Quality of Life Research

, Volume 26, Issue 6, pp 1493–1505

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

DOI: 10.1007/s11136-017-1510-z

Cite this article as:
Hannan, L.M., Whitehurst, D.G.T., Bryan, S. et al. Qual Life Res (2017) 26: 1493. doi:10.1007/s11136-017-1510-z

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 

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

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