness of PbQoL measures in Parkinson’s.


Ten databases were systematically searched up to July 2015. Studies were included if a PbQoL instrument along with a common Parkinson’s clinical or QoL measure was used, and the utility values were reported. The PbQoL instruments were assessed for construct validity (discriminant and convergent validity) and responsiveness.


Twenty-three of 2758 studies were included, of which the majority evidence was for EQ-5D. Overall good evidence of discriminant validity was demonstrated in the Health Utility Index (HUI)-3, EQ-5D-5L, EQ-5D-3L, 15D, HUI-2, and Disability and Distress Index (DDI). Nevertheless, HUI-2 and EQ-5D-3L were shown to be less sensitive among patients with mild Parkinson’s. Moderate to strong correlations were shown between the PbQoL measures (EQ-5D-3L, EQ-5D-5L, 15D, DDI, and HUI-II) and Parkinson’s-specific measures. Twelve studies provided evidence for the assessment of responsiveness of EQ-5D-3L and one study for 15D, among which six studies reached inconsistent results between EQ-5D-3L and the Parkinson’s-specific measures in measuring the change overtime.


The construct validity of the PbQoL measures was generally good, but there are concerns regarding their responsiveness to change. In Parkinson’s, the inclusion of a Parkinson’s-specific QoL measure or a generic but broader scoped mental and well-being focused measure to incorporate aspects not included in the common PbQoL measures is recommended.


Quality of life Utility Parkinson’s Systematic review PDQ-39 EQ-5D Construct validity Responsiveness 



Assessment of Quality of Life


Cost-benefit analysis


Condition-specific preference-based measure


Cost-utility analysis


Disability and Distress Index


EuroQoL EQ-5D


Hospital Anxiety and Depression scale


Health Utilities Index


Hoehn and Yahr scale


Incremental cost-effectiveness ratio


Minimal clinically important difference


National Institute for Health and Care Excellence


Preference-based quality of life


Parkinson’s Disease Questionnaire-39-item


Parkinson’s Disease Questionnaire-39-item-Summary Index


Parkinson’s Disease Quality of Life questionnaire


Parkinson’s Disease QUAlity of LIFe scale


People with Parkinson’s


Quality-adjusted life-years


Quality of life


Randomized controlled trials


Short-Form 6-Dimension


Short-Form 36-item


Standard gamble


Time trade-off


Unified Parkinson’s Disease Rating Scale


Visual analogue scale


Compliance with ethical standards

Conflict of interest

Dr. Emma McIntosh is funded by a Parkinson’s UK Senior Fellowship. Yiqiao Xin declared no conflict of interest.

Human and animal rights

This manuscript is a systematic review which only contains data from previously published studies. No clinical trials were conducted nor patient data were collected for this research.

Supplementary material

11136_2016_1428_MOESM1_ESM.docx (25 kb)
Supplementary material 1 (DOCX 24 kb)


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Health Economics and Health Technology Assessment (HEHTA), Institute of Health and Wellbeing (IHW)University of GlasgowGlasgowUK

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