Feasibility, acceptability and construct validity of EQ-5D in systemic sclerosis

Roberta Gualtierotti, Francesca Ingegnoli, Luciana Scalone, Paolo Cortesi, Eleonora Bruschi, Maria Gerosa, Pier Luigi Meroni

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Systemic sclerosis is a chronic disabling disease that is often associated with severe physical and psychological impairment. Nonetheless, health-related quality of life (HRQoL) in patients with systemic sclerosis is often left behind in clinical practice and research. One of the reasons for this lack of evaluation is the current use of tools, such as the short form-36 (SF-36) questionnaire, that are complete but complicated to use in everyday routine. Other self-reported outcome measures such as the health assessment questionnaire (HAQ) are simple, but specifically designed for physical disability.

STUDY AIMS AND METHODS: Our aim was to evaluate the feasibility, acceptability and construct validity of EQ-5D, a simple and quick self-assessment tool, and to compare its performance with SF-36 and HAQ. We investigated 119 consecutive patients with systemic sclerosis (94% female; age: median 63 years, interquartile range 53-70 years) at three different rheumatology centres. Acceptability was evaluated from comments made by the patients and feasibility on the basis of the number of patients needing assistance or not answering questions (missing data). Construct validity was based on both convergent and divergent validity between conceptually similar and dissimilar domains, respectively, of the compared instruments.

RESULTS: EQ-5D was well accepted by patients. The percentage of patients missing data in at least one EQ-5D domain was 2.5%. Spearman's correlation coefficients between similar dimensions of EQ-5D vs SF-36 and vs HAQ were moderate (≥0.30) to strong (≥0.50); in contrast, correlation coefficients between less comparable dimensions were weak. As expected, the EQ-5D anxiety/depression domain did not correlate with any of the HAQ domains. The EQ-5D visual analogue scale (VAS) concordance with SF-36 general health domain and HAQ total score was strong (≥0.50 for both). Median value for the EQ-5D index (interquartile range) was 0.81 (0.75-0.86). The EQ-5D index had correlation coefficients >0.40 with all SF-36 domains and with all HAQ domains, HAQ total and HAQ VAS.

CONCLUSIONS: Our data demonstrate good acceptability, feasibility and construct validity of EQ-5D in patients with systemic sclerosis. We suggest the use of EQ-5D in systemic sclerosis patients as an HRQoL measure in clinical practice, in randomised clinical trials and/or in pharmacoeconomic evaluations.

Original languageEnglish
Pages (from-to)w14394
Number of pages20
JournalSchweizerische Medizinische Wochenschrift
Volume146
DOIs
Publication statusPublished - Jan 19 2017

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Systemic Scleroderma
Health
Visual Analog Scale
Quality of Life
Surveys and Questionnaires
Pharmaceutical Economics
Rheumatology
Chronic Disease
Anxiety
Randomized Controlled Trials
Outcome Assessment (Health Care)
Depression
Psychology

Keywords

  • Diagnostic Self Evaluation
  • Disability Evaluation
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Patient Acceptance of Health Care
  • Psychometrics
  • Quality of Life
  • Reproducibility of Results
  • Scleroderma, Systemic
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Journal Article
  • Validation Studies

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Feasibility, acceptability and construct validity of EQ-5D in systemic sclerosis. / Gualtierotti, Roberta; Ingegnoli, Francesca; Scalone, Luciana; Cortesi, Paolo; Bruschi, Eleonora; Gerosa, Maria; Meroni, Pier Luigi.

In: Schweizerische Medizinische Wochenschrift, Vol. 146, 19.01.2017, p. w14394.

Research output: Contribution to journalArticle

Gualtierotti, R, Ingegnoli, F, Scalone, L, Cortesi, P, Bruschi, E, Gerosa, M & Meroni, PL 2017, 'Feasibility, acceptability and construct validity of EQ-5D in systemic sclerosis', Schweizerische Medizinische Wochenschrift, vol. 146, pp. w14394. https://doi.org/smw.2016.14394
Gualtierotti R, Ingegnoli F, Scalone L, Cortesi P, Bruschi E, Gerosa M et al. Feasibility, acceptability and construct validity of EQ-5D in systemic sclerosis. Schweizerische Medizinische Wochenschrift. 2017 Jan 19;146:w14394. https://doi.org/smw.2016.14394
Gualtierotti, Roberta ; Ingegnoli, Francesca ; Scalone, Luciana ; Cortesi, Paolo ; Bruschi, Eleonora ; Gerosa, Maria ; Meroni, Pier Luigi. / Feasibility, acceptability and construct validity of EQ-5D in systemic sclerosis. In: Schweizerische Medizinische Wochenschrift. 2017 ; Vol. 146. pp. w14394.
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abstract = "BACKGROUND: Systemic sclerosis is a chronic disabling disease that is often associated with severe physical and psychological impairment. Nonetheless, health-related quality of life (HRQoL) in patients with systemic sclerosis is often left behind in clinical practice and research. One of the reasons for this lack of evaluation is the current use of tools, such as the short form-36 (SF-36) questionnaire, that are complete but complicated to use in everyday routine. Other self-reported outcome measures such as the health assessment questionnaire (HAQ) are simple, but specifically designed for physical disability.STUDY AIMS AND METHODS: Our aim was to evaluate the feasibility, acceptability and construct validity of EQ-5D, a simple and quick self-assessment tool, and to compare its performance with SF-36 and HAQ. We investigated 119 consecutive patients with systemic sclerosis (94{\%} female; age: median 63 years, interquartile range 53-70 years) at three different rheumatology centres. Acceptability was evaluated from comments made by the patients and feasibility on the basis of the number of patients needing assistance or not answering questions (missing data). Construct validity was based on both convergent and divergent validity between conceptually similar and dissimilar domains, respectively, of the compared instruments.RESULTS: EQ-5D was well accepted by patients. The percentage of patients missing data in at least one EQ-5D domain was 2.5{\%}. Spearman's correlation coefficients between similar dimensions of EQ-5D vs SF-36 and vs HAQ were moderate (≥0.30) to strong (≥0.50); in contrast, correlation coefficients between less comparable dimensions were weak. As expected, the EQ-5D anxiety/depression domain did not correlate with any of the HAQ domains. The EQ-5D visual analogue scale (VAS) concordance with SF-36 general health domain and HAQ total score was strong (≥0.50 for both). Median value for the EQ-5D index (interquartile range) was 0.81 (0.75-0.86). The EQ-5D index had correlation coefficients >0.40 with all SF-36 domains and with all HAQ domains, HAQ total and HAQ VAS.CONCLUSIONS: Our data demonstrate good acceptability, feasibility and construct validity of EQ-5D in patients with systemic sclerosis. We suggest the use of EQ-5D in systemic sclerosis patients as an HRQoL measure in clinical practice, in randomised clinical trials and/or in pharmacoeconomic evaluations.",
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AU - Gualtierotti, Roberta

AU - Ingegnoli, Francesca

AU - Scalone, Luciana

AU - Cortesi, Paolo

AU - Bruschi, Eleonora

AU - Gerosa, Maria

AU - Meroni, Pier Luigi

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N2 - BACKGROUND: Systemic sclerosis is a chronic disabling disease that is often associated with severe physical and psychological impairment. Nonetheless, health-related quality of life (HRQoL) in patients with systemic sclerosis is often left behind in clinical practice and research. One of the reasons for this lack of evaluation is the current use of tools, such as the short form-36 (SF-36) questionnaire, that are complete but complicated to use in everyday routine. Other self-reported outcome measures such as the health assessment questionnaire (HAQ) are simple, but specifically designed for physical disability.STUDY AIMS AND METHODS: Our aim was to evaluate the feasibility, acceptability and construct validity of EQ-5D, a simple and quick self-assessment tool, and to compare its performance with SF-36 and HAQ. We investigated 119 consecutive patients with systemic sclerosis (94% female; age: median 63 years, interquartile range 53-70 years) at three different rheumatology centres. Acceptability was evaluated from comments made by the patients and feasibility on the basis of the number of patients needing assistance or not answering questions (missing data). Construct validity was based on both convergent and divergent validity between conceptually similar and dissimilar domains, respectively, of the compared instruments.RESULTS: EQ-5D was well accepted by patients. The percentage of patients missing data in at least one EQ-5D domain was 2.5%. Spearman's correlation coefficients between similar dimensions of EQ-5D vs SF-36 and vs HAQ were moderate (≥0.30) to strong (≥0.50); in contrast, correlation coefficients between less comparable dimensions were weak. As expected, the EQ-5D anxiety/depression domain did not correlate with any of the HAQ domains. The EQ-5D visual analogue scale (VAS) concordance with SF-36 general health domain and HAQ total score was strong (≥0.50 for both). Median value for the EQ-5D index (interquartile range) was 0.81 (0.75-0.86). The EQ-5D index had correlation coefficients >0.40 with all SF-36 domains and with all HAQ domains, HAQ total and HAQ VAS.CONCLUSIONS: Our data demonstrate good acceptability, feasibility and construct validity of EQ-5D in patients with systemic sclerosis. We suggest the use of EQ-5D in systemic sclerosis patients as an HRQoL measure in clinical practice, in randomised clinical trials and/or in pharmacoeconomic evaluations.

AB - BACKGROUND: Systemic sclerosis is a chronic disabling disease that is often associated with severe physical and psychological impairment. Nonetheless, health-related quality of life (HRQoL) in patients with systemic sclerosis is often left behind in clinical practice and research. One of the reasons for this lack of evaluation is the current use of tools, such as the short form-36 (SF-36) questionnaire, that are complete but complicated to use in everyday routine. Other self-reported outcome measures such as the health assessment questionnaire (HAQ) are simple, but specifically designed for physical disability.STUDY AIMS AND METHODS: Our aim was to evaluate the feasibility, acceptability and construct validity of EQ-5D, a simple and quick self-assessment tool, and to compare its performance with SF-36 and HAQ. We investigated 119 consecutive patients with systemic sclerosis (94% female; age: median 63 years, interquartile range 53-70 years) at three different rheumatology centres. Acceptability was evaluated from comments made by the patients and feasibility on the basis of the number of patients needing assistance or not answering questions (missing data). Construct validity was based on both convergent and divergent validity between conceptually similar and dissimilar domains, respectively, of the compared instruments.RESULTS: EQ-5D was well accepted by patients. The percentage of patients missing data in at least one EQ-5D domain was 2.5%. Spearman's correlation coefficients between similar dimensions of EQ-5D vs SF-36 and vs HAQ were moderate (≥0.30) to strong (≥0.50); in contrast, correlation coefficients between less comparable dimensions were weak. As expected, the EQ-5D anxiety/depression domain did not correlate with any of the HAQ domains. The EQ-5D visual analogue scale (VAS) concordance with SF-36 general health domain and HAQ total score was strong (≥0.50 for both). Median value for the EQ-5D index (interquartile range) was 0.81 (0.75-0.86). The EQ-5D index had correlation coefficients >0.40 with all SF-36 domains and with all HAQ domains, HAQ total and HAQ VAS.CONCLUSIONS: Our data demonstrate good acceptability, feasibility and construct validity of EQ-5D in patients with systemic sclerosis. We suggest the use of EQ-5D in systemic sclerosis patients as an HRQoL measure in clinical practice, in randomised clinical trials and/or in pharmacoeconomic evaluations.

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KW - Disability Evaluation

KW - Feasibility Studies

KW - Female

KW - Humans

KW - Male

KW - Patient Acceptance of Health Care

KW - Psychometrics

KW - Quality of Life

KW - Reproducibility of Results

KW - Scleroderma, Systemic

KW - Severity of Illness Index

KW - Surveys and Questionnaires

KW - Journal Article

KW - Validation Studies

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