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Health-Related Quality of Life in Patients With Different Diseases Measured With the EQ-5D-5L: A Systematic Review.

ABSTRACT: Background: The EQ-5D-5L is a generic preference-based questionnaire developed by the EuroQol Group to measure health-related quality of life (HRQoL) in 2005. Since its development, it has been increasingly applied in populations with various diseases and has been found to have good reliability and sensitivity. This study aimed to summarize the health utility elicited from EQ-5D-5L for patients with different diseases in cross-sectional studies worldwide. Methods: Web of Science, MEDLINE, EMBASE, and the Cochrane Library were searched from January 1, 2012, to October 31, 2019. Cross-sectional studies reporting utility values measured with the EQ-5D-5L in patients with any specific disease were eligible. The language was limited to English. Reference lists of the retrieved studies were manually searched to identify more studies that met the inclusion criteria. Methodological quality was assessed with the Agency for Health Research and Quality (AHRQ) checklist. In addition, meta-analyses were performed for utility values of any specific disease reported in three or more studies. Results: In total, 9,400 records were identified, and 98 studies met the inclusion criteria. In the included studies, 50 different diseases and 98,085 patients were analyzed. Thirty-five studies involving seven different diseases were included in meta-analyses. The health utility ranged from 0.31 to 0.99 for diabetes mellitus [meta-analysis random-effect model (REM): 0.83, (95% CI = 0.77-0.90); fixed-effect model (FEM): 0.93 (95% CI = 0.93-0.93)]; from 0.62 to 0.90 for neoplasms [REM: 0.75 (95% CI = 0.68-0.82); FEM: 0.80 (95% CI = 0.78-0.81)]; from 0.56 to 0.85 for cardiovascular disease [REM: 0.77 (95% CI = 0.75-0.79); FEM: 0.76 (95% CI = 0.75-0.76)]; from 0.31 to 0.78 for multiple sclerosis [REM: 0.56 (95% CI = 0.47-0.66); FEM: 0.67 (95% CI = 0.66-0.68)]; from 0.68 to 0.79 for chronic obstructive pulmonary disease [REM: 0.75 (95% CI = 0.71-0.80); FEM: 0.76 (95% CI = 0.75-0.77)] from 0.65 to 0.90 for HIV infection [REM: 0.84 (95% CI = 0.80-0.88); FEM: 0.81 (95% CI = 0.80-0.82)]; from 0.37 to 0.89 for chronic kidney disease [REM: 0.70 (95% CI = 0.48-0.92; FEM: 0.76 (95% CI = 0.74-0.78)]. Conclusions: EQ-5D-5L is one of the most widely used preference-based measures of HRQoL in patients with different diseases worldwide. The variation of utility values for the same disease was influenced by the characteristics of patients, the living environment, and the EQ-5D-5L value set. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42020158694.

SUBMITTER: Zhou T

PROVIDER: S-EPMC8275935 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThe EQ-5D is a generic health survey that can be used to compare improvement across different interventions, measure changes in health-related quality of life over time, or to explore cost-effectiveness among treatments, hospitals, or providers. The original EQ-5D survey has three response options for each of five health dimensions; however, with so few response options, ceiling and floor effects are problematic in some populations. A new version, called the EQ-5D-5L, was developed, which gives respondents five answer options (the "5L" refers to five response levels, which is in contrast to the original survey's three levels). However, the validity of this version has not, to our knowledge, been evaluated in patients undergoing total hip arthroplasty (THA).Questions/purposesThe purposes of this study were (1) to characterize the redistribution of responses using the new version; (2) to describe the ceiling and floor effects in the current three-level version and identify whether the new EQ-5D-5L survey diminished these effects; and (3) to understand the convergent validity of the new version with the old and the EQ visual analog scale.MethodsBoth versions of the survey were administered either preoperatively or 1 to 6 years after THA, allowing at least 2 weeks between administrations. Responses to the two versions were compared to determine response redistribution properties, ceiling and floor effects, and convergent validity. Sample sizes were determined so that the study would have 90% power to detect a Spearman correlation over 0.7 when comparing the responses of the three-level survey with the five-level survey and allowing for a rate of 25% loss to followup.ResultsMost patients before surgery used the new responses in the majority of dimensions, whereas the patients taking the test after surgery used the new responses predominantly for the pain dimension. The five-level diminished ceiling effects in both groups by up to 30% and diminished floor effects in the pain dimension for patients taking the assessment before surgery by 14%, which was the only dimension in either patient group that had high rates of floor effects. The correlation between the surveys' visual analog scale and response patterns was not different for the two versions of the survey in these populations.ConclusionsThe EQ-5D five-level survey appears able to discriminate new health states indistinguishable in the original, which may allow more sensitive measurements of change in patients undergoing THA. The five-level survey should be considered for implementation in local and national registry monitoring of health-related quality of life in patients undergoing THA.

Dataset Information

Health-Related Quality of Life in Patients With Different Diseases Measured With the EQ-5D-5L: A Systematic Review.

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