Skip to main content

Advertisement

SpringerLink
Log in

A head-to-head comparison of measurement properties of the EQ-5D-3L and EQ-5D-5L in acute myeloid leukemia patients

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to compare the measurement properties of EQ-5D-3L(3L) and EQ-5D-5L(5L) in patients with acute myeloid leukemia (AML) in China.

Methods

We consecutively recruited 168 patients with AML from three tertiary hospitals to complete two rounds of interviews using the two versions of the EQ-5D. We compared (i) the ceiling effect using the McNemar’s test, (ii) test–retest reliability using intraclass correlation coefficient (ICC) and Cohen’s weighted Kappa, (iii) convergent validity using Spearman’s rank correlation coefficient (r) and iv) discriminatory ability using F statistic and area under the receiver operating characteristics curve (AUROC) of the 5L and the 3L.

Results

The 5L descriptive system showed significantly lower ceiling effects in comparison to the 3L descriptive system (p < 0.001). While 5L showed superior reproducibility (Cohen’s weighted Kappa = 0.56–0.67 and ICC = 0.89), both instruments exhibited good test–retest reliability. Even though both 3L and 5L showed good convergent and known-groups validity, 5L showed better convergent validity and discriminatory ability.

Conclusion

The current study found both 3L and 5L to be suitable for use in AML patients. However, 5L showed superior measurement properties compared to 3L. Thus, 5L could be the preferred instrument over 3L for use in AML patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Devlin, N. J., & Brooks, R. (2017 Apr). EQ-5D and the EuroQol group: past, present and future. Applied Health Economics and Health Policy, 15(2), 127–137.

    Article  Google Scholar 

  2. Brooks, R. J. (1996). EuroQol: the current state of play. Healthy Policy, 37(1), 53–72.

    Article  CAS  Google Scholar 

  3. Group TE. (1990). EuroQol—a new facility for the measurement of health-related quality of life. Health Policy, 36, 199–208.

    Google Scholar 

  4. https://euroqol.org/eq-5d-instruments/eq-5d-3l-about/ TioE-D-LAo.

  5. https://euroqol.org/eq-5d-instruments/eq-5d-5l-about/ TioE-D-LAo.

  6. Pattanaphesaj, J., & Thavorncharoensap, M. J. H. (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(1), 14.

    Article  Google Scholar 

  7. 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.

    Article  Google Scholar 

  8. Golicki, D., Niewada, M., Karlińska, A., Buczek, J., Kobayashi, A., Janssen, M. F., et al. (2014). Comparing responsiveness of the EQ-5D-5L, EQ-5D-3L and EQ VAS in stroke patients. Quality of Life Research, 24(6), 1555–1263.

    Article  Google Scholar 

  9. Poór, A. K., Rencz, F., Brodszky, V., Gulácsi, L., Beretzky, Z., Hidvégi, B., et al. (2016). Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L in psoriasis patients. Value in Health, 19(7), A572–A573.

    Article  Google Scholar 

  10. 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), 1727–1236.

    Article  CAS  Google Scholar 

  11. Pickard, A. S., De Leon, M. C., Kohlmann, T., Cella, D., & Sarah, M. C. (2007). Psychometric comparison of the standard EQ-5D to a 5 level version in cancer patients. Rosenbloom, 45(3), 259–263.

    Google Scholar 

  12. 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.

    Article  Google Scholar 

  13. Cheng, M. J., Hourigan, C. S., & Smith, T. J. (2014). Adult acute myeloid leukemia long-term survivors. Journal of Leukemia (Los Angel), 2, 2.

    Google Scholar 

  14. van Dongen-Leunis, A., Redekop, W. K., & Uyl-de Groot, C. A. (2016). Which questionnaire should be used to measure quality-of-life utilities in patients with acute leukemia? An evaluation of the validity and interpretability of the EQ-5D-5L and preference-based questionnaires derived from the EORTC QLQ-C30. Value Health., 19(6), 834–843.

    Article  Google Scholar 

  15. Liu, G. G., Wu, H., Li, M., Chen, G., & Nan, L. J. (2014). Chinese time trade-off values for EQ-5D health states. Value in Health, 17(5), 597–604.

    Article  Google Scholar 

  16. Luo, N., Liu, G., Li, M., Guan, H., Jin, X., & Rand-Hendriksen, K. (2017 Apr). Estimating an EQ-5D-5L value set for China. Value Health, 20(4), 662–669.

    Article  Google Scholar 

  17. Fairclough, D. L., & Cella, D. F. (1996). Functional Assessment of Cancer Therapy (FACT-G): Non-response to individual questions. Quality of Life Research, 5(3), 321–329.

    Article  CAS  Google Scholar 

  18. Yu, C. L., Fielding, R., Chan, C. L., Tse, V. K., Choi, P. H., Lau, W. H., et al. (2015). Measuring quality of life of Chinese cancer patients: A validation of the Chinese version of the Functional Assessment of Cancer Therapy-General (FACT-G) scale. Multicenter Study, 88(7), 1715–1727.

    Google Scholar 

  19. Wan, C., Meng, Q., Tang, X., Zhang, C., Luo, J., & Zhang, X. (2006). Validation of cancer patient quality of life measurement scale FACT-G Chinese version. Journal of Practical Oncology, 21(1), 77–80.

    Google Scholar 

  20. Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.

    Article  CAS  Google Scholar 

  21. Marziliano, A., Pessin, H., Rosenfeld, B., & Breitbart, W. (2018). Measuring cohesion and self-disclosure in psychotherapy groups for patients with advanced cancer: An analysis of the psychometric properties of the group therapy experience scale. International Journal of Group Psychotherapy, 68(3), 407–427.

    Article  Google Scholar 

  22. Xiao, S. Y. (1994). The theoretical basis and research applications of “Social Support Rating Scale”. The Journal of Clinical Psychiatry, 4(2), 98–100.

    Google Scholar 

  23. Li, L., Liu, C., Cai, X., Yu, H., Zeng, X., Sui, M., et al. (2019 May 30). Validity and reliability of the EQ-5D-5 L in family caregivers of leukemia patients. BMC Cancer, 19(1), 522.

    Article  CAS  Google Scholar 

  24. Flowers, C., Pashos, C. L., Weiss, M. A., Lamanna, N., Farber, C. M., Kipps, T. J., et al. (2011). Variation in health-related quality of life (HRQOL) by ECOG performance status (PS) and fatigue among patients with chronic lymphocytic leukemia (CLL). Journal of Clinical Oncology. https://doi.org/10.1200/jco.2012.30.15_suppl.6122.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Efficace, F., Rosti, G., Aaronson, N., Cottone, F., Angelucci, E., Molica, S., et al. (2014 Apr). Patient- versus physician-reporting of symptoms and health status in chronic myeloid leukemia. Haematologica, 99(4), 788–793.

    Article  Google Scholar 

  26. Terwee, C. B., Bot, S. D., de Boer, M. R., van der Windt, D. A., Knol, D. L., Dekker, J., et al. (2007 Jan). Quality criteria were proposed for measurement properties of health status questionnaires. Journal of Clinical Epidemiology, 60(1), 34–42.

    Article  Google Scholar 

  27. 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.

    Article  Google Scholar 

  28. Cohen, J. (2013). Statistical power analysis for the behavioral sciences. London: Routledge.

    Book  Google Scholar 

  29. Yfantopoulos, J. N., & Chantzaras, A. E. (2017 May). 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(4), 519–531.

    Article  Google Scholar 

  30. Janssen, M. F., Bonsel, G. J., & Luo, N. (2018 Jun). Is EQ-5D-5L better than EQ-5D-3L? A head-to-head comparison of descriptive systems and value sets from seven countries. Pharmacoeconomics., 36(6), 675–697.

    Article  Google Scholar 

  31. Vickrey, B. G., Hays, R. D., Genovese, B. J., Myers, L. W., & Ellison, G. W. (1997). Comparison of a generic to disease-targeted health-related quality-of-life measures for multiple sclerosis. Journal of Clinical Epidemiology, 50(5), 557–569.

    Article  CAS  Google Scholar 

  32. Pickard, A. S., Ray, S., Ganguli, A., & Cella, D. (2012). Comparison of FACT- and EQ-5D-based utility scores in cancer. Value Health, 15(2), 305–311.

    Article  Google Scholar 

  33. Huang, I. C., Willke, R. J., Atkinson, M. J., Lenderking, W. R., Frangakis, C., & Wu, A. W. (2007). US and UK versions of the EQ-5D preference weights: does choice of preference weights make a difference? Quality of Life Research, 16(6), 1065–1072.

    Article  Google Scholar 

  34. Hays, R. D., Anderson, R., & Revicki, D. (1993). Psychometric considerations in evaluating health-related quality of life measures. Quality of Life Research., 2(6), 441–449.

    Article  CAS  Google Scholar 

  35. Petrou, S., Morrell, J., & Spiby, H. (2009 May). Assessing the empirical validity of alternative multi-attribute utility measures in the maternity context. Health Qual Life Outcomes., 6(7), 40.

    Article  Google Scholar 

  36. Petrou, S., & Hockley, C. (2005 Nov). An investigation into the empirical validity of the EQ-5D and SF-6D based on hypothetical preferences in a general population. Health Economics, 14(11), 1169–1189.

    Article  Google Scholar 

  37. Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33(1), 159–174.

    Article  CAS  Google Scholar 

  38. Rajmil LJJoE, Health C. Health measurement scales. A practical guide to their development and use, 3rd ed. 2015;47(5):484.e1-.e1.

  39. Schwenkglenks, M., & Matter-Walstra, K. (2016). Is the EQ-5D suitable for use in oncology? An overview of the literature and recent developments. Expert Review of Pharmacoeconomics & Outcomes Research, 16(2), 207–219.

    Article  Google Scholar 

  40. Lang, H. C., Chuang, L., Shun, S. C., Hsieh, C. L., & Lan, C.-F. (2010). Validation of EQ-5D in patients with cervical cancer in Taiwan. Supportive Care in Cancer, 18(10), 1279–1286.

    Article  Google Scholar 

  41. Janssen, M. F., Pickard, A. S., Golicki, D., Gudex, C., Niewada, M., Scalone, L., et al. (2013 Sep). 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.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We are especially grateful to the study participants who have suffered from leukemia and have never given up. We also acknowledge the interviewers for helping with the data collection.

Funding

This work was supported by the National Social Science Foundation of China (Grant No. 71974048, 71503062) and by the China Medical Board (CMB-19–308).

Author information

Author notes

    Authors and Affiliations

    1. Department of Hematology, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China

      Hongjuan Yu

    2. Southern University of Science and Technology Hospital, Shenzhen, 518000, China

      Hongjuan Yu

    3. School of Health Management, Harbin Medical University, Harbin, 150086, China

      Xueyun Zeng, Mingjie Sui, Rui Liu & Weidong Huang

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

      Rachel Lee-Yin Tan & Nan Luo

    5. Bejing Tsinghua Changgung Hospital, Beijing, 102218, China

      Jinjin Yang

    Author notes

    1. Hongjuan Yu, Xueyun Zeng and Mingjie Sui contributed equally to this article. They are co-first authors.

      Authors
      1. Hongjuan Yu
        View author publications

        You can also search for this author in PubMed Google Scholar

      2. Xueyun Zeng
        View author publications

        You can also search for this author in PubMed Google Scholar

      3. Mingjie Sui
        View author publications

        You can also search for this author in PubMed Google Scholar

      4. Rui Liu
        View author publications

        You can also search for this author in PubMed Google Scholar

      5. Rachel Lee-Yin Tan
        View author publications

        You can also search for this author in PubMed Google Scholar

      6. Jinjin Yang
        View author publications

        You can also search for this author in PubMed Google Scholar

      7. Weidong Huang
        View author publications

        You can also search for this author in PubMed Google Scholar

      8. Nan Luo
        View author publications

        You can also search for this author in PubMed Google Scholar

      Contributions

      HY, XZ, MS and RL drafted the manuscript and performed the data analysis. JY, CL and JX collected the data and interpreted the results. WH, HY and HY contributed to study design as well as drafting and editing of the manuscript. RLYT and NL contributed to the reviewing and editing of the manuscript. All authors read and approved the final manuscript.

      Corresponding author

      Correspondence to Weidong Huang.

      Ethics declarations

      Conflict of interest

      NL is a member of the EuroQol group. All other authors declare no conflict of interest.

      Ethical approval

      All procedures performed in studies involving human participants were in accordance with the ethical standards and were approved by the Regional Ethical Committee, Harbin Medical University (Project Identification Code: HMUIRB2014012).

      Additional information

      Publisher's Note

      Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

      Rights and permissions

      Reprints and permissions

      About this article

      Check for updates. Verify currency and authenticity via CrossMark

      Cite this article

      Yu, H., Zeng, X., Sui, M. et al. A head-to-head comparison of measurement properties of the EQ-5D-3L and EQ-5D-5L in acute myeloid leukemia patients. Qual Life Res 30, 855–866 (2021). https://doi.org/10.1007/s11136-020-02644-w

      Download citation

      • Accepted:

      • Published:

      • Issue Date:

      • DOI: https://doi.org/10.1007/s11136-020-02644-w

      Keywords

      Search

      Navigation