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Interchangeability of the EQ-5D and the SF-6D, and comparison of their psychometric properties in a spinal postoperative Spanish population

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Abstract

Objective

EuroQol-5D (EQ-5D) and Short-Form Six-Dimensions (SF-6D) are widely used to calculate quality-adjusted life-years in cost-utility analysis. The choice of the instrument could influence the results of cost-utility analysis. Our objective was to compare the psychometric properties of the EQ-5D and SF-6D in a postoperative Spanish population, as well as assess their interchangeability in a cost-utility analysis.

Design

Ambispective study.

Setting

Tertiary public hospital.

Participants

275 Spanish patients who had undergone surgery for lumbar disc herniation.

Intervention(s)

Patients completed EQ-5D-3L and Short-Form 36 (SF-36v2) questionnaires. Internal consistency, floor and ceiling effects, agreement, and construct validity (convergent validity, including dimension-to-dimension correlations, and “known groups” validity) were assessed. The Spanish tariffs were applied.

Main outcome measure(s)

Cronbach’s α coefficient, Spearman’s rank correlation coefficient, Lin’s concordance correlation coefficient, intraclass correlation coefficient and Bland–Altman plot.

Results

Main findings were: (a) lack of agreement between EQ-5D and SF-6D utilities (Lin’s concordance correlation coefficient: 0.664 [95% CI: 0.600–0.720]; the Bland–Altman plot showed a mean difference of 0.0835 and wide limits of agreement [− 0.2602–0.4272]). (b) Lack of correlation between domains that theoretically measure similar aspects of quality of life, with the exception of “pain” domain.

Conclusions

The preference-based EQ-5D and SF-6D instruments showed valid psychometric properties to assess generic outcome in a Spanish population who had undergone surgery for lumbar disc herniation; however, utility scores derived from the measures were different. Thus, these two instruments cannot be used interchangeably to perform a cost-utility analysis, and they should both be included in sensitivity analyses.

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Acknowledgements

The authors thank Fernando Andrés Petrel (Clinical Research Support Unit, General University Hospital of Albacete, Spain) for his invaluable help with the statistical analysis.

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Authors and Affiliations

  1. Department of Applied Economy, Facultad de Ciencias Económicas y Empresariales de Albacete, Universidad de Castilla La-Mancha, Pza. De la Universidad, 1, 02071, Albacete, Spain

    Carmen Selva-Sevilla

  2. Department of Neurosurgery, Complejo Hospitalario Universitario de Albacete, Albacete, Spain

    Paula Ferrara

  3. Department of Anesthesiology, Complejo Hospitalario Universitario de Albacete, Albacete, Spain

    Manuel Gerónimo-Pardo

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  1. Carmen Selva-Sevilla
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  3. Manuel Gerónimo-Pardo
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Correspondence to Carmen Selva-Sevilla.

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Selva-Sevilla, C., Ferrara, P. & Gerónimo-Pardo, M. Interchangeability of the EQ-5D and the SF-6D, and comparison of their psychometric properties in a spinal postoperative Spanish population. Eur J Health Econ 21, 649–662 (2020). https://doi.org/10.1007/s10198-020-01161-4

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