Quality of Life Research

, Volume 26, Issue 6, pp 1493–1505 | Cite as

Framing of mobility items: a source of poor agreement between preference-based health-related quality of life instruments in a population of individuals receiving assisted ventilation

  • Liam M. Hannan
  • David G. T. Whitehurst
  • Stirling Bryan
  • Jeremy D. Road
  • Christine F. McDonald
  • David J. Berlowitz
  • Mark E. Howard
Article

Abstract

Purpose

To explore the influence of descriptive differences in items evaluating mobility on index scores generated from two generic preference-based health-related quality of life (HRQoL) instruments.

Methods

The study examined cross-sectional data from a postal survey of individuals receiving assisted ventilation in two state/province-wide home mechanical ventilation services, one in British Columbia, Canada and the other in Victoria, Australia. The Assessment of Quality of Life 8-dimension (AQoL-8D) and the EQ-5D-5L were included in the data collection. Graphical illustrations, descriptive statistics, and measures of agreement [intraclass correlation coefficients (ICCs) and Bland–Altman plots] were examined using index scores derived from both instruments. Analyses were performed on the full sample as well as subgroups defined according to respondents’ self-reported ability to walk.

Results

Of 868 individuals receiving assisted ventilation, 481 (55.4%) completed the questionnaire. Mean index scores were 0.581 (AQoL-8D) and 0.566 (EQ-5D-5L) with ‘moderate’ agreement demonstrated between the two instruments (ICC = 0.642). One hundred fifty-nine (33.1%) reported level 5 (‘I am unable to walk about’) on the EQ-5D-5L Mobility item. The walking status of respondents had a marked influence on the comparability of index scores, with a larger mean difference (0.206) and ‘slight’ agreement (ICC = 0.386) observed when the non-ambulant subgroup was evaluated separately.

Conclusions

This study provides further evidence that between-measure discrepancies between preference-based HRQoL instruments are related in part to the framing of mobility-related items. Longitudinal studies are necessary to determine the responsiveness of preference-based HRQoL instruments in cohorts that include non-ambulant individuals.

Keywords

AQoL-8D EQ-5D-5L Mobility Quality of life Respiratory insufficiency Non-invasive ventilation 

References

  1. 1.
    Terwee, C. B., Bot SDM, de Boer, M. R., van der Windt D a WM, Knol, D. L., & Dekker, J., et al. (2007). Quality criteria were proposed for measurement properties of health status questionnaires. Journal of Clinical Epidemiology, 60, 34–42.CrossRefPubMedGoogle Scholar
  2. 2.
    Brazier, J., & Deverill, M. (1999). A checklist for judging preference-based measures of health related quality of life: Learning from psychometrics. Health economics, 8, 41–51.CrossRefPubMedGoogle Scholar
  3. 3.
    National Institute for Health and Care Excellence (NICE). Process and methods guides: Guide to the methods of technology appraisal. 2013;34–5. http://publications.nice.org.uk/pmg9.
  4. 4.
    Pharmaceutical Benefits Advisory Committee. Guidelines for preparing submissions to the Pharmaceutical Benefits Advisory Committee. Version 4.5. 2015.Google Scholar
  5. 5.
    Canadian Agency for Drugs and Technologies in Health (CADTH). Guidelines for the Economic Evaluation of Health Technologies, 3rd Edition. 2006.Google Scholar
  6. 6.
    Australian Government: Department of Health and Aging. Review of Health Technology Assessment in Australia. 2009.Google Scholar
  7. 7.
    Neumann, P. J., Goldie, S. J., & Weinstein, M. C. (2000). Preference-based measures in economic evaluation in health care. Annual Review of Public Health, 21, 587–611.CrossRefPubMedGoogle Scholar
  8. 8.
    Brazier, J., Ratcliffe, J., Salomon, J. A., & Tsuchiya, A. (2007) Measuring and valuing health benefits for economic evaluation. Oxford: Oxford University Press.Google Scholar
  9. 9.
    Guyatt, G. H., Veldhuyzen Van Zanten, S. J., Feeny, D. H., & Patrick, D. L. (1989). Measuring quality of life in clinical trials: A taxonomy and review. Canadian Medical Association Journal, 140, 1441–1448.PubMedPubMedCentralGoogle Scholar
  10. 10.
    Haywood, K. L., Garratt, A. M., Dziedzic, K., & Dawes, P. T. (2002). Generic measures of health-related quality of life in ankylosing spondylitis: Reliability, validity and responsiveness. Rheumatology, 41, 1380–1387.CrossRefPubMedGoogle Scholar
  11. 11.
    Fryback, D. G., Palta, M., Cherepanov, D., Bolt, D., & Kim, J.-S. (2010). Comparison of five health-related quality-of-life indexes using Item response theory analysis. Medical Decision Making, 30, 5–15.CrossRefPubMedGoogle Scholar
  12. 12.
    Moock, J., & Kohlmann, T. (2008). Comparing preference-based quality-of-life measures: Results from rehabilitation patients with musculoskeletal, cardiovascular, or psychosomatic disorders. Quality of Life Research, 17, 485–495.CrossRefPubMedGoogle Scholar
  13. 13.
    Richardson, J., Khan, M. A., Iezzi, A., & Maxwell, A. (2014). Comparing and explaining differences in the magnitude, content, and sensitivity of utilities predicted by the EQ-5D, SF-6D, HUI 3, 15D, QWB, and AQoL-8D multiattribute utility instruments. Medical Decision Making, 35, 276–291.CrossRefPubMedGoogle Scholar
  14. 14.
    Whitehurst DGT, Bryan, S., & Lewis, M. (2011). Systematic review and empirical comparison of contemporaneous EQ-5D and SF-6D group mean scores. Medical Decision Making, 31, E34–E44.CrossRefPubMedGoogle Scholar
  15. 15.
    Brazier, J., Roberts, J., Tsuchiya, A., & Busschbach, J. (2004). A comparison of the EQ-5D and SF-6D across seven patient groups. Health Economics, 13, 873–884.CrossRefPubMedGoogle Scholar
  16. 16.
    Bryan, S., & Longworth, L. (2005). Measuring health-related utility: Why the disparity between EQ-5D and SF-6D? European Journal of Health Economics, 50, 253–260.CrossRefGoogle Scholar
  17. 17.
    Richardson J, McKie J, & Bariola E. Review and critique of health related multi attribute utility instruments [Internet]. Cent. Heal. Econ. 2011. Report No.: Research Paper 64. http://www.aqol.com.au/papers/researchpaper64.pdf.
  18. 18.
    Fisk, J. D., Brown, M. G., Sketris, I. S., Metz, L. M., Murray, T. J., & Stadnyk, K. J. (2005). A comparison of health utility measures for the evaluation of multiple sclerosis treatments. Journal of Neurology Neurosurgery and Psychiatry, 76, 58–63.CrossRefGoogle Scholar
  19. 19.
    Andresen, E. M., Gravitt, G. W., Aydelotte, M. E., & Podgorski, C. A. (1999). Limitations of the SF-36 in a sample of nursing home residents. Age and Ageing, 28, 562–566.CrossRefPubMedGoogle Scholar
  20. 20.
    Whitehurst, D. G. T., Mittmann, N., Noonan, V., Dvorak, M. F. S., & Bryan, S. (2016). Health state descriptions, valuations and individuals’ capacity to walk: A comparative evaluation of preference-based instruments in the context of spinal cord injury. Quality of Life Research, 25, 2481–2496.CrossRefPubMedGoogle Scholar
  21. 21.
    Whitehurst, D. G. T., Suryaprakash, N., Engel, L., Mittmann, N., Noonan, V. K., Dvorak MFS, et al. (2014). Perceptions of individuals living with spinal cord injury toward preference-based quality of life instruments: A qualitative exploration. Health and Quality of Life Outcomes, 12, 50.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Whitehurst, D. G. T., Engel, L., & Bryan, S. (2014). Short Form health surveys and related variants in spinal cord injury research: A systematic review. Journal of Spinal Cord Medicine, 37, 128–138.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Hays, R. D., Hahn, H., & Marshall, G. (2002). Use of the SF-36 and other health-related quality of life measures to assess persons with disabilities. Archives of Physical Medicine and Rehabilitation, 83, S4–S9.CrossRefPubMedGoogle Scholar
  24. 24.
    Richardson, J., Iezzi, A., Khan, M. A., & Maxwell, A. (2014). Validity and reliability of the assessment of quality of life (AQoL)-8D multi-attribute utility instrument. Patient, 7, 85–96.CrossRefPubMedGoogle Scholar
  25. 25.
    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, 1727–1736.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Goldstein, R. S., Psek J a, & Gort, E. H. (1995). Home mechanical ventilation. Demographics and user perspectives. Chest, 108, 1581–1586.CrossRefPubMedGoogle Scholar
  27. 27.
    Hannan, L. M., Sahi, H., Road, J. D., McDonald, C. F., Berlowitz, D. J., & Howard, M. E. (2016). Care practices and health-related quality of life for individuals receiving assisted ventilation: A cross-national study. Annals of the American Thoracic Society, 13, 894–903.CrossRefPubMedGoogle Scholar
  28. 28.
    Census.gov. (2016). https://www.census.gov/en.html. Accessed June 2016.
  29. 29.
    Hawthorne, G., Richardson, J., & Osborne, R. (1999). The assessment of quality of life (AQoL) instrument: A psychometric measure of health-related quality of life. Quality of Life Research, 8, 209–224.CrossRefPubMedGoogle Scholar
  30. 30.
    Richardson, J., Sinha, K., Iezzi, A., & Khan, M. A. (2014). Modelling utility weights for the Assessment of quality of life (AQoL)-8D. Quality of Life Research, 23, 2395–2404.CrossRefPubMedGoogle Scholar
  31. 31.
  32. 32.
  33. 33.
    Richardson, J., Iezzi, A., & Khan, M. A. (2015). Why do multi-attribute utility instruments produce different utilities: The relative importance of the descriptive systems, scale and “micro-utility” effects. Quality of Life Research, 24, 2045–2053.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Xie, F., Pullenayegum, E., Gaebel, K., Bansback, N., Bryan, S., & Ohinmaa, A., et al. (2016). A time trade-off-derived value set of the EQ-5D-5L for Canada. Medical Care, 54, 98–105.CrossRefPubMedGoogle Scholar
  35. 35.
    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. Office of Health Economics, London.Google Scholar
  36. 36.
    Bland, J. M., & Altman, D. G. (1986). Statistical methods for assessing agreement between two methods of clinical measurement. Lancet, 1, 307–310.CrossRefPubMedGoogle Scholar
  37. 37.
    Shrout, P. E., & Fleiss, J. L. (1979). Intraclass correlations: Uses in assessing rater reliability. Psychological Bulletin, 86, 420–428.CrossRefPubMedGoogle Scholar
  38. 38.
    Whitehurst DGT, Norman, R., Brazier, J. E., & Viney, R. (2014). Comparison of contemporaneous EQ-5D and SF-6D responses using scoring algorithms derived from similar valuation exercises. Value Health, 17, 570–577.CrossRefPubMedGoogle Scholar
  39. 39.
    Shrout, P. E. (1998). Measurement reliability and agreement in psychiatry. Statistical Methods in Medical Research, 7, 301–317.CrossRefPubMedGoogle Scholar
  40. 40.
    Michel, Y. A., Engel, L., Rand-Hendriksen, K., Augestad, L. A., & Whitehurst, D. G. (2016). “When I saw walking I just kind of took it as wheeling”: Interpretations of mobility-related items in generic, preference-based health state instruments in the context of spinal cord injury. Health and Quality of Life Outcomes, 14, 164.CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Grieve, R., Grishchenko, M., & Cairns, J. (2009). SF-6D versus EQ-5D: Reasons for differences in utility scores and impact on reported cost-utility. European Journal of Health Economics, 10, 15–23.CrossRefPubMedGoogle Scholar
  42. 42.
    Whitehurst DGT, & Bryan, S. (2011). Another study showing that two preference-based measures of health-related quality of life (EQ-5D and SF-6D) are not interchangeable. But why should we expect them to be? Value Health, 14, 531–538.CrossRefPubMedGoogle Scholar
  43. 43.
    Konerding, U., Moock, J., & Kohlmann, T. (2009). The classification systems of the EQ-5D, the HUI II and the SF-6D: What do they have in common? Quality of Life Research, 18, 1249–1261.CrossRefPubMedGoogle Scholar
  44. 44.
    Asada, Y. (2005). Medical technologies, nonhuman aids, human assistance, and environmental factors in the assessment of health states. Quality of Life Research, 14, 867–874.CrossRefPubMedGoogle Scholar
  45. 45.
    Bach, J. R., & Campagnolo, D. (1992). Psychosocial adjustment of post-poliomyelitis ventilator assisted individuals. Archives of Physical Medicine and Rehabilitation, 73, 934–939.PubMedGoogle Scholar
  46. 46.
    Hung, M.-C., Yan, Y.-H., Fan, P.-S., Lin, M.-S., Chen, C.-R., & Kuo, L.-C., et al. (2010). Measurement of quality of life using EQ-5D in patients on prolonged mechanical ventilation: Comparison of patients, family caregivers, and nurses. Quality of Life Research, 19, 721–727.CrossRefPubMedGoogle Scholar
  47. 47.
    Norman R, Cronin P, & Viney R. (2013) A pilot discrete choice experiment to explore preferences for EQ-5D-5L health states. Applied Health Economics and Health Policy. 11:287–98.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Liam M. Hannan
    • 1
    • 2
    • 3
    • 4
  • David G. T. Whitehurst
    • 5
    • 6
    • 7
  • Stirling Bryan
    • 7
    • 8
    • 9
  • Jeremy D. Road
    • 10
    • 11
  • Christine F. McDonald
    • 1
    • 2
    • 3
    • 4
  • David J. Berlowitz
    • 1
    • 2
    • 3
    • 4
  • Mark E. Howard
    • 1
    • 2
    • 3
    • 4
  1. 1.Institute for Breathing and SleepAustin HealthHeidelbergAustralia
  2. 2.Department of Respiratory and Sleep MedicineAustin HealthVictoriaAustralia
  3. 3.Medicine, Dentistry, and Health ScienceUniversity of MelbourneVictoriaAustralia
  4. 4.Victorian Respiratory Support ServiceAustin HealthVictoriaAustralia
  5. 5.Faculty of Health SciencesSimon Fraser UniversityBurnabyCanada
  6. 6.International Collaboration on Repair Discoveries (ICORD), Faculty of MedicineUniversity of British ColumbiaVancouverCanada
  7. 7.Centre for Clinical Epidemiology and EvaluationVancouver Coastal Health Research InstituteVancouverCanada
  8. 8.School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
  9. 9.Health Economics Research UnitUniversity of AberdeenAberdeenUK
  10. 10.Department of MedicineUniversity of British ColumbiaVancouverCanada
  11. 11.Provincial Respiratory Outreach ProgramVancouverCanada

Personalised recommendations