Relationship between the EQ-5D index and measures of clinical outcomes in selected studies of cardiovascular interventio
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BioMed Central
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Relationship between the EQ-5D index and measures of clinical outcomes in selected studies of cardiovascular interventions Kimberley A Goldsmith1,2,3, Matthew T Dyer4,5, Peter M Schofield1, Martin J Buxton4 and Linda D Sharples*1,2 Address: 1Papworth Hospital NHS Trust, Cambridge, UK, 2MRC Biostatistics Unit, Institute of Public Health, Cambridge, UK, 3Institute of Psychiatry, King's College London, UK, 4Health Economics Research Group, Brunel University, Uxbridge, UK and 5National Collaborating Centre for Mental Health, The Royal College of Psychiatrists, UK Email: Kimberley A Goldsmith - [email protected]; Matthew T Dyer - [email protected]; Peter M Schofield - [email protected]; Martin J Buxton - [email protected]; Linda D Sharples* - [email protected] * Corresponding author
Published: 26 November 2009 Health and Quality of Life Outcomes 2009, 7:96
doi:10.1186/1477-7525-7-96
Received: 5 June 2009 Accepted: 26 November 2009
This article is available from: http://www.hqlo.com/content/7/1/96 © 2009 Goldsmith et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: The EuroQoL 5D (EQ-5D) has been widely used in studies of cardiac disease, but its measurement properties in this group are not well established. The study aimed to quantify the relationship between measures commonly used in studies of cardiac disease and the EQ-5D index across different levels of disease severity. Methods: Patient-level data from 7 studies of cardiac interventions were used, which included randomised trials and observational studies. Relationships between the EQ-5D index and commonly used cardiac measures, Canadian Cardiovascular Society (CCS) angina severity class, treadmill exercise time (ETT) and scales of the Seattle Angina Questionnaire (SAQ) were examined. Mixed effects linear regression was used to assess these relationships, with the EQ-5D index as the response. Results: Study sample sizes ranged from 68 to 2419. Mean baseline EQ-5D index ranged from 0.77 in patients at diagnosis (95% CI 0.75, 0.78) to 0.43 in patients with advanced disease (95% CI 0.39, 0.48) and differed significantly across studies (p < 0.001). There was evidence of a ceiling effect in patients at diagnosis. The minimum clinically important difference of a one minute increase in ETT was associated with a 0.019 (95% CI 0.014, 0.025) increase in EQ-5D index. One class increase in CCS was associated with a 0.11 (95% CI 0.09, 0.13) decrease in EQ-5D index. A 10 unit increase in SAQ scales was associated with increases between 0.04 and 0.07 in EQ-5D index (95% CIs 0.03, 0.05 and 0.05, 0.08). Tests of heterogeneity indicated the EQ-5D-covariate relationships were consistent across levels of disease se
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