Abstract
We aimed to conduct a head-to-head comparison of the five-level version of the EuroQol five-dimensional questionnaire (EQ-5D-5L) and the Assessment of Quality of Life-6D (AQoL-6D) in measuring health-related quality of life (HRQoL) of older people at risk of osteoporotic fracture. Participants (n = 291) were recruited from the Third Affiliated Hospital of Sun Yat-Sen University. Study participants were asked to complete the EQ-5D-5L and the AQoL-6D and the results were converted to health-state utilities (HSUs) using population-specific scoring algorithms. The agreement among HSUs was evaluated using the intraclass correlation coefficient and illustrated using Bland–Altman plots. The minimally important difference (MID) for the EQ-5D and AQoL was set at 0.074 and 0.06. Information on socio-demographic background, socio-economic status and clinical risk factors in FRAX® was collected. Nonparametric statistics were used to explore the known-group validity measured by fracture risk. Mean (median) EQ-5D-5L and AQoL-6D HSUs were 0.73(0.83) and 0.74(0.79) for the study population. The EQ-5D-5L and the AQoL-6D HSUs strongly agreed and the HSU difference reached the MID level in both instruments. While a decreasing trend of AQoL-6D utilities was observed with worsening bone mineral density, EQ-5D-5L HSUs were similar in individuals with normal and osteopenic bone mineral densities. The AQoL-6D was also effective for measuring difference in independent living, relationships, mental health, coping and pain. Both instruments showed good known-group validity. The EQ-5D-5L and AQoL-6D are all valid measures for older people at risk of osteoporotic fracture.
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Funding
This work is funded by the Science and Technology Planning Project of Guangdong Province, China [Grant Number 2016A020216013]. Dr Lei Si is supported by a National Health and Medical Research Council Early Career Fellowship [Grant Number GNT1139826] and a National Health and Medical Research Council (NHMRC) Project Grant (APP1127827). The funding sources had no role in the design of this study and will not have any role during its execution, analyses, interpretation of the data or decision to submit results.
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by LS, LT, GC, XZ, JL, QL and ZL. The first draft of the manuscript was written by LS and LT. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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LS, LT, YX, GC, MH, MY, YZ, XZ, YJ, QW, JG and AJP declare no conflicts of interest.
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Si, L., Tu, L., Xie, Y. et al. Evaluating Health Related Quality of Life in Older People at Risk of Osteoporotic Fracture: A Head-to-Head Comparison of the EQ-5D-5L and AQoL-6D. Soc Indic Res 160, 809–824 (2022). https://doi.org/10.1007/s11205-020-02414-8
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DOI: https://doi.org/10.1007/s11205-020-02414-8