Adding a fatigue item to the EQ-5D-5L improves its psychometric performance in the general population

被引:10
作者
Spronk, Inge [1 ,2 ]
Polinder, Suzanne [1 ]
Bonsel, Gouke J. [3 ]
Janssen, M. F. [4 ]
Haagsma, Juanita A. [1 ]
机构
[1] Univ Med Ctr Rotterdam, Dept Publ Hlth, Erasmus MC, POB 2040, NL-3000 CA Rotterdam, Netherlands
[2] Maasstad Hosp, Assoc Dutch Burn Ctr, Rotterdam, Netherlands
[3] EuroQol Grp Execut Off, Rotterdam, Netherlands
[4] Erasmus MC, Dept Psychiat, Sect Med Psychol & Psychotherapy, Rotterdam, Netherlands
关键词
EQ-5D; Health-related quality of life; Fatigue; Bolt-on; General population; QUALITY-OF-LIFE; BOLT-ON DIMENSIONS; 5-LEVEL VERSION; HEALTH-STATUS; IMPACT; EUROQOL; PREVALENCE; PREFERENCES; SYMPTOMS; IDENTIFY;
D O I
10.1186/s41687-021-00406-x
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background Fatigue is a common and often disturbing sequela of serious chronic health conditions. In the widely applied HRQL instrument, the EQ-5D, this aspect is not included directly, for its assumed lack of additional information. We investigated the validity of this assumption by determining the gain-if any-of an additional fatigue item to the EQ-5D-5L in a general population sample. Methods A Dutch general population sample (including diseased people) completed a web-based survey including the EQ-5D-5L and the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). The RPQ fatigue item was used to create the EQ-5D-5L + Fatigue. We head-to-head compared the psychometric performance contrasting the EQ-5D-5L and EQ-5D-5L + Fatigue: distribution (e.g. ceiling), informativity cf. Shannon's indices, convergent validity, domain dependency, and explanatory power. Results were compared between subgroups with and without >= 1 chronic health condition. Results The study population consisted of 3027 persons of whom 52% had a chronic health condition. The mean EQ-5D-5L utility score was 0.83 and 48% experienced some degree of fatigue. Adding the fatigue item to the EQ-5D-5L decreased the ceiling effect, increased absolute informativity (HMODIFIER LETTER PRIME = 6.44 vs. HMODIFIER LETTER PRIME = 4.90) and relative informativity (JMODIFIER LETTER PRIME = 0.46 vs. JMODIFIER LETTER PRIME = 0.42). The extra fatigue item slightly increased convergent validity (Spearman's rank correlation coefficient = - 0.61 vs. - 0.62). Domain dependency analysis showed that all EQ-5D-5L domains are dominant over the fatigue item. Explanatory power of the EQ-5D-5L + Fatigue was higher compared to the EQ-5D-5L (R-2 = 0.42 vs. 0.39). The gain is substantially larger in the subgroup with chronic health conditions. Conclusions Adding a fatigue item to the EQ-5D-5L improved all psychometric performance criteria of the enriched instrument in the general population. Effects are substantially larger in the subgroup with chronic health conditions, indicating that adding a fatigue item to the EQ-5D-5L is especially relevant in evaluating the HRQL of diseased people.
引用
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页数:10
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