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Quality of Life Research

, Volume 26, Issue 12, pp 3409–3419 | Cite as

Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L in psoriasis patients

  • Adrienn Katalin Poór
  • Fanni RenczEmail author
  • Valentin Brodszky
  • László Gulácsi
  • Zsuzsanna Beretzky
  • Bernadett Hidvégi
  • Péter Holló
  • Sarolta Kárpáti
  • Márta Péntek
Article

Abstract

The purpose of this study is to assess the measurement properties of EQ-5D-5L compared to EQ-5D-3L in psoriasis patients.

Methods

A cross-sectional survey was carried out at an academic dermatology clinic in Hungary. Psoriasis patients completed the EQ-5D-3L, EQ-5D-5L and Dermatology Life Quality Index (DLQI) questionnaires, and Psoriasis Area and Severity Index (PASI) was assessed. The UK value sets were used to calculate the 3L and 5L index scores. We tested the feasibility, ceiling effect, redistribution properties, the level of inconsistency and informativity (Shannon and Shannon Evenness indices). Spearman’s rank-order correlations were performed between EQ-5D, EQ VAS, DLQI and PASI scores. Known-groups validity was evaluated by comparing age groups, clinical subtypes and treatment groups.

Results

Mean age of the 238 patients was 47 years, and 36.6% of them received biological therapy. Mean EQ-5D index score was 0.77 (SD: 0.26) with the 3L and 0.84 (SD: 0.19) with the 5L. The overall ceiling effect decreased from 37.1 (3L) to 32.9% (5L). Shannon index improved significantly for most dimensions, but Shannon Evenness index improved only in three dimensions. Compared to the 3L, the 5L version confirmed a better convergent validity with PASI, but not with the DLQI. Known-groups validity was equally demonstrated both for the 5L and 3L.

Conclusions

The EQ-5D-5L seems to improve measurement properties by reducing ceiling effects, strengthening correlations with PASI and improving informativity. Follow-up studies are needed to test responsiveness and reliability in psoriasis.

Keywords

EQ-5D-3L EQ-5D-5L Psoriasis Health-related quality of life Measurement properties Psychometrics 

Notes

Acknowledgements

Authors are grateful to Elly Stolk (EuroQol Group, Scientific Team Leader) and Miklós Sárdy (Semmelweis University, Department of Dermatology, Venereology and Dermatooncology) for their valuable comments on the manuscript.

Funding

Márta Péntek’s work in this study was supported by an independent research grant from her employer Corvinus University of Budapest (‘Kutatási Kiválóság Díj 2016’—Research Excellence Award 2016).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study protocol was approved by the Semmelweis University Regional and Institutional Committee of Science and Research Ethics (Reference No. 58./2015).

Informed consent

Informed consent was obtained from all participants included in the study.

References

  1. 1.
    Michalek, I. M., Loring, B., & John, S. M. (2017). A systematic review of worldwide epidemiology of psoriasis. Journal of the European Academy of Dermatology and Venereology, 31(2), 205–212.CrossRefPubMedGoogle Scholar
  2. 2.
    Boehncke, W. H., & Schon, M. P. (2015). Psoriasis. Lancet, 386(9997), 983–994.CrossRefPubMedGoogle Scholar
  3. 3.
    Ahmed, N., Prior, J. A., Chen, Y., Hayward, R., Mallen, C. D., & Hider, S. L. (2016). Prevalence of cardiovascular-related comorbidity in ankylosing spondylitis, psoriatic arthritis and psoriasis in primary care: a matched retrospective cohort study. Clinical Rheumatology, 35(12), 3069–3073.CrossRefPubMedGoogle Scholar
  4. 4.
    Frieder, J., & Ryan, C. (2016). Psoriasis and cardiovascular disorders. G Ital Dermatol Venereol, 151(6), 678–693.PubMedGoogle Scholar
  5. 5.
    Gelfand, J. M. (2016). Psoriasis, Type 2 diabetes mellitus, and obesity: Weighing the evidence. JAMA Dermatology, 152(7), 753–754.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    van der Voort, E. A., Wakkee, M., Veldt-Kok, P., Darwish Murad, S., & Nijsten, T. (2016). Enhanced liver fibrosis test (ELF) in psoriasis, psoriatic arthritis and rheumatoid arthritis patients: a cross-sectional comparison with procollagen-3 N-terminal peptide (P3NP). British Journal Dermatology, 30, 7.Google Scholar
  7. 7.
    Mortezavi, M., Thiele, R., & Ritchlin, C. (2015). The joint in psoriatic arthritis. Clinical and Experimental Rheumatology, 33(5 Suppl 93), S20–S25.PubMedGoogle Scholar
  8. 8.
    de Korte, J., Sprangers, M. A., Mombers, F. M., & Bos, J. D. (2004). Quality of life in patients with psoriasis: a systematic literature review. Journal of Investigative Dermatology Symposium Proceedings, 9(2), 140–147.CrossRefGoogle Scholar
  9. 9.
    Obradors, M., Blanch, C., Comellas, M., Figueras, M., & Lizan, L. (2016). Health-related quality of life in patients with psoriasis: a systematic review of the European literature. Quality of Life Research, 25(11), 2739–2754.CrossRefPubMedGoogle Scholar
  10. 10.
    Moller, A. H., Erntoft, S., Vinding, G. R., & Jemec, G. B. (2015). A systematic literature review to compare quality of life in psoriasis with other chronic diseases using EQ-5D-derived utility values. Patient Relat Outcome Meas, 6, 167–177.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Rapp, S. R., Feldman, S. R., Exum, M. L., Fleischer, A. B., Jr., & Reboussin, D. M. (1999). Psoriasis causes as much disability as other major medical diseases. Journal of the American Academy of Dermatology, 41(3 Pt 1), 401–407.CrossRefPubMedGoogle Scholar
  12. 12.
    Ellis, C. N., Reiter, K. L., Wheeler, J. R., & Fendrick, A. M. (2002). Economic analysis in dermatology. Journal of the American Academy of Dermatology, 46(2), 271–283.CrossRefPubMedGoogle Scholar
  13. 13.
    Gutknecht, M., Krensel, M., & Augustin, M. (2016). Health economic analyses of psoriasis management: A systematic literature search. Archives of Dermatological Research, 308(9), 601–616.CrossRefPubMedGoogle Scholar
  14. 14.
    Pereira, F. R., Basra, M. K., Finlay, A. Y., & Salek, M. S. (2012). The role of the EQ-5D in the economic evaluation of dermatological conditions and therapies. Dermatology, 225(1), 45–53.CrossRefPubMedGoogle Scholar
  15. 15.
    EuroQol, G. (1990). EuroQol–a new facility for the measurement of health-related quality of life. Health Policy, 16(3), 199–208.CrossRefGoogle Scholar
  16. 16.
    Brooks, R. (1996). EuroQol: the current state of play. Health Policy, 37(1), 53–72.CrossRefPubMedGoogle Scholar
  17. 17.
    Devlin, N. J., & Krabbe, P. F. (2013). The development of new research methods for the valuation of EQ-5D-5L. Eur J Health Econ, 14(Suppl 1), S1–S3.CrossRefPubMedGoogle Scholar
  18. 18.
    Herdman, M., Gudex, C., Lloyd, A., Janssen, M., Kind, P., Parkin, D., et al. (2011). Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research, 20(10), 1727–1736.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Janssen, M. F., Pickard, A. S., Golicki, D., Gudex, C., Niewada, M., Scalone, L., et al. (2013). Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups: a multi-country study. Quality of Life Research, 22(7), 1717–1727.CrossRefPubMedGoogle Scholar
  20. 20.
    Feng, Y., Devlin, N., & Herdman, M. (2015). Assessing the health of the general population in England: How do the three- and five-level versions of EQ-5D compare? Health and Quality of Life Outcomes, 13, 171.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Ferreira, L. N., Ferreira, P. L., Ribeiro, F. P., & Pereira, L. N. (2016). Comparing the performance of the EQ-5D-3L and the EQ-5D-5L in young Portuguese adults. Health and Quality of Life Outcomes, 14, 89.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Golicki, D., Niewada, M., Karlinska, A., Buczek, J., Kobayashi, A., Janssen, M. F., et al. (2015). Comparing responsiveness of the EQ-5D-5L, EQ-5D-3L and EQ VAS in stroke patients. Quality of Life Research, 24(6), 1555–1563.CrossRefPubMedGoogle Scholar
  23. 23.
    Greene, M. E., Rader, K. A., Garellick, G., Malchau, H., Freiberg, A. A., & Rolfson, O. (2015). The EQ-5D-5L improves on the EQ-5D-3L for health-related quality-of-life assessment in patients undergoing total hip arthroplasty. Clinical Orthopaedics and Related Research, 473(11), 3383–3390.CrossRefPubMedGoogle Scholar
  24. 24.
    Jia, Y. X., Cui, F. Q., Li, L., Zhang, D. L., Zhang, G. M., Wang, F. Z., et al. (2014). Comparison between the EQ-5D-5L and the EQ-5D-3L in patients with hepatitis B. Quality of Life Research, 23(8), 2355–2363.CrossRefPubMedGoogle Scholar
  25. 25.
    Pan, C. W., Sun, H. P., Wang, X., Ma, Q., Xu, Y., Luo, N., et al. (2015). The EQ-5D-5L index score is more discriminative than the EQ-5D-3L index score in diabetes patients. Quality of Life Research, 24(7), 1767–1774.CrossRefPubMedGoogle Scholar
  26. 26.
    Pickard, A. S., De Leon, M. C., Kohlmann, T., Cella, D., & Rosenbloom, S. (2007). Psychometric comparison of the standard EQ-5D to a 5 level version in cancer patients. Medical Care, 45(3), 259–263.CrossRefPubMedGoogle Scholar
  27. 27.
    Yfantopoulos, J. N., & Chantzaras, A. E. (2016). Validation and comparison of the psychometric properties of the EQ-5D-3L and EQ-5D-5L instruments in Greece. The European Journal of Health Economics, 18, 519–531.CrossRefPubMedGoogle Scholar
  28. 28.
    Yfantopoulos, J., Chantzaras, A., & Kontodimas, S. (2017). Assessment of the psychometric properties of the EQ-5D-3L and EQ-5D-5L instruments in psoriasis. Archives of Dermatological Research, 309(5), 357–370.CrossRefPubMedGoogle Scholar
  29. 29.
    Conner-Spady, B. L., Marshall, D. A., Bohm, E., Dunbar, M. J., Loucks, L., Al Khudairy, A., et al. (2015). Reliability and validity of the EQ-5D-5L compared to the EQ-5D-3L in patients with osteoarthritis referred for hip and knee replacement. Quality of Life Research, 24(7), 1775–1784.CrossRefPubMedGoogle Scholar
  30. 30.
    Janssen, M. F., Birnie, E., Haagsma, J. A., & Bonsel, G. J. (2008). Comparing the standard EQ-5D three-level system with a five-level version. Value Health, 11(2), 275–284.CrossRefPubMedGoogle Scholar
  31. 31.
    Kim, S. H., Kim, H. J., Lee, S. I., & Jo, M. W. (2012). Comparing the psychometric properties of the EQ-5D-3L and EQ-5D-5L in cancer patients in Korea. Quality of Life Research, 21(6), 1065–1073.CrossRefPubMedGoogle Scholar
  32. 32.
    Pattanaphesaj, J., & Thavorncharoensap, M. (2015). Measurement properties of the EQ-5D-5L compared to EQ-5D-3L in the Thai diabetes patients. Health and Quality of Life Outcomes, 13, 14.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Pickard, A. S., Wilke, C. T., Lin, H. W., & Lloyd, A. (2007). Health utilities using the EQ-5D in studies of cancer. Pharmacoeconomics, 25(5), 365–384.CrossRefPubMedGoogle Scholar
  34. 34.
    Sakthong, P., Sonsa-Ardjit, N., Sukarnjanaset, P., & Munpan, W. (2015). Psychometric properties of the EQ-5D-5L in Thai patients with chronic diseases. Quality of Life Research, 24(12), 3015–3022.CrossRefPubMedGoogle Scholar
  35. 35.
    Scalone, L., Ciampichini, R., Fagiuoli, S., Gardini, I., Fusco, F., Gaeta, L., et al. (2013). Comparing the performance of the standard EQ-5D 3L with the new version EQ-5D 5L in patients with chronic hepatic diseases. Quality of Life Research, 22(7), 1707–1716.CrossRefPubMedGoogle Scholar
  36. 36.
    Ali, F. M., Cueva, A. C., Vyas, J., Atwan, A. A., Salek, M. S., Finlay, A. Y., et al. (2017). A systematic review of the use of quality-of-life instruments in randomized controlled trials for psoriasis. British Journal of Dermatology, 176(3), 577–593.CrossRefPubMedGoogle Scholar
  37. 37.
    Dubois Declercq, S., & Pouliot, R. (2013). Promising new treatments for psoriasis. Scientific World Journal, 2013, 980419.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Ritchlin, C. T., & Krueger, J. G. (2016). New therapies for psoriasis and psoriatic arthritis. Current Opinion in Rheumatology, 28(3), 204–210.CrossRefPubMedGoogle Scholar
  39. 39.
    Yang, Y., Brazier, J., & Longworth, L. (2015). EQ-5D in skin conditions: an assessment of validity and responsiveness. The European Journal of Health Economics, 16(9), 927–939.CrossRefPubMedGoogle Scholar
  40. 40.
    Fredriksson, T., & Pettersson, U. (1978). Severe psoriasis–oral therapy with a new retinoid. Dermatologica, 157(4), 238–244.CrossRefPubMedGoogle Scholar
  41. 41.
    van Hout, B., Janssen, M. F., Feng, Y. S., Kohlmann, T., Busschbach, J., Golicki, D., et al. (2012). Interim scoring for the EQ-5D-5L: mapping the EQ-5D-5L to EQ-5D-3L value sets. Value Health, 15(5), 708–715.CrossRefPubMedGoogle Scholar
  42. 42.
    Dolan, P. (1997). Modeling valuations for EuroQol health states. Medical Care, 35(11), 1095–1108.CrossRefPubMedGoogle Scholar
  43. 43.
    Devlin, N., Shah, K., Feng, Y., Mulhern, B., & van Hout, B. (2016). Valuing health-related quality of life: An EQ-5D-5L value set for England. Research Paper 16/01. Retrieved March 27 2017 from https://eq-5dpublications.euroqol.org/download?id=0_60043&fileId=59836.
  44. 44.
    Rencz, F., Gulacsi, L., Drummond, M., Golicki, D., Prevolnik Rupel, V., Simon, J., et al. (2016). EQ-5D in central and eastern europe: 2000–2015. Quality of Life Research, 25(11), 2693–2710.CrossRefPubMedGoogle Scholar
  45. 45.
    Finlay, A. Y., & Khan, G. K. (1994). Dermatology life quality index (DLQI)–a simple practical measure for routine clinical use. Clinical and Experimental Dermatology, 19(3), 210–216.CrossRefPubMedGoogle Scholar
  46. 46.
    Basra, M. K., Fenech, R., Gatt, R. M., Salek, M. S., & Finlay, A. Y. (2008). The dermatology life quality index 1994–2007: A comprehensive review of validation data and clinical results. British Journal of Dermatology, 159(5), 997–1035.PubMedGoogle Scholar
  47. 47.
    Lewis, V., & Finlay, A. Y. (2004). 10 years experience of the Dermatology Life Quality Index (DLQI). Journal of Investigative Dermatology Symposium Proceedings, 9(2), 169–180.CrossRefGoogle Scholar
  48. 48.
    Hagg, D., Sundstrom, A., Eriksson, M., & Schmitt-Egenolf, M. (2015). Decision for biological treatment in real life is more strongly associated with the psoriasis area and severity index (PASI) than with the dermatology life quality index (DLQI). Journal of the European Academy of Dermatology and Venereology, 29(3), 452–456.CrossRefPubMedGoogle Scholar
  49. 49.
    Pathirana, D., Ormerod, A. D., Saiag, P., Smith, C., Spuls, P. I., Nast, A., et al. (2009). European S3-guidelines on the systemic treatment of psoriasis vulgaris. Journal of the European Academy of Dermatology and Venereology, 23(Suppl 2), 1–70.CrossRefPubMedGoogle Scholar
  50. 50.
    Wakkee, M., Thio, H. B., Spuls, P. I., de Jong, E. M., & Nijsten, T. (2008). Evaluation of the reimbursement criteria for biological therapies for psoriasis in the Netherlands. British Journal of Dermatology, 158(5), 1159–1161.CrossRefPubMedGoogle Scholar
  51. 51.
    Mrowietz, U., Kragballe, K., Reich, K., Spuls, P., Griffiths, C. E. M., Nast, A., et al. (2011). Definition of treatment goals for moderate to severe psoriasis: a European consensus. Archives of Dermatological Research, 303(1), 1–10.CrossRefPubMedGoogle Scholar
  52. 52.
    Rencz, F., Baji, P., Gulacsi, L., Karpati, S., Pentek, M., Poor, A. K., et al. (2016). Discrepancies between the dermatology life quality index and utility scores. Quality of Life Research, 25(7), 1687–1696.CrossRefPubMedGoogle Scholar
  53. 53.
    Rencz, F., Kemeny, L., Gajdacsi, J. Z., Owczarek, W., Arenberger, P., Tiplica, G. S., et al. (2015). Use of biologics for psoriasis in Central and Eastern European countries. Journal of the European Academy of Dermatology and Venereology, 29(11), 2222–2230.CrossRefPubMedGoogle Scholar
  54. 54.
    Gottlieb, A. B., & Armstrong, A. W. (2013). Psoriasis outcome measures: a report from the GRAPPA 2012 annual meeting. Journal of Rheumatology, 40(8), 1428–1433.CrossRefPubMedGoogle Scholar
  55. 55.
    Mease, P. J. (2011). Measures of psoriatic arthritis: Tender and swollen joint assessment, psoriasis area and severity index (PASI), nail psoriasis severity index (NAPSI), modified nail psoriasis severity index (mNAPSI), Mander/Newcastle enthesitis index (MEI), leeds enthesitis index (LEI), spondyloarthritis research consortium of Canada (SPARCC), Maastricht ankylosing spondylitis enthesis score (MASES), Leeds dactylitis index (LDI), patient global for psoriatic arthritis, dermatology life quality index (DLQI), psoriatic arthritis quality of life (PsAQOL), functional assessment of chronic illness therapy-fatigue (FACIT-F), psoriatic arthritis response criteria (PsARC), psoriatic arthritis joint activity index (PsAJAI), disease activity in psoriatic arthritis (DAPSA), and composite psoriatic disease activity index (CPDAI). Arthritis Care Research, 63(Suppl 11), S64–S85.CrossRefPubMedGoogle Scholar
  56. 56.
    Janssen, M. F., Birnie, E., & Bonsel, G. J. (2007). Evaluating the discriminatory power of EQ-5D, HUI2 and HUI3 in a US general population survey using Shannon’s indices. Quality of Life Research, 16(5), 895–904.CrossRefPubMedCentralGoogle Scholar
  57. 57.
    Shannon, C. E. (1948). The mathematical theory of communication. The Bell System Technical Journal, 27, 379–423.CrossRefGoogle Scholar
  58. 58.
    Shannon, C. E., & Weaver, W. (1949). The Mathematical Theory of Communication (pp. 104–107). Urbana: University of Illinois Press.Google Scholar
  59. 59.
    Swinscow, T., & Campbell, M. (2002). Statistics at square one. London, United Kingdom: BMJ.Google Scholar
  60. 60.
    Heredi, E., Rencz, F., Balogh, O., Gulacsi, L., Herszenyi, K., Hollo, P., et al. (2014). Exploring the relationship between EQ-5D, DLQI and PASI, and mapping EQ-5D utilities: A cross-sectional study in psoriasis from Hungary. The European Journal of Health Economics, 15(Suppl 1), S111–S119.CrossRefPubMedGoogle Scholar
  61. 61.
    Moradi, M., Rencz, F., Brodszky, V., Moradi, A., Balogh, O., & Gulacsi, L. (2015). Health status and quality of life in patients with psoriasis: An Iranian cross-sectional survey. Archives of Iranian Medicine, 18(3), 153–159.PubMedGoogle Scholar
  62. 62.
    Rencz, F., Brodszky, V., Péntek, M., Balogh, O., Remenyik, É., Szegedi, A., et al. (2014). Disease burden of psoriasis associated with psoriatic arthritis in Hungary. Orvosi Hetilap, 155(48), 1913–1921.CrossRefPubMedGoogle Scholar
  63. 63.
    Rencz, F., Hollo, P., Karpati, S., Pentek, M., Remenyik, E., Szegedi, A., et al. (2015). Moderate to severe psoriasis patients’ subjective future expectations regarding health-related quality of life and longevity. Journal of the European Academy of Dermatology and Venereology, 29(7), 1398–1405.CrossRefPubMedGoogle Scholar
  64. 64.
    Janssen, B., Lloyd, A., & Wailoo, A. (2016). Increasing EuroQol (EQ-5D) from 3 to 5 levels: implications for users—Does “new” mean “better”?, Congress: ISPOR 19th Annual European Congress. Vienna, Austria, Oct 29–Nov 2, 2016. Retrieved March 26, 2017 from https://www.ispor.org/Event/ReleasedPresentations/2016Vienna
  65. 65.
    Versteegh, M. M., Vermeulen, K. M., Evers, S. M. A. A., de Wit, G. A., Prenger, R., & Stolk, E. A. (2016). Dutch tariff for the five-level version of EQ-5D. Value Health, 19(4), 343–352.CrossRefGoogle Scholar
  66. 66.
    Puzenat, E., Bronsard, V., Prey, S., Gourraud, P. A., Aractingi, S., Bagot, M., et al. (2010). What are the best outcome measures for assessing plaque psoriasis severity? A systematic review of the literature. Journal of the European Academy of Dermatology and Venereology, 24(Suppl 2), 10–16.CrossRefPubMedGoogle Scholar
  67. 67.
    Nast, A., & Schmitt, J. (2013). Physician Global Assessment (PGA) and Psoriasis Area and Severity Index (PASI): why do both? A systematic analysis of randomized controlled trials of biologic agents for moderate to severe plaque psoriasis. Journal of the American Academy of Dermatology, 68(6), 1040–1041.CrossRefPubMedGoogle Scholar
  68. 68.
    Blome, C., Beikert, F. C., Rustenbach, S. J., & Augustin, M. (2013). Mapping DLQI on EQ-5D in psoriasis: transformation of skin-specific health-related quality of life into utilities. Archives of Dermatological Research, 305(3), 197–204.CrossRefPubMedGoogle Scholar
  69. 69.
    Norlin, J. M., Steen Carlsson, K., Persson, U., & Schmitt-Egenolf, M. (2012). Analysis of three outcome measures in moderate to severe psoriasis: a registry-based study of 2450 patients. British Journal of Dermatology, 166(4), 797–802.CrossRefPubMedGoogle Scholar
  70. 70.
    Szende, A., & Nemeth, R. (2003). Health-related quality of life of the Hungarian population. Orvosi Hetilap, 144(34), 1667–1674.PubMedGoogle Scholar
  71. 71.
    Baji, P., Brodszky, V., Rencz, F., Boncz, I., Gulacsi, L., & Pentek, M. (2015). Health status of the Hungarian population between 2000-2010. Orvosi Hetilap, 156(50), 2035–2044.CrossRefPubMedGoogle Scholar
  72. 72.
    Gudjonsson, J. E., & Elder, J. T. (2007). Psoriasis: epidemiology. Clinics in Dermatology, 25(6), 535–546.CrossRefPubMedGoogle Scholar
  73. 73.
    Hungarian Central Statistical Office. Population by education and age group. (2011). Retrieved March 26, 2017 from http://www.ksh.hu/nepszamlalas/docs/tables/regional/01/01_1_1_4_1_en.xls
  74. 74.
    Hagg, D., Eriksson, M., Sundstrom, A., & Schmitt-Egenolf, M. (2013). The higher proportion of men with psoriasis treated with biologics may be explained by more severe disease in men. PLoS ONE, 8(5), e63619.CrossRefPubMedPubMedCentralGoogle Scholar
  75. 75.
    Kojanova, M., Fialova, J., Cetkovska, P., Gkalpakiotis, S., Jircikova, J., Dolezal, T., et al. (2017). Characteristics and risk profile of psoriasis patients included in the Czech national registry BIOREP and a comparison with other registries. International Journal of Dermatology, 56(4), 428–434.CrossRefPubMedGoogle Scholar
  76. 76.
    Swinburn, P., Lloyd, A., Boye, K. S., Edson-Heredia, E., Bowman, L., & Janssen, B. (2013). Development of a disease-specific version of the EQ-5D-5L for use in patients suffering from psoriasis: lessons learned from a feasibility study in the UK. Value Health, 16(8), 1156–1162.CrossRefPubMedGoogle Scholar
  77. 77.
    Pickard, A. S., Gooderham, M., Hartz, S., & Nicolay, C. (2017). EQ-5D health utilities: exploring ways to improve upon responsiveness in psoriasis. Journal of Medical Economics, 20(1), 19–27.CrossRefPubMedGoogle Scholar
  78. 78.
    Buchholz, I., Thielker, K., Feng, Y. S., Kupatz, P., & Kohlmann, T. (2015). Measuring changes in health over time using the EQ-5D 3L and 5L: a head-to-head comparison of measurement properties and sensitivity to change in a German inpatient rehabilitation sample. Quality of Life Research, 24(4), 829–835.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Dermatology, Venereology and DermatooncologySemmelweis UniversityBudapestHungary
  2. 2.Department of Health EconomicsCorvinus University of BudapestBudapestHungary
  3. 3.Doctoral School of Business and ManagementCorvinus University of BudapestBudapestHungary

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