Validity and responsiveness of the EQ-5D in assessing and valuing health status in patients with anxiety disorders
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RESEARCH
Validity and responsiveness of the EQ-5D in assessing and valuing health status in patients with anxiety disorders Research
Hans-Helmut König*1,2, Anja Born3, Oliver Günther2, Herbert Matschinger4, Sven Heinrich1,2, Steffi G Riedel-Heller5, Matthias C Angermeyer6 and Christiane Roick2
Abstract Background: The EQ-5D is a generic questionnaire which generates a health profile as well as index scores for healthrelated quality of life that may be used in cost-utility analysis. Aims of the study: To examine validity and responsiveness of the EQ-5D in patients with anxiety disorders. Methods: 389 patients with anxiety disorders completed the EQ-5D at baseline and 6-month follow-up. Subjective measures of quality of life (WHOQOL-BREF) and psychopathology (BAI, BDI-II, BSQ, ACQ, MI) were used for comparison. Validity was analyzed by assessing associations between EQ-5D scores and related other scores. Responsiveness was analyzed by calculating effect sizes of differences in scores between baseline and follow-up for 3 groups indicating more, constant or less anxiety. Meaningful difference scores for shifting to less or more anxiety were derived by means of regression analysis. Results: 88.4% of respondents reported problems in at least one of the EQ-5D dimension at baseline; the mean EQ VAS score was 63.8. The EQ-5D dimension most consistently associated with the measures used for comparison was 'anxiety/depression'. EQ VAS and EQ-5D index scores were highly correlated (|r|>0.5) with scores of the WHOQOL-BREF dimensions 'physical', 'mental' and 'overall' as well as BAI and BDI-II. The EQ-5D index tended to be the most responsive score. Standardized meaningful difference scores were not significantly different between EQ VAS, EQ-5D index and measures used for comparison. Conclusions: The EQ-5D seems to be reasonably valid and moderately responsive in patients with anxiety disorders. The EQ-5D index may be suitable for calculating QALYs in economic evaluation of health care interventions for patients with anxiety disorders. Trial registration: Current Controlled Trials ISRCTN15716049 Background The EQ-5D is a short generic patient-rated questionnaire for subjectively describing and valuing health-related quality of life (HRQOL); it is often used as an outcome measure in both clinical and health care services research (see complete list of references provided by the EuroQol Group [1]). The EQ-5D provides a descriptive profile of HRQOL as well as a subjective overall rating of the patient's own health state on the day of administration by * Correspondence: [email protected] 1 Department of Medical Sociology and Health Economics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
Full list of author information is available at the end of the article
means of a visual analogue scale (EQ VAS) [2,3]. Furthermore, according to a particular set of preference values derived from surveys of the general population, an index score (EQ-5D index) is assigned
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