Framing of mobility items: a source of poor agreement between preference-based health-related quality of life instruments in a population of individuals receiving assisted ventilation

Liam M. Hannan, David G. T. Whitehurst, Stirling Bryan, Jeremy D. Road, Christine F. McDonald, David J. Berlowitz, Mark E. Howard

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: To explore the influence of descriptive differences in items evaluating mobility on index scores generated from two generic preference-based health-related quality of life (HRQoL) instruments.

Methods: The study examined cross-sectional data from a postal survey of individuals receiving assisted ventilation in two state/province-wide home mechanical ventilation services, one in British Columbia, Canada and the other in Victoria, Australia. The Assessment of Quality of Life 8-dimension (AQoL-8D) and the EQ-5D-5L were included in the data collection. Graphical illustrations, descriptive statistics, and measures of agreement [intraclass correlation coefficients (ICCs) and Bland–Altman plots] were examined using index scores derived from both instruments. Analyses were performed on the full sample as well as subgroups defined according to respondents’ self-reported ability to walk.

Results: Of 868 individuals receiving assisted ventilation, 481 (55.4%) completed the questionnaire. Mean index scores were 0.581 (AQoL-8D) and 0.566 (EQ-5D-5L) with ‘moderate’ agreement demonstrated between the two instruments (ICC = 0.642). One hundred fifty-nine (33.1%) reported level 5 (‘I am unable to walk about’) on the EQ-5D-5L Mobility item. The walking status of respondents had a marked influence on the comparability of index scores, with a larger mean difference (0.206) and ‘slight’ agreement (ICC = 0.386) observed when the non-ambulant subgroup was evaluated separately.

Conclusions: This study provides further evidence that between-measure discrepancies between preference-based HRQoL instruments are related in part to the framing of mobility-related items. Longitudinal studies are necessary to determine the responsiveness of preference-based HRQoL instruments in cohorts that include non-ambulant individuals.
Original languageEnglish
Pages (from-to)1493-1505
Number of pages13
JournalQuality of Life Research
Volume26
Issue number6
Early online date2 Mar 2017
DOIs
Publication statusPublished - Jun 2017

Keywords

  • AQoL-8D
  • EQ-5D-5L
  • Mobility
  • Quality of life
  • Respiratory insufficiency
  • Non-invasive ventilation

Cite this

Framing of mobility items : a source of poor agreement between preference-based health-related quality of life instruments in a population of individuals receiving assisted ventilation. / Hannan, Liam M.; Whitehurst, David G. T.; Bryan, Stirling; Road, Jeremy D.; McDonald, Christine F.; Berlowitz, David J.; Howard, Mark E.

In: Quality of Life Research, Vol. 26, No. 6, 06.2017, p. 1493-1505.

Research output: Contribution to journalArticle

Hannan, Liam M. ; Whitehurst, David G. T. ; Bryan, Stirling ; Road, Jeremy D. ; McDonald, Christine F. ; Berlowitz, David J. ; Howard, Mark E. / Framing of mobility items : a source of poor agreement between preference-based health-related quality of life instruments in a population of individuals receiving assisted ventilation. In: Quality of Life Research. 2017 ; Vol. 26, No. 6. pp. 1493-1505.
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abstract = "Purpose: To explore the influence of descriptive differences in items evaluating mobility on index scores generated from two generic preference-based health-related quality of life (HRQoL) instruments.Methods: The study examined cross-sectional data from a postal survey of individuals receiving assisted ventilation in two state/province-wide home mechanical ventilation services, one in British Columbia, Canada and the other in Victoria, Australia. The Assessment of Quality of Life 8-dimension (AQoL-8D) and the EQ-5D-5L were included in the data collection. Graphical illustrations, descriptive statistics, and measures of agreement [intraclass correlation coefficients (ICCs) and Bland–Altman plots] were examined using index scores derived from both instruments. Analyses were performed on the full sample as well as subgroups defined according to respondents’ self-reported ability to walk.Results: Of 868 individuals receiving assisted ventilation, 481 (55.4{\%}) completed the questionnaire. Mean index scores were 0.581 (AQoL-8D) and 0.566 (EQ-5D-5L) with ‘moderate’ agreement demonstrated between the two instruments (ICC = 0.642). One hundred fifty-nine (33.1{\%}) reported level 5 (‘I am unable to walk about’) on the EQ-5D-5L Mobility item. The walking status of respondents had a marked influence on the comparability of index scores, with a larger mean difference (0.206) and ‘slight’ agreement (ICC = 0.386) observed when the non-ambulant subgroup was evaluated separately.Conclusions: This study provides further evidence that between-measure discrepancies between preference-based HRQoL instruments are related in part to the framing of mobility-related items. Longitudinal studies are necessary to determine the responsiveness of preference-based HRQoL instruments in cohorts that include non-ambulant individuals.",
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author = "Hannan, {Liam M.} and Whitehurst, {David G. T.} and Stirling Bryan and Road, {Jeremy D.} and McDonald, {Christine F.} and Berlowitz, {David J.} and Howard, {Mark E.}",
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T2 - a source of poor agreement between preference-based health-related quality of life instruments in a population of individuals receiving assisted ventilation

AU - Hannan, Liam M.

AU - Whitehurst, David G. T.

AU - Bryan, Stirling

AU - Road, Jeremy D.

AU - McDonald, Christine F.

AU - Berlowitz, David J.

AU - Howard, Mark E.

N1 - Funding LMH received financial support in the form of a Postgraduate Scholarship from the National Health and Medical Research Foundation (Australia).

PY - 2017/6

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N2 - Purpose: To explore the influence of descriptive differences in items evaluating mobility on index scores generated from two generic preference-based health-related quality of life (HRQoL) instruments.Methods: The study examined cross-sectional data from a postal survey of individuals receiving assisted ventilation in two state/province-wide home mechanical ventilation services, one in British Columbia, Canada and the other in Victoria, Australia. The Assessment of Quality of Life 8-dimension (AQoL-8D) and the EQ-5D-5L were included in the data collection. Graphical illustrations, descriptive statistics, and measures of agreement [intraclass correlation coefficients (ICCs) and Bland–Altman plots] were examined using index scores derived from both instruments. Analyses were performed on the full sample as well as subgroups defined according to respondents’ self-reported ability to walk.Results: Of 868 individuals receiving assisted ventilation, 481 (55.4%) completed the questionnaire. Mean index scores were 0.581 (AQoL-8D) and 0.566 (EQ-5D-5L) with ‘moderate’ agreement demonstrated between the two instruments (ICC = 0.642). One hundred fifty-nine (33.1%) reported level 5 (‘I am unable to walk about’) on the EQ-5D-5L Mobility item. The walking status of respondents had a marked influence on the comparability of index scores, with a larger mean difference (0.206) and ‘slight’ agreement (ICC = 0.386) observed when the non-ambulant subgroup was evaluated separately.Conclusions: This study provides further evidence that between-measure discrepancies between preference-based HRQoL instruments are related in part to the framing of mobility-related items. Longitudinal studies are necessary to determine the responsiveness of preference-based HRQoL instruments in cohorts that include non-ambulant individuals.

AB - Purpose: To explore the influence of descriptive differences in items evaluating mobility on index scores generated from two generic preference-based health-related quality of life (HRQoL) instruments.Methods: The study examined cross-sectional data from a postal survey of individuals receiving assisted ventilation in two state/province-wide home mechanical ventilation services, one in British Columbia, Canada and the other in Victoria, Australia. The Assessment of Quality of Life 8-dimension (AQoL-8D) and the EQ-5D-5L were included in the data collection. Graphical illustrations, descriptive statistics, and measures of agreement [intraclass correlation coefficients (ICCs) and Bland–Altman plots] were examined using index scores derived from both instruments. Analyses were performed on the full sample as well as subgroups defined according to respondents’ self-reported ability to walk.Results: Of 868 individuals receiving assisted ventilation, 481 (55.4%) completed the questionnaire. Mean index scores were 0.581 (AQoL-8D) and 0.566 (EQ-5D-5L) with ‘moderate’ agreement demonstrated between the two instruments (ICC = 0.642). One hundred fifty-nine (33.1%) reported level 5 (‘I am unable to walk about’) on the EQ-5D-5L Mobility item. The walking status of respondents had a marked influence on the comparability of index scores, with a larger mean difference (0.206) and ‘slight’ agreement (ICC = 0.386) observed when the non-ambulant subgroup was evaluated separately.Conclusions: This study provides further evidence that between-measure discrepancies between preference-based HRQoL instruments are related in part to the framing of mobility-related items. Longitudinal studies are necessary to determine the responsiveness of preference-based HRQoL instruments in cohorts that include non-ambulant individuals.

KW - AQoL-8D

KW - EQ-5D-5L

KW - Mobility

KW - Quality of life

KW - Respiratory insufficiency

KW - Non-invasive ventilation

U2 - 10.1007/s11136-017-1510-z

DO - 10.1007/s11136-017-1510-z

M3 - Article

VL - 26

SP - 1493

EP - 1505

JO - Quality of Life Research

JF - Quality of Life Research

SN - 0962-9343

IS - 6

ER -