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The EQ-5D-5L health status questionnaire in COPD: validity, responsiveness and minimum important difference

The EQ-5D-5L health status questionnaire in COPD: validity, responsiveness and minimum important difference
The EQ-5D-5L health status questionnaire in COPD: validity, responsiveness and minimum important difference
Background The EQ-5D, a generic health status questionnaire that is widely used in health economic evaluation, was recently expanded to the EQ-5D-5L to address criticisms of unresponsiveness and ceiling effect. Aims To describe the validity, responsiveness and minimum important difference of the EQ-5D-5L in COPD. Methods Study 1: The validity of the EQ-5D-5L utility index and visual analogue scale (EQ-VAS) was compared with four established disease-specific health status questionnaires and other measures of disease severity 1in 616 stable outpatients with COPD. Study 2: The EQ-5D-5L utility index and EQ-VAS were measured in 324 patients with COPD before and after 8 weeks of pulmonary rehabilitation. Distribution and anchor-based 1approaches were used to estimate the minimum important difference. Results There were moderate-to-strong correlations between utility index and EQ-VAS with disease-specific questionnaires (Pearson's r=0.47-0.72). A ceiling effect was seen in 7% and 2.6% of utility index and EQ-VAS. Utility index decreased (worsening health status) with indices of worsening disease severity. With rehabilitation, mean (95% CI) changes in utility index and EQ-VAS were 0.065 (0.047 to 0.083) and 8.6 (6.5 to 10.7), respectively, with standardised response means of 0.39 and 0.44. The mean (range) anchor estimates of the minimum important difference for utility index and EQVAS were 0.051 (0.037 to 0.063) and 6.9 (6.5 to 8.0), respectively. Conclusions The EQ-5D-5L is a valid and responsive measure of health status in COPD and may provide useful additional cost-effectiveness data in clinical trials.
0040-6376
493-500
Nolan, Claire M.
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Longworth, Louise
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Lord, Joanne
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Canavan, Jane L.
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Jones, Sarah E.
b932064d-d979-453e-a67e-eb3fb8a7a78e
Kon, Samantha S.
fa311b3b-b22d-416f-b404-73638469ccc3
Man, William D.-C.
ef30a187-66e3-4781-b835-b034dbd1efda
Nolan, Claire M.
2197a24f-37e9-48e0-8851-0cd3d5206412
Longworth, Louise
818766cc-ec6d-4679-a07f-625b4281eda4
Lord, Joanne
fd3b2bf0-9403-466a-8184-9303bdc80a9a
Canavan, Jane L.
04d6f776-c9d6-457d-91ea-ad33c6207799
Jones, Sarah E.
b932064d-d979-453e-a67e-eb3fb8a7a78e
Kon, Samantha S.
fa311b3b-b22d-416f-b404-73638469ccc3
Man, William D.-C.
ef30a187-66e3-4781-b835-b034dbd1efda

Nolan, Claire M., Longworth, Louise, Lord, Joanne, Canavan, Jane L., Jones, Sarah E., Kon, Samantha S. and Man, William D.-C. (2016) The EQ-5D-5L health status questionnaire in COPD: validity, responsiveness and minimum important difference. Thorax, 71 (6), 493-500. (doi:10.1136/thoraxjnl-2015-207782).

Record type: Article

Abstract

Background The EQ-5D, a generic health status questionnaire that is widely used in health economic evaluation, was recently expanded to the EQ-5D-5L to address criticisms of unresponsiveness and ceiling effect. Aims To describe the validity, responsiveness and minimum important difference of the EQ-5D-5L in COPD. Methods Study 1: The validity of the EQ-5D-5L utility index and visual analogue scale (EQ-VAS) was compared with four established disease-specific health status questionnaires and other measures of disease severity 1in 616 stable outpatients with COPD. Study 2: The EQ-5D-5L utility index and EQ-VAS were measured in 324 patients with COPD before and after 8 weeks of pulmonary rehabilitation. Distribution and anchor-based 1approaches were used to estimate the minimum important difference. Results There were moderate-to-strong correlations between utility index and EQ-VAS with disease-specific questionnaires (Pearson's r=0.47-0.72). A ceiling effect was seen in 7% and 2.6% of utility index and EQ-VAS. Utility index decreased (worsening health status) with indices of worsening disease severity. With rehabilitation, mean (95% CI) changes in utility index and EQ-VAS were 0.065 (0.047 to 0.083) and 8.6 (6.5 to 10.7), respectively, with standardised response means of 0.39 and 0.44. The mean (range) anchor estimates of the minimum important difference for utility index and EQVAS were 0.051 (0.037 to 0.063) and 6.9 (6.5 to 8.0), respectively. Conclusions The EQ-5D-5L is a valid and responsive measure of health status in COPD and may provide useful additional cost-effectiveness data in clinical trials.

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Accepted/In Press date: 7 January 2016
e-pub ahead of print date: 30 March 2016
Published date: June 2016
Organisations: Faculty of Medicine

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Local EPrints ID: 402731
URI: http://eprints.soton.ac.uk/id/eprint/402731
ISSN: 0040-6376
PURE UUID: ea7fd707-ff59-4b2d-abd2-424e8f524dd4
ORCID for Joanne Lord: ORCID iD orcid.org/0000-0003-1086-1624

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Date deposited: 14 Nov 2016 13:58
Last modified: 17 Dec 2019 01:33

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Contributors

Author: Claire M. Nolan
Author: Louise Longworth
Author: Joanne Lord ORCID iD
Author: Jane L. Canavan
Author: Sarah E. Jones
Author: Samantha S. Kon
Author: William D.-C. Man

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