Abstract
BACKGROUND: The EuroQol-5 Dimension (EQ-5D), developed in 1990, is a most widely used generic tool to measure the health-related quality of life (HRQoL) and considered suitable for patients with asthma. In 2009, the EuroQol Group developed a new EQ-5D version to overcome limitations related to its consistently reported high ceiling effect. To enhance the sensitivity for assessing the HRQoL in further patient populations, the number of responses of EQ-5D was increased from 3 to 5 levels (EQ-5D-5L). Moreover, the availability of well-defined requirements for its Web-based administration allows EQ-5D-5L use to monitor the HRQoL in electronic health (eHealth) programs. No study has evaluated the metric properties of the new EQ-5D-5L in patients with asthma yet.
OBJECTIVE: This study aims to examine the distribution, construct validity, and reliability of the new EQ-5D-5L questionnaire administered online to adults with asthma.
METHODS: We evaluated patients with asthma (age: 18-40 years) from a primary care setting in France and England, who self-completed the EQ-5D-5L questionnaire online. The inclusion criteria were persistent asthma defined as >6 months of prescribed inhaled corticosteroids and long-acting beta-agonists or inhaled corticosteroids alone during the 12 months prior to inclusion. The EQ-5D index was obtained by applying the English preference value set for the new EQ-5D-5L and the French 3L-5L crosswalk value set. Both value sets produced single preference-based indices ranging from 1 (best health state) to negative values (health states valued as worse than death), where 0=death, allowing the calculation of quality-adjusted life years. Responses to dimensions and index distribution, including ceiling and floor effects, were examined. The construct validity was assessed by comparing the means of known groups by analyses of variance and calculation of effect sizes.
RESULTS: Of 312 patients answering the baseline Web-based survey, 290 completed the EQ-5D-5L (93%). The floor effect was null, and the ceiling effect was 26.5% (74/279). The mean EQ-5D-5L index was 0.88 (SD 0.14) with the English value set and 0.83 (SD 0.19) with the French 3L-5L crosswalk value set. In both indices, large effect sizes were observed for known groups defined by the Asthma Control Questionnaire (1.06 and 1.04, P<.001). Differences between extreme groups defined by chronic conditions (P=.002 and P=.003 for the English value set and French 3L-5L crosswalk value set, respectively), short-acting beta-agonists (SABAs) canisters in the last 12 months (P=.02 and P=.03), or SABA use during the previous 4 weeks (P=.03 and P=.01) were of moderate magnitude with effect sizes around 0.5.
CONCLUSIONS: The new EQ-5D-5L questionnaire has an acceptable ceiling effect, a good construct validity based on the discriminant ability for distinguishing among health-related known groups, and high reliability, supporting its adequacy for assessing the HRQoL in patients with asthma. EQ-5D-5L completion by most Web-based respondents supports the feasibility of this administration form.
| Original language | English |
|---|---|
| Article number | e10178 |
| Journal | Journal of Medical Internet Research |
| Volume | 21 |
| Issue number | 1 |
| Early online date | 14 Mar 2018 |
| DOIs | |
| Publication status | Published - 23 Jan 2019 |
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Keywords
- asthma
- EQ-5D-5L
- EuroQol
- health-related quality of life
- web-based survey
- validity
- patient-reported outcome measures
- Web-based survey
- 5-LEVEL VERSION
- SYMPTOMS
- TIME TRADE-OFF
- VALUATION
- CARE
- VALUE SET
- INSTRUMENTS
- SEVERITY
- HEALTH-STATUS
ASJC Scopus subject areas
- Health Informatics
Cite this
EuroQol (EQ-5D-5L) Validity in Assessing the Quality of Life in Adults With Asthma : Cross-Sectional Study. / ASTRO-LAB group.
In: Journal of Medical Internet Research, Vol. 21, No. 1, e10178, 23.01.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - EuroQol (EQ-5D-5L) Validity in Assessing the Quality of Life in Adults With Asthma
T2 - Cross-Sectional Study
AU - Hernandez, Gimena
AU - Garin, Olatz
AU - Dima, Alexandra L
AU - Pont, Angels
AU - Martí Pastor, Marc
AU - Alonso, Jordi
AU - Van Ganse, Eric
AU - Laforest, Laurent
AU - de Bruin, Marijn
AU - Mayoral, Karina
AU - Serra-Sutton, Vicky
AU - Ferrer, Montse
AU - ASTRO-LAB group
N1 - Acknowledgments: Financial support for this study was provided by the European Union Seventh Framework Programme FP7 (ASTROLAB project EC HEALTH-F5-2011-282593), Instituto de Salud Carlos III FEDER (PI12/00772), Fondo de Investigación Sanitaria, ISCIII (PI15/00449), Fondo de Investigación Sanitaria, ISCIII (PI16/00130), Fondo de Investigación Sanitaria, ISCIII (FI16/00071), ISCIII (Río Hortega, CM15/00167), and DIUE of Generalitat de Catalunya (2017 SGR 452, 2014 SGR 748). The funding agreement ensures the authors’ independence in designing the study, interpreting the data, and writing and publishing the report. The authors would like to acknowledge Aurea Martin for her help in the English editing and proofreading process, and in finalizing this manuscript. Members of the ASTRO-LAB group are: Sandrine Herbage, Manon Belhassen, Marine Ginoux (LBBE, University Claude Bernard Lyon 1, France); Stéphane Schück, Nathalie Texier, Sandy Leproust, Hélène Le Cloarec (Kappa Santé, France); Richard Hubbard (University of Nottingham, England); Alison Bourke, Mary Thompson, Delphine Vial, David Ansell (Cegedim Strategic Data, England); Javier Olaiz, Ana Valcarcel Orti (Lyon Ingénierie Projet, France); and authors MdB, ALD, EVG, LL, MF, OG, and GH.
PY - 2019/1/23
Y1 - 2019/1/23
N2 - BACKGROUND: The EuroQol-5 Dimension (EQ-5D), developed in 1990, is a most widely used generic tool to measure the health-related quality of life (HRQoL) and considered suitable for patients with asthma. In 2009, the EuroQol Group developed a new EQ-5D version to overcome limitations related to its consistently reported high ceiling effect. To enhance the sensitivity for assessing the HRQoL in further patient populations, the number of responses of EQ-5D was increased from 3 to 5 levels (EQ-5D-5L). Moreover, the availability of well-defined requirements for its Web-based administration allows EQ-5D-5L use to monitor the HRQoL in electronic health (eHealth) programs. No study has evaluated the metric properties of the new EQ-5D-5L in patients with asthma yet.OBJECTIVE: This study aims to examine the distribution, construct validity, and reliability of the new EQ-5D-5L questionnaire administered online to adults with asthma.METHODS: We evaluated patients with asthma (age: 18-40 years) from a primary care setting in France and England, who self-completed the EQ-5D-5L questionnaire online. The inclusion criteria were persistent asthma defined as >6 months of prescribed inhaled corticosteroids and long-acting beta-agonists or inhaled corticosteroids alone during the 12 months prior to inclusion. The EQ-5D index was obtained by applying the English preference value set for the new EQ-5D-5L and the French 3L-5L crosswalk value set. Both value sets produced single preference-based indices ranging from 1 (best health state) to negative values (health states valued as worse than death), where 0=death, allowing the calculation of quality-adjusted life years. Responses to dimensions and index distribution, including ceiling and floor effects, were examined. The construct validity was assessed by comparing the means of known groups by analyses of variance and calculation of effect sizes.RESULTS: Of 312 patients answering the baseline Web-based survey, 290 completed the EQ-5D-5L (93%). The floor effect was null, and the ceiling effect was 26.5% (74/279). The mean EQ-5D-5L index was 0.88 (SD 0.14) with the English value set and 0.83 (SD 0.19) with the French 3L-5L crosswalk value set. In both indices, large effect sizes were observed for known groups defined by the Asthma Control Questionnaire (1.06 and 1.04, P<.001). Differences between extreme groups defined by chronic conditions (P=.002 and P=.003 for the English value set and French 3L-5L crosswalk value set, respectively), short-acting beta-agonists (SABAs) canisters in the last 12 months (P=.02 and P=.03), or SABA use during the previous 4 weeks (P=.03 and P=.01) were of moderate magnitude with effect sizes around 0.5.CONCLUSIONS: The new EQ-5D-5L questionnaire has an acceptable ceiling effect, a good construct validity based on the discriminant ability for distinguishing among health-related known groups, and high reliability, supporting its adequacy for assessing the HRQoL in patients with asthma. EQ-5D-5L completion by most Web-based respondents supports the feasibility of this administration form.
AB - BACKGROUND: The EuroQol-5 Dimension (EQ-5D), developed in 1990, is a most widely used generic tool to measure the health-related quality of life (HRQoL) and considered suitable for patients with asthma. In 2009, the EuroQol Group developed a new EQ-5D version to overcome limitations related to its consistently reported high ceiling effect. To enhance the sensitivity for assessing the HRQoL in further patient populations, the number of responses of EQ-5D was increased from 3 to 5 levels (EQ-5D-5L). Moreover, the availability of well-defined requirements for its Web-based administration allows EQ-5D-5L use to monitor the HRQoL in electronic health (eHealth) programs. No study has evaluated the metric properties of the new EQ-5D-5L in patients with asthma yet.OBJECTIVE: This study aims to examine the distribution, construct validity, and reliability of the new EQ-5D-5L questionnaire administered online to adults with asthma.METHODS: We evaluated patients with asthma (age: 18-40 years) from a primary care setting in France and England, who self-completed the EQ-5D-5L questionnaire online. The inclusion criteria were persistent asthma defined as >6 months of prescribed inhaled corticosteroids and long-acting beta-agonists or inhaled corticosteroids alone during the 12 months prior to inclusion. The EQ-5D index was obtained by applying the English preference value set for the new EQ-5D-5L and the French 3L-5L crosswalk value set. Both value sets produced single preference-based indices ranging from 1 (best health state) to negative values (health states valued as worse than death), where 0=death, allowing the calculation of quality-adjusted life years. Responses to dimensions and index distribution, including ceiling and floor effects, were examined. The construct validity was assessed by comparing the means of known groups by analyses of variance and calculation of effect sizes.RESULTS: Of 312 patients answering the baseline Web-based survey, 290 completed the EQ-5D-5L (93%). The floor effect was null, and the ceiling effect was 26.5% (74/279). The mean EQ-5D-5L index was 0.88 (SD 0.14) with the English value set and 0.83 (SD 0.19) with the French 3L-5L crosswalk value set. In both indices, large effect sizes were observed for known groups defined by the Asthma Control Questionnaire (1.06 and 1.04, P<.001). Differences between extreme groups defined by chronic conditions (P=.002 and P=.003 for the English value set and French 3L-5L crosswalk value set, respectively), short-acting beta-agonists (SABAs) canisters in the last 12 months (P=.02 and P=.03), or SABA use during the previous 4 weeks (P=.03 and P=.01) were of moderate magnitude with effect sizes around 0.5.CONCLUSIONS: The new EQ-5D-5L questionnaire has an acceptable ceiling effect, a good construct validity based on the discriminant ability for distinguishing among health-related known groups, and high reliability, supporting its adequacy for assessing the HRQoL in patients with asthma. EQ-5D-5L completion by most Web-based respondents supports the feasibility of this administration form.
KW - asthma
KW - EQ-5D-5L
KW - EuroQol
KW - health-related quality of life
KW - web-based survey
KW - validity
KW - patient-reported outcome measures
KW - Web-based survey
KW - 5-LEVEL VERSION
KW - SYMPTOMS
KW - TIME TRADE-OFF
KW - VALUATION
KW - CARE
KW - VALUE SET
KW - INSTRUMENTS
KW - SEVERITY
KW - HEALTH-STATUS
UR - http://www.scopus.com/inward/record.url?scp=85060369857&partnerID=8YFLogxK
UR - http://www.mendeley.com/research/euroqol-eq5d5l-validity-assessing-quality-life-adults-asthma-crosssectional-study
U2 - 10.2196/10178
DO - 10.2196/10178
M3 - Article
C2 - 30672744
VL - 21
JO - Journal of Medical Internet Research
JF - Journal of Medical Internet Research
SN - 1439-4456
IS - 1
M1 - e10178
ER -