EuroQol (EQ-5D-5L) Validity in Assessing the Quality of Life in Adults With Asthma

Cross-Sectional Study

ASTRO-LAB group

Research output: Contribution to journalArticle

2 Citations (Scopus)
7 Downloads (Pure)

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 languageEnglish
Article numbere10178
JournalJournal of Medical Internet Research
Volume21
Issue number1
Early online date14 Mar 2018
DOIs
Publication statusPublished - 23 Jan 2019

Fingerprint

Asthma
Cross-Sectional Studies
Quality of Life
Health
Adrenal Cortex Hormones
Quality-Adjusted Life Years
Reproducibility of Results
England
France
Surveys and Questionnaires
Primary Health Care
Analysis of Variance
Population

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 journalArticle

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title = "EuroQol (EQ-5D-5L) Validity in Assessing the Quality of Life in Adults With Asthma: Cross-Sectional Study",
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.",
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",
author = "Gimena Hernandez and Olatz Garin and Dima, {Alexandra L} and Angels Pont and {Mart{\'i} Pastor}, Marc and Jordi Alonso and {Van Ganse}, Eric and Laurent Laforest and {de Bruin}, Marijn and Karina Mayoral and Vicky Serra-Sutton and Montse Ferrer and {ASTRO-LAB group}",
note = "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 Investigaci{\'o}n Sanitaria, ISCIII (PI15/00449), Fondo de Investigaci{\'o}n Sanitaria, ISCIII (PI16/00130), Fondo de Investigaci{\'o}n Sanitaria, ISCIII (FI16/00071), ISCIII (R{\'i}o 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); St{\'e}phane Sch{\"u}ck, Nathalie Texier, Sandy Leproust, H{\'e}l{\`e}ne Le Cloarec (Kappa Sant{\'e}, 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 Ing{\'e}nierie Projet, France); and authors MdB, ALD, EVG, LL, MF, OG, and GH.",
year = "2019",
month = "1",
day = "23",
doi = "10.2196/10178",
language = "English",
volume = "21",
journal = "Journal of Medical Internet Research",
issn = "1439-4456",
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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

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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

VL - 21

JO - Journal of Medical Internet Research

JF - Journal of Medical Internet Research

SN - 1439-4456

IS - 1

M1 - e10178

ER -