Health-related quality of life in injury patients: the added value of extending the EQ-5D-3L with a cognitive dimension.

ABSTRACT: INTRODUCTION:The EQ-5D is frequently used to understand the development of health-related quality of life (HRQL) following injury. However, the lack of a cognition dimension is generally felt as disadvantageous as many injuries involve cognitive effects. We aimed to assess the added value of a cognitive dimension in a cohort of injury patients. METHODS:We analyzed EQ-5D-3L extended with cognition (EQ-5D?+?C) dimension responses of 5346 adult injury patients. We studied dimension dependency, assessed the additional effect of the cognitive dimension on the EQ-VAS, and, using the EQ-VAS as a dependent variable, determined the impact of EQ-5D and EQ-5D?+?C attributes in multivariate regression analyses. RESULTS:Extreme cognitive problems combined with no problems on other dimensions are uncommon, whereas severe problems on other dimensions frequently occur without cognitive problems. The EQ-VAS significantly decreased when cognitive problems emerged. Univariate regression analyses indicated that all EQ-5D?+?C dimensions were significantly associated with the EQ-VAS. Exploratory analyses showed that using any set of five of the six EQ-5D?+?C dimensions resulted in almost identical explained variance, and adding the remaining 6th dimension resulted in a similar additional impact. CONCLUSIONS:The addition of the cognition dimension increased the explanatory power of the EQ-5D-3L. Although the increase in explanatory power was relatively small after the cognition dimension was added, the decrease of HRQoL (measured with the EQ-VAS) resulting from cognitive problems was comparable to the decreases resulting from other EQ-5D dimensions.

SUBMITTER: Ophuis RH 

PROVIDER: S-EPMC6571080 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature