Acceptability and Validity of the EQ-5D in Patients Living With Dementia

To assess the acceptability and validity of the 3 levels of the EQ-5D (EQ-5D-3L) compared with the Quality of Life in Alzheimer’s Diseases (QoL-AD) in patients living with dementia. The analysis was based on 560 dyads of persons with dementia and their caregivers of the multicenter observational stu...

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Bibliographic Details
Published in:Value in health Vol. 23; no. 6; pp. 760 - 767
Main Authors: Michalowsky, Bernhard, Xie, Feng, Kohlmann, Thomas, Gräske, Johannes, Wübbeler, Markus, Thyrian, Jochen René, Hoffmann, Wolfgang
Format: Journal Article
Language:English
Published: Lawrenceville Elsevier Inc 01.06.2020
Elsevier Science Ltd
Subjects:
Acceptability
Activities of daily living
Alzheimer's disease
Caregivers
Convergent validity
Dementia
Dementia disorders
EQ-5D
Health
Health services
Health status
Indexes
Internal Medicine
Neurodegenerative diseases
Observational studies
patient-reported outcomes
Patients
preference-based measures
Quality of care
Quality of life
Ratings & rankings
Regression analysis
Response rates
Self evaluation
validation
Validity
Valuation methods
EQ-5D
patient-reported outcomes
preference-based measures
Alzheimer’s disease
dementia
quality of life
validation
ISSN:1098-3015, 1524-4733, 1524-4733
Online Access:Get full text
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Summary:To assess the acceptability and validity of the 3 levels of the EQ-5D (EQ-5D-3L) compared with the Quality of Life in Alzheimer’s Diseases (QoL-AD) in patients living with dementia. The analysis was based on 560 dyads of persons with dementia and their caregivers of the multicenter observational study of dementia care networks in Germany (DemNet-D). Health-related quality of life was assessed by face-to-face interviews using the EQ-5D-3L (self-rating) and the QoL-AD (self- and proxy-rating). The number of missing values, the score ranges (observed vs possible range) and the floor and ceiling effects were used to assess the acceptability. We used one-way analyses of variance and multivariate linear regression models to evaluate the discriminative ability. The convergent validity was assessed using Spearman's correlation coefficient (rs) and multivariate regression models. The EQ-5D index had a higher response rate (89% vs 84%) and a comparable floor (>1%) but a higher ceiling effect (18% vs >1%) compared with the QoL-AD. Both measures can significantly differentiate between different stages of general health, instrumental activities of daily living, and depression. The EQ-5D index and the visual analog scale self-rating scores strongly correlated with the QoL-AD self-rating (rs = 0.644 and 0.553, respectively) but not with the proxy-rating score (rs = 0.314 and rs = 0.170, respectively), which was confirmed by multivariate regression analyses. The results satisfy acceptability, discriminative ability, and convergent validity for moderately cognitively and functionally impaired patients living with dementia. The EQ-5D-3L performed comparably with the QoL-AD, and could, therefore, be used in economic evaluations in dementia. The differences between self- and proxy-ratings should be evaluated and considered in the interpretation of health-related quality of life scores.
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ISSN:1098-3015
1524-4733
1524-4733
DOI:10.1016/j.jval.2020.01.022