Validity and Responsiveness of EQ-5D in Asthma: A Systematic Review and Meta-analysis.

IF 3.4 3区医学 Q1 HEALTH CARE SCIENCES & SERVICES Patient-Patient Centered Outcomes Research Pub Date : 2024-09-07 DOI:10.1007/s40271-024-00711-9

Ai-Ping Chua, Ling Jie Cheng, Zhi Yi Soh, Le Ann Chen, Nan Luo

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Abstract

Objective: We aimed to synthesize the evidence on the construct validity and responsiveness of the EQ-5D and compare them with asthma-specific health-related quality-of-life scales, to guide further research and clinical applications in asthma.

Methods: We searched key databases from inception to 1 June, 2024 and used the COnsensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) method to appraise the evidence. The effect size estimates were aggregated using the inverse variance method to evaluate the relative efficiency of EQ-5D measures against the Asthma Quality of Life Questionnaire (AQLQ) and/or its corresponding preference-based index, Asthma Quality of Life-5 Dimensions (AQL-5D).

Results: There were 493 tests (construct validity: 428; responsiveness: 65) drawn from 37 selected articles (validation: 7; clinical: 30). Overall, 78.4% and 76.9% of the a priori hypotheses for assessing construct validity (convergent validity: 56.4%; known groups: 88.5%) and responsiveness, respectively, were satisfied. The methodological quality was "very good" or "adequate" in 78.2% of construct validity tests and 92.3% of responsiveness tests. The pooled correlation coefficient between EQ-5D index and AQLQ total scores was 0.52 (95% confidence interval 0.43-0.59), and between EQ visual analog scale and AQLQ total scores was 0.53 (95% confidence interval 0.34-0.69). The Cohen's d ratios for the index, level sum scores, and visual analog scale compared to AQLQ were 0.56 (n = 27), 1.16 (n = 16), and 0.75 (n = 37). The EQ-5D index's Cohen's d ratio compared to AQL-5D was 0.49 (n = 5). The standardized response mean ratios for the index and visual analog scale compared to AQLQ were 0.26 (n = 11) and 0.63 (n = 9).

Conclusions: The EQ-5D demonstrated overall good validity and responsiveness in the adult asthma population. However, a comparison against disease-specific instruments suggested scope for improvement in its psychometric performance for this population.

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EQ-5D 在哮喘中的有效性和响应性：系统回顾与元分析》。

目的：我们旨在综合 EQ-5D 的结构效度和反应性方面的证据，并将其与哮喘特异性健康相关生活质量量表进行比较，以指导哮喘的进一步研究和临床应用：我们检索了从开始到 2024 年 6 月 1 日的主要数据库，并采用基于共识的健康测量工具选择标准 (COSMIN) 方法对证据进行评估。使用反方差法对效应大小估计值进行汇总，以评估EQ-5D测量方法与哮喘生活质量问卷（AQLQ）和/或其相应的基于偏好的指数--哮喘生活质量-5维度（AQL-5D）--的相对效率：共进行了 493 次测试（建构有效性：428 次；响应性：65 次），这些测试来自 37 篇选定的文章（验证：7 篇；临床：30 篇）。总体而言，分别有 78.4% 和 76.9% 的先验假设满足了对构建有效性（收敛有效性：56.4%；已知组别：88.5%）和响应性的评估要求。78.2%的构建有效性测试和 92.3%的响应性测试的方法质量为 "非常好 "或 "足够好"。EQ-5D指数与AQLQ总分的汇总相关系数为0.52（95%置信区间为0.43-0.59），EQ视觉模拟量表与AQLQ总分的汇总相关系数为0.53（95%置信区间为0.34-0.69）。与 AQLQ 相比，指数、水平总分和视觉模拟量表的 Cohen's d 比值分别为 0.56（n = 27）、1.16（n = 16）和 0.75（n = 37）。与 AQL-5D 相比，EQ-5D 指数的 Cohen's d 比率为 0.49（n = 5）。与 AQLQ 相比，指数和视觉模拟量表的标准化响应平均比率分别为 0.26（n = 11）和 0.63（n = 9）：结论：EQ-5D 在成人哮喘人群中表现出总体良好的有效性和响应性。结论：EQ-5D 在成人哮喘人群中表现出总体良好的有效性和响应性，但与疾病特异性工具的比较表明，该工具在该人群中的心理测量性能还有待提高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Patient-Patient Centered Outcomes Research HEALTH CARE SCIENCES & SERVICES-

CiteScore

6.60

自引率

8.30%

发文量

审稿时长

>12 weeks

期刊介绍： The Patient provides a venue for scientifically rigorous, timely, and relevant research to promote the development, evaluation and implementation of therapies, technologies, and innovations that will enhance the patient experience. It is an international forum for research that advances and/or applies qualitative or quantitative methods to promote the generation, synthesis, or interpretation of evidence. The journal has specific interest in receiving original research, reviews and commentaries related to qualitative and mixed methods research, stated-preference methods, patient reported outcomes, and shared decision making. Advances in regulatory science, patient-focused drug development, patient-centered benefit-risk and health technology assessment will also be considered. Additional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in The Patient may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances. All manuscripts are subject to peer review by international experts.