TY - JOUR
T1 - Estimation of minimal clinically important difference in EQ-5D visual analog scale score after pulmonary rehabilitation in subjects with COPD
AU - Zanini, Andrea
AU - Aiello, Marina
AU - Adamo, Daniela
AU - Casale, Silvia
AU - Cherubino, Francesca
AU - Patrona, Sabrina Della
AU - Raimondi, Eleonora
AU - Zampogna, Elisabetta
AU - Chetta, Alfredo
AU - Spanevello, Antonio
PY - 2015
Y1 - 2015
N2 - Background: The effect of pulmonary rehabilitation (PR) on the EuroQol Group's 5-dimension questionnaire (EQ-5D) in COPD has been poorly investigated. In addition, conflicting results were reported about the visual analog scale component of EQ-5D (EQ-VAS). The purpose of this study was to evaluate the responsiveness of EQ-VAS to PR and its relationship with clinical and functional parameters in subjects with COPD, as well as to define the minimal clinically important difference (MCID) estimate for the EQ-VAS after PR. Methods: A total of 468 in-patients with stable moderate-to-severe COPD, allocated to a 3-wk PR program, were retrospectively evaluated. EQ-VAS was assessed before and after PR, and its relationship with baseline pulmonary function, changes in 6-min walk test, and baseline, and transitional dyspnea index (BDI/TDI) after PR were evaluated. Using an anchor-based approach and receiver operating characteristic curves, the EQ-VAS change cutoff that identified subjects achieving the known MCID for TDI after PR was identified. Results: Four hundred and thirty-nine subjects (94%, mean FEV1 55.3% predicted) completed pre- and post-PR EQ-VAS scores. After PR, EQ-VAS increased from 58 ± 17 to 72 ± 15 (ΔEQ-VAS 14 ± 12, P <.001). ΔEQ-VAS was negatively related to baseline FEV1 (r = −0.32, P <.001) and positively to TDI (r = 0.50, P <.001) and 6-min walk distance (r = 0.46, P <.001) changes. Receiver operating characteristic curves identified an EQ-VAS change cutoff of 8 as the best discriminating value to identify the MCID for TDI (0.78 sensitivity and 0.81 specificity; area under curve: 0.845, P <.001). Conclusions: Our study shows that, in in-patients with stable moderate-to-severe COPD, EQ-VAS is a valid and reliable tool to assess the responsiveness to PR, with an estimated MCID of 8 points. The EQ-VAS can be a practical alternative to more time-consuming measures of health-related quality of life.
AB - Background: The effect of pulmonary rehabilitation (PR) on the EuroQol Group's 5-dimension questionnaire (EQ-5D) in COPD has been poorly investigated. In addition, conflicting results were reported about the visual analog scale component of EQ-5D (EQ-VAS). The purpose of this study was to evaluate the responsiveness of EQ-VAS to PR and its relationship with clinical and functional parameters in subjects with COPD, as well as to define the minimal clinically important difference (MCID) estimate for the EQ-VAS after PR. Methods: A total of 468 in-patients with stable moderate-to-severe COPD, allocated to a 3-wk PR program, were retrospectively evaluated. EQ-VAS was assessed before and after PR, and its relationship with baseline pulmonary function, changes in 6-min walk test, and baseline, and transitional dyspnea index (BDI/TDI) after PR were evaluated. Using an anchor-based approach and receiver operating characteristic curves, the EQ-VAS change cutoff that identified subjects achieving the known MCID for TDI after PR was identified. Results: Four hundred and thirty-nine subjects (94%, mean FEV1 55.3% predicted) completed pre- and post-PR EQ-VAS scores. After PR, EQ-VAS increased from 58 ± 17 to 72 ± 15 (ΔEQ-VAS 14 ± 12, P <.001). ΔEQ-VAS was negatively related to baseline FEV1 (r = −0.32, P <.001) and positively to TDI (r = 0.50, P <.001) and 6-min walk distance (r = 0.46, P <.001) changes. Receiver operating characteristic curves identified an EQ-VAS change cutoff of 8 as the best discriminating value to identify the MCID for TDI (0.78 sensitivity and 0.81 specificity; area under curve: 0.845, P <.001). Conclusions: Our study shows that, in in-patients with stable moderate-to-severe COPD, EQ-VAS is a valid and reliable tool to assess the responsiveness to PR, with an estimated MCID of 8 points. The EQ-VAS can be a practical alternative to more time-consuming measures of health-related quality of life.
KW - COPD
KW - EuroQol
KW - Pulmonary rehabilitation
KW - VAS
UR - http://www.scopus.com/inward/record.url?scp=84935102164&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84935102164&partnerID=8YFLogxK
U2 - 10.4187/respcare.03272
DO - 10.4187/respcare.03272
M3 - Article
C2 - 25336531
AN - SCOPUS:84935102164
VL - 60
SP - 88
EP - 95
JO - Respiratory Care
JF - Respiratory Care
SN - 0020-1324
IS - 1
ER -