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A head-to-head comparison of five-level (EQ-5D-5L-Y) and three-level EQ-5D-Y questionnaires in paediatric patients

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Abstract

Purpose

The aim of this study was to assess the psychometric properties of a youth version of the EQ-5D five-level questionnaire (5LY) and its three-level version (3LY) in a sample of Chinese paediatric patients.

Methods

A consecutive sample of idiopathic scoliosis patients were recruited from a referral outpatient scoliosis center at Hong Kong, China in October 2017 and completed the two versions of EQ-5D-Y. Redistribution properties in each dimension of EQ-5D-Y were analyzed between 5LY and 3LY by logistics regressions. Absolute reduction and relative reduction in ceiling effects from the 3LY to the 5LY were calculated. Test–retest reliability was assessed by examining the Gwet’s agreement coefficient (Gwet’s AC) for five individual dimension responses over the 2-week period.

Results

A total of 129 idiopathic scoliosis patients completed the two versions of EQ-5D-Y at baseline assessment, among which 70 patients completed the test–retest interview in 2–3 weeks after baseline assessment. For redistribution properties, the proportion of inconsistency was low in all the dimensions, ranging from 0.0% (“Usual activities”) to 3.9% (“Pain/discomfort”). Ceiling effects were reduced in four dimensions. “Usual activities” dimension showed significant reduction (absolute and relative reductions: 3.9% and 4.3%; p = 0.025) and the “worried/sad/unhappy” dimension showed the largest significant reduction in ceiling effects (absolute and relative reductions: 7.8% and 9.8%; p = 0.012). The 3LY and 5LY showed very good agreement (> 80%) of individual dimension responses between two assessments, except for the “worried/sad/unhappy” dimension in 3LY.

Conclusion

Through this head-to-head comparison, the 5LY had significant improvements in ceiling effects in two dimensions when compared to 3LY but other measurement properties of 3LY and 5LY performed similar in the idiopathic scoliosis patient group.

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References

  1. Herdman, M., Gudex, C., Lloyd, A., Janssen, M.F., Kind, P., Parkin, D., Bonsel, G., Badia, X.: Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual. Life Res. 20, 1727–1736 (2011)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Janssen, M.F., Birnie, E., Haagsma, J.A., Bonsel, G.J.: Comparing the standard EQ-5D three-level system with a five-level version. Value Health 11, 275–284 (2008)

    Article  Google Scholar 

  3. Kim, S.H., Kim, H.J., Lee, S.I., Jo, M.W.: Comparing the psychometric properties of the EQ-5D-3L and EQ-5D-5L in cancer patients in Korea. Qual. Life Res. 21, 1065–1073 (2012)

    Article  PubMed  Google Scholar 

  4. Yfantopoulos, J., Chantzaras, A., Kontodimas, S.: Assessment of the psychometric properties of the EQ-5D-3L and EQ-5D-5L instruments in psoriasis. Arch. Dermatol. Res. 309, 357–370 (2017)

    Article  PubMed  Google Scholar 

  5. Janssen, M.F., Bonsel, G.J., Luo, N.: Is EQ-5D-5L better than EQ-5D-3L? A head-to-head comparison of descriptive systems and value sets from seven countries. PharmacoEconomics 38, 675–697 (2018)

    Article  Google Scholar 

  6. Janssen, M.F., Pickard, A.S., Golicki, D., Gudex, C., Niewada, M., Scalone, L., Swinburn, P., Busschbach, J.: Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups: a multi-country study. Qual. Life Res. 22, 1717–1727 (2013)

    Article  CAS  PubMed  Google Scholar 

  7. Ravens-Sieberer, U., Wille, N., Badia, X., Bonsel, G., Burström, K., Cavrini, G., Devlin, N., Egmar, A.-C., Gusi, N., Herdman, M., et al.: Feasibility, reliability, and validity of the EQ-5D-Y: results from a multinational study. Qual. Life Res. 19, 887–897 (2010)

    Article  PubMed  PubMed Central  Google Scholar 

  8. Wille, N., Badia, X., Bonsel, G., Burström, K., Cavrini, G., Devlin, N., Egmar, A.-C., Greiner, W., Gusi, N., Herdman, M., et al.: Development of the EQ-5D-Y: a child-friendly version of the EQ-5D. Qual. Life Res. 19, 875–886 (2010)

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kreimeier, S., Åström, M., Burström, K., Egmar, A., Gusi, N., Herdman, M., Kind, P., Oppe, M., Sousa, M.P., Greiner, W.: Extension of the labels within the Eq-5d-Y. Value Health 19, A480 (2016)

    Article  Google Scholar 

  10. Burström, K., Bartonek, Å, Broström, E.W., Sun, S., Egmar, A.C.: EQ-5D-Y as a health-related quality of life measure in children and adolescents with functional disability in Sweden: testing feasibility and validity. Acta Paediatr. 103, 426–435 (2014)

    Article  PubMed  Google Scholar 

  11. Chen, G., Flynn, T., Stevens, K., Brazier, J., Huynh, E., Sawyer, M., Roberts, R., Ratcliffe, J.: Assessing the health-related quality of life of Australian adolescents: an empirical comparison of the child health utility 9D and EQ-5D-Y instruments. Value Health 18, 432–438 (2015)

    Article  PubMed  Google Scholar 

  12. Chen, G., Ratcliffe, J.: A review of the development and application of generic multi-attribute utility instruments for paediatric populations. PharmacoEconomics 33, 1013–1028 (2015)

    Article  PubMed  Google Scholar 

  13. Åström, M., Persson, C., Lindén-Boström, M., Rolfson, O., Burström, K.: Population health status based on the EQ-5D-Y-3L among adolescents in Sweden: results by sociodemographic factors and self-reported comorbidity. Qual. Life Res. 27, 2859–2871 (2018)

    Article  PubMed  PubMed Central  Google Scholar 

  14. Lonstein, J.E.: Adolescent idiopathic scoliosis. Lancet 344, 1407–1412 (1994)

    Article  CAS  PubMed  Google Scholar 

  15. Cheung, J.P., Cheung, P.W., Wong, C.K., Samartzis, D., Luk, K.D., Lam, C.L., Cheung, K.M.: Psychometric validation of the traditional Chinese version of the early onset scoliosis-24 item questionnaire (EOSQ-24). Spine (Phila Pa 1976) 41, E1460–E1469 (2016)

    Article  Google Scholar 

  16. Cheung, K.M., Cheung, J.P., Samartzis, D., Mak, K.C., Wong, Y.W., Cheung, W.Y., Akbarnia, B.A., Luk, K.D.: Magnetically controlled growing rods for severe spinal curvature in young children: a prospective case series. Lancet 379, 1967–1974 (2012)

    Article  PubMed  Google Scholar 

  17. Cheung, P.W.H., Wong, C.K.H., Samartzis, D., Luk, K.D.K., Lam, C.L.K., Cheung, K.M.C., Cheung, J.P.Y.: Psychometric validation of the EuroQoL 5-dimension 5-level (EQ-5D-5L) in Chinese patients with adolescent idiopathic scoliosis. Scoliosis Spinal Disord 11, 19 (2016)

    Article  PubMed  PubMed Central  Google Scholar 

  18. Cheung, J.P., Cheung, P.W., Samartzis, D., Cheung, K.M., Luk, K.D.: The use of the distal radius and ulna classification for the prediction of growth: peak growth spurt and growth cessation. Bone Joint J 98-B, 1689–1696 (2016)

    Article  CAS  PubMed  Google Scholar 

  19. Cheung, J.P.Y., Yiu, K.K.L., Vidyadhara, S., Chan, P.P.Y., Cheung, P.W.H., Mak, K.C.: Predictability of supine radiographs for determining in-brace correction for adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 43, 971–976 (2018)

    Article  Google Scholar 

  20. Eyvazov, K., Samartzis, D., Cheung, J.P.: The association of lumbar curve magnitude and spinal range of motion in adolescent idiopathic scoliosis: a cross-sectional study. BMC Musculoskelet. Disord. 18, 51 (2017)

    Article  PubMed  PubMed Central  Google Scholar 

  21. Terwee, C.B., Mokkink, L.B., Knol, D.L., Ostelo, R.W.J.G., Bouter, L.M., de Vet, H.C.W.: Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist. Qual. Life Res. 21, 651–657 (2012)

    Article  PubMed  Google Scholar 

  22. Pickard, A.S., Kohlmann, T., Janssen, M.F., Bonsel, G., Rosenbloom, S., Cella, D.: Evaluating equivalency between response systems: application of the Rasch model to a 3-level and 5-level EQ-5D. Med. Care 45, 812–819 (2007)

    Article  PubMed  Google Scholar 

  23. Lee, C.F., Ng, R., Luo, N., Wong, N.S., Yap, Y.S., Lo, S.K., Chia, W.K., Yee, A., Krishna, L., Wong, C.: The English and Chinese versions of the five-level EuroQoL Group’s five-dimension questionnaire (EQ-5D) were valid and reliable and provided comparable scores in Asian breast cancer patients. Support. Care Cancer 21, 201–209 (2013)

    Article  PubMed  Google Scholar 

  24. Rabin, R., Gudex, C., Selai, C., Herdman, M.: From translation to version management: a history and review of methods for the cultural adaptation of the EuroQol five-dimensional questionnaire. Value Health 17, 70–76 (2014)

    Article  Google Scholar 

  25. Gwet, K.L.: Computing inter-rater reliability and its variance in the presence of high agreement. Br J Math Stat Psychol 61, 29–48 (2008)

    Article  PubMed  Google Scholar 

  26. Adobor, R.D., Rimeslåtten, S., Keller, A., Brox, J.I.: Repeatability, reliability, and concurrent validity of the Scoliosis Research Society-22 questionnaire and EuroQol in patients with adolescent idiopathic scoliosis. Spine 35, 206–209 (2010)

    Article  PubMed  Google Scholar 

  27. Wongpakaran, N., Wongpakaran, T., Wedding, D., Gwet, K.L.: A comparison of Cohen’s kappa and Gwet’s AC1 when calculating inter-rater reliability coefficients: a study conducted with personality disorder samples. BMC Med. Res. Methodol. 13, 61 (2013)

    Article  PubMed  PubMed Central  Google Scholar 

  28. Landis, J.R., Koch, G.G.: The measurement of observer agreement for categorical data. Biometrics 33, 159–174 (1977)

    Article  CAS  Google Scholar 

  29. Shannon, C.E.: The mathematical theory of communication. MD Comput. 1997 14, 306–317 (1963)

    Google Scholar 

  30. Van Hout, B., Janssen, M., Feng, Y.-S., Kohlmann, T., Busschbach, J., Golicki, D., Lloyd, A., Scalone, L., Kind, P., Pickard, A.S.: Interim scoring for the EQ-5D-5L: mapping the EQ-5D-5L to EQ-5D-3L value sets. Value Health 15, 708–715 (2012)

    Article  PubMed  Google Scholar 

  31. Janssen, M.F.B., Birnie, E., Bonsel, G.J.: Evaluating the discriminatory power of EQ-5D, HUI2 and HUI3 in a US general population survey using Shannon’s indices. Qual. Life Res. 16, 895–904 (2007)

    Article  PubMed Central  Google Scholar 

  32. Hengwei, F., Zifang, H., Qifei, W., Weiqing, T., Nali, D., Ping, Y., Junlin, Y.: Prevalence of idiopathic scoliosis in Chinese schoolchildren: a large, population-based study. Spine 41, 259–264 (2016)

    Article  PubMed  Google Scholar 

  33. Cheung, P.W.H., Wong, C.K.H., Lau, S.T., Cheung, J.P.Y.: Responsiveness of the EuroQoL 5-dimension (EQ-5D) in adolescent idiopathic scoliosis. Eur. Spine J. 27, 278–285 (2018)

    Article  PubMed  Google Scholar 

  34. Hsu, C.N., Lin, H.W., Pickard, A.S., Tain, Y.L.: EQ-5D-Y for the assessment of health-related quality of life among Taiwanese youth with mild-to-moderate chronic kidney disease. Int. J. Qual. Health Care 30, 298–305 (2018)

    Article  PubMed  Google Scholar 

  35. Scalone, L., Ciampichini, R., Fagiuoli, S., Gardini, I., Fusco, F., Gaeta, L., Del Prete, A., Cesana, G., Mantovani, L.G.: Comparing the performance of the standard EQ-5D 3L with the new version EQ-5D 5L in patients with chronic hepatic diseases. Qual. Life Res. 22, 1707–1716 (2013)

    Article  PubMed  Google Scholar 

  36. Pattanaphesaj, J., Thavorncharoensap, M.: Measurement properties of the EQ-5D-5L compared to EQ-5D-3L in the Thai diabetes patients. Health Qual. Life Outcomes 13, 14 (2015)

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

Authors would like to thank Dr Michael Herdman, Dr Simone Kreimeier and Prof Wolfgang Greiner for their input to the development process of 5LY, and two anonymous reviewers for valuable comments and suggestions.

Funding

This work was funded by the General Research Fund (#17119518 and #17156416), Research Grant Council, Hong Kong SAR.

Author information

Authors and Affiliations

  1. Department of Family Medicine and Primary Care, The University of Hong Kong, Rm 1-01, 1/F, Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong SAR, China

    Carlos King Ho Wong

  2. Department of Orthopaedics and Traumatology, The University of Hong Kong, 5/F Professorial Block, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China

    Prudence Wing Hang Cheung & Jason Pui Yin Cheung

  3. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

    Nan Luo

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  1. Carlos King Ho Wong
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Contributions

CKHW wrote the manuscript, researched data, contributed to statistical analysis and interpretation of results. PWHC wrote the manuscript, acquisition of data and interpretation of results. NL contributed to study design, interpretation of results and reviewed/edited the manuscript. JPYC contributed to acquisition of data and reviewed/edited the manuscript. All authors approved the final version of manuscript.

Corresponding authors

Correspondence to Carlos King Ho Wong or Jason Pui Yin Cheung.

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All authors declare that they have no conflict of interest.

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

Ethical approval

Ethics approval for this study was obtained from the Institutional Review Board of the Hong Kong West Cluster of the Hospital Authority.

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Wong, C.K.H., Cheung, P.W.H., Luo, N. et al. A head-to-head comparison of five-level (EQ-5D-5L-Y) and three-level EQ-5D-Y questionnaires in paediatric patients. Eur J Health Econ 20, 647–656 (2019). https://doi.org/10.1007/s10198-018-1026-7

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  • DOI: https://doi.org/10.1007/s10198-018-1026-7

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