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Psychometric properties of the EQ-5D-5L in Thai patients with chronic diseases

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Abstract

Purpose

Due to the problem of high ceiling effects of the EQ-5D-3L, the EQ-5D-5L was developed. However, little was known about the full psychometric properties of the EQ-5D-5L. Thus, this study aimed to evaluate its practicality, reliability, validity, and responsiveness in Thai patients with chronic diseases.

Methods

One thousand one hundred and fifty-six adults taking a medicine at least 3 months were identified from three university hospitals in Bangkok, Thailand, between July 2014 and March 2015. Practicality was evaluated by administration times and ceiling effects. Test–retest reliability was assessed using weighted kappa and intraclass correlation coefficients (ICCs). Validity was tested with correlations between the EQ-5D-5L and WHOQoL-BREF and SF-12v2, and known-groups validity. Responsiveness was measured with standardized effect sizes (SES).

Results

The mean administration time was approximately 2 min, and the ceiling effect of the EQ-5D-5L index was 13.6 %. The weighted kappa values and ICC of the EQ-5D-5L were 0.48–0.61 and 0.82, respectively. Similar dimensions of the EQ-5D-5L had higher correlations with those of WHOQoL-BREF and SF-12v2. As expected, elderly, female, low-educated, unemployed, higher number of comorbidities and medicines, patients’ perception of poor disease control, and having an adverse drug reaction tended to have poorer EQ-5D-5L scores. The SES of EQ-5D-5L index and EQ-VAS were considered small (0.33–0.42) for the improved group. For the worsened group, the SES of the EQ-5D-5L index were considered small (−0.29) but that of the EQ-VAS considered large (−0.82).

Conclusions

The EQ-5D-5L was practical, reliable, valid, and responsive in Thai patients with chronic diseases.

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References

  1. Brooks, R., & EuroQoL Group. (1996). EuroQoL: The current state of play. Health Policy, 37, 53–72.

    Article  CAS  PubMed  Google Scholar 

  2. Rasanen, P., Roine, E., Sintonen, H., Semberg-Konttinen, V., Ryynanen, O. P., & Roine, R. (2006). Use of quality-adjusted life years for the estimation of effectiveness of health care: A systematic literature review. International Journal of Technology Assessment in Health Care, 22, 235–241.

    Article  PubMed  Google Scholar 

  3. Sakthong, P. (2008). Measurement of clinical-effect utility. Journal of Medical Association of Thailand, 91, S43–S52.

    Google Scholar 

  4. Brazier, J., Jones, N., & Kind, P. (1993). Testing the validity of the Euroqol and comparing it with the SF-36 health survey questionnaire. Quality of Life Research, 2, 169–180.

    Article  CAS  PubMed  Google Scholar 

  5. Kaarlola, A., Pettila, V., & Kekki, P. (2004). Performance of two measures of general health-related quality of life, the EQ-5D and the RAND-36 among critically ill patients. Intensive Care Medicine, 30, 2245–2252.

    Article  PubMed  Google Scholar 

  6. Luo, N., Chew, L. H., Fong, K. Y., Koh, D. R., Ng, S. C., Yoon, K. H., et al. (2003). Validity and reliability of the EQ-5D self-report questionnaire in English-speaking Asian patients with rheumatic diseases in Singapore. Quality of Life Research, 12, 87–92.

    Article  CAS  PubMed  Google Scholar 

  7. Marra, C. A., Woolcott, J. C., Kopec, J. A., Shojania, K., Offer, R., Brazier, J. E., et al. (2005). A comparison of generic, indirect utility measures (the HUI2, HUI3, SF-6D, and the EQ-5D0 and disease-specific instruments (the RAQoL and the HAQ) in rheumatoid arthritis. Social Science and Medicine, 60, 1571–1582.

    Article  PubMed  Google Scholar 

  8. Nowels, D., McGloin, J., Westfall, J. M., & Holcomb, S. (2005). Validation of the EQ-5D quality of life instrument in patients after myocardial infarction. Quality of Life Research, 14, 95–105.

    Article  PubMed  Google Scholar 

  9. Wu, A. W., Jacobson, D. L., Frick, K. D., Clark, R., Revicki, D. A., Freedberg, K. A., et al. (2002). Validity and responsiveness of the EuroQOL as a measure of the health-related quality of life in people enrolled in an AIDS clinical trial. Quality of Life Research, 11, 273–282.

    Article  CAS  PubMed  Google Scholar 

  10. Sakthong, P., Schommer, J. C., Gross, C. R., Prasithsirikul, W., & Sakulbumrungsil, R. (2009). Health utilities in patients with HIV/AIDS in Thailand. Value in Health, 12, 377–384.

    Article  PubMed  Google Scholar 

  11. Herdman, M., Gudex, C., Lloyd, A., Janssen, M. F., 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.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Kim, T. H., Jo, M. W., Lee, S. I., Kim, S. H., & Chung, S. M. (2013). Psychometric properties of the EQ-5D-5L in the general population of South Korea. Quality of Life Research, 22, 2245–2253.

    Article  PubMed  Google Scholar 

  13. Hinz, A., Kohlmann, T., Stobel-Rochter, Y., Zenger, M., & Brahler, E. (2014). The quality of life questionnaire EQ-5D-5L: psychometric properties and normative values for the general German population. Quality of Life Research, 23, 443–447.

    Article  PubMed  Google Scholar 

  14. Kim, T. H., Kim, S. H., 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, 1065–1073.

    Article  PubMed  Google Scholar 

  15. Scalone, L., Coampichini, R., Fagiouli, 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, 1707–1716.

    Article  PubMed  Google Scholar 

  16. Golicki, D., Niewada, M., Buczek, J., Karlinska, A., 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,. doi:10.1007/s11136-014-0873-7.

    Google Scholar 

  17. Golicki, D., Niewada, M., Buczek, J., Karlinska, A., Kobayashi, A., Janssen, M. F., et al. (2015). Validity of EQ-5D-5L in stroke. Quality of Life Research, 24, 845–850.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Garcia-Gordillo, M. A., Pozo-Cruz, B. D., Adsuar, J. C., Sanchez-Martinez, F. I., & Abelian-Perpinan, J. M. (2014). Validation and comparison of the 15-D and EQ-5D-5L instruments in a Spanish Parkinson’s disease population sample. Quality of Life Research, 23, 1315–1326.

    Article  PubMed  Google Scholar 

  19. Tran, B. X., Ohinmaa, A., & Nguyen, L. T. (2012). Quality of life profile and psychometric properties of the EQ-5D-5L in HIV/AIDS patients. Health and Quality of life Outcomes, 10, 132.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Agborsangaya, C. B., Lahtinen, M., Cooke, T., & Johnson, J. A. (2014). Comparing the EQ-5D 3L and 5L: Measurement properties and association with chronic conditions and multimorbidity in the general population. Health and Quality of life Outcomes, 12, 74.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Pattanaphesaj, J. (2014). Health related quality of life measure (EQ-5D-5L): Measurement property testing and its preference-based score in Thai population. Dissertation, Mahidol University, Bangkok.

  22. Pattanaphesaj, J., & Thavorncharoensap, M. (2015). Measurement properties of the EQ-5D-5L compared to EQ-5D-3L in Thai diabetes patients. Health and Quality of life Outcomes, 13, 14.

    Article  PubMed Central  PubMed  Google Scholar 

  23. WHOQOL Group. (1998). The World Health Organization Quality of Life assessment instrument (WHOQOL): Development and general psychometric properties. Social Science and Medicine, 46, 1569–1585.

    Article  Google Scholar 

  24. WHOQOL Group. (1998). Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychological Medicine, 28, 551–558.

    Article  Google Scholar 

  25. Mahatnirunkul, S., Tuntipivatanakul, W., & Pumpisanchai, W. (1998). Comparison of the WHOQOL-100 and the WHOQOL-BREF (26 items). Journal of Mental Health Thai, 5, 4–15.

    Google Scholar 

  26. Nunnally, J. C, Jr. (1998). Psychometric theory (2nd ed.). New York: McGraw-Hill.

    Google Scholar 

  27. Ware, J. E., Kosinski, M., & Dewey, J. E. (2000). How to score version two of the SF-36 health survey. Lincoln, RI: Quality Metric, Incorporated.

    Google Scholar 

  28. Ware, J. E., Kosinski, M., Turner-Bowker, D., & Gandek, B. (2002). How to score version 2 of the SF-12 health survey. Lincoln, RI: Quality Metric, Incorporated.

    Google Scholar 

  29. Rosner, B. (2000). Fundamental of Biostatistics (5th ed.). Pacific Grove, CA: Duxbury Thomson Learning.

    Google Scholar 

  30. Fleiss, J. L., Levin, B., & Paik, M. C. (2013). Statistical methods for rates and proportions. New Jersey: Wiley.

    Google Scholar 

  31. Naranjo, C. A., Busto, U., Sellers, E. M., Sandor, P., Ruiz, I., Roberts, E. A., et al. (1981). A method for estimating the probability of adverse drug reactions. Clinical Pharmacology and Therapeutics, 30, 239–245.

    Article  CAS  PubMed  Google Scholar 

  32. Cohen, P. (1983). Applied multiple regression/correlation analysis for the behavioral sciences (2nd ed.). New Jersey: Lawrence Erlbaum Associates.

    Google Scholar 

  33. Sakthong, P., Sakulbumrungsil, R., & Chabunthom, R. (2008). A comparison of EQ-5D index scores using the UK, US, and Japan preference weights in a Thai sample with type 2 diabetes. Health and Quality of Life Outcomes, 6, 71.

    Article  PubMed Central  PubMed  Google Scholar 

  34. Sakthong, P., & Kasemsup, V. (2012). Health utility measured with EQ-5D in Thai patients undergoing peritoneal dialysis. Value in Health, 15, S79–S84.

    Article  PubMed  Google Scholar 

  35. Saiguay, W., & Sakthong, P. (2013). The psychometric testing of the Thai version of the health utilities index in patients with ischemic heart disease. Quality of Life Research, 22, 1753–1759.

    Article  PubMed  Google Scholar 

  36. Maindal, H. T., Sokolowski, I., & Vedsted, P. (2009). Translation, adaptation and validation of the American short form Patient Activation Measure (PAM13) in a Danish version. BMC Public Health, 9, 209.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

This study was funded by Thailand Research Fund, Chulalongkorn University and Faculty of Pharmaceutical Sciences, Chulalongkorn University (Grant Number: RSA 5580035). The authors would like to thank all patients for their participation in the study and the hospital staff for assistance with the data collection.

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Correspondence to Phantipa Sakthong.

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Sakthong, P., Sonsa-ardjit, N., Sukarnjanaset, P. et al. Psychometric properties of the EQ-5D-5L in Thai patients with chronic diseases. Qual Life Res 24, 3015–3022 (2015). https://doi.org/10.1007/s11136-015-1038-z

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  • DOI: https://doi.org/10.1007/s11136-015-1038-z

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