Bushnell Donald M, Martin Mona L, Ricci Jean-François, Bracco Andrea
Health Research Associates, Inc., Mountlake Terrace, WA 98043, USA.
Value Health. 2006 Mar-Apr;9(2):90-7. doi: 10.1111/j.1524-4733.2006.00086.x.
The EQ-5D is a standardized, nondisease-specific instrument for evaluating patients' preference-based valuations of health-related quality of life (HRQoL). This study's purpose was to determine the psychometric properties of EQ-5D in patients with irritable bowel syndrome (IBS).
Data from four European IBS studies were assessed: UK (n = 161 and n = 297), Spain (n = 503), and Germany (n = 100). The EQ-5D is a five-item health state descriptive system used to develop health states (EQ-5D(INDEX)) and a visual analog scale (VAS) (0-100 from worst to best imaginable health state, EQ-5D(VAS)). Measures used with the EQ-5D included the SF-36, Irritable Bowel Syndrome--Quality of Life (IBS-QOL), and both subjective and clinical global assessments of IBS. Convergent validity was assessed using SF-36 and IBS-QOL data, discriminant validity using global ratings of IBS severity, and responsiveness by subjective and physician assessment of condition.
Moderate-to-high associations (r >or= 0.33) were seen between the EQ-5D(VAS) and the SF-36 and IBS-QOL subscales. Mean response scores to EQ-5D(INDEX) dimensions and the EQ-5D(VAS) score were significantly better for control patients than for patients with IBS (all P < 0.01). The EQ-5D(VAS) was able to discriminate between levels of pain severity (quartiles, P < 0.001; mild/moderate/severe, P < 0.05) and general health severity (mild/moderate/severe, P < 0.001). The EQ-5D(VAS) and the EQ-5D(INDEX) were responsive in patients using both a self-perceived (Subject's Global Assessment) and physician-rated (Clinic Global Assessment) improvement.
The EQ-5D performs well in comparison to general and disease-specific outcomes. It is a valid and responsive measure that can be used to generate preference-based valuations of HRQoL in patients with IBS and useful for comparisons in clinical and cost-effectiveness studies.
EQ-5D是一种标准化的、非疾病特异性的工具，用于评估患者基于偏好的健康相关生活质量（HRQoL）估值。本研究的目的是确定EQ-5D在肠易激综合征（IBS）患者中的心理测量特性。
评估了四项欧洲IBS研究的数据：英国（n = 161和n = 297）、西班牙（n = 503）和德国（n = 100）。EQ-5D是一个五项健康状态描述系统，用于构建健康状态（EQ-5D(INDEX)）和一个视觉模拟量表（VAS）（从最差到最佳可想象健康状态为0 - 100，EQ-5D(VAS)）。与EQ-5D一起使用的测量工具包括SF-36、肠易激综合征生活质量量表（IBS-QOL）以及IBS的主观和临床整体评估。使用SF-36和IBS-QOL数据评估收敛效度，使用IBS严重程度的整体评分评估区分效度，并通过主观和医生对病情的评估来评估反应度。
EQ-5D(VAS)与SF-36和IBS-QOL分量表之间存在中度至高的相关性（r≥0.33）。对照患者对EQ-5D(INDEX)维度的平均反应得分和EQ-5D(VAS)得分显著优于IBS患者（所有P < 0.01）。EQ-5D(VAS)能够区分疼痛严重程度水平（四分位数，P < 0.001；轻度/中度/重度，P < 0.05）和总体健康严重程度（轻度/中度/重度，P < 0.001）。EQ-5D(VAS)和EQ-5D(INDEX)在患者使用自我感知（受试者整体评估）和医生评分（临床整体评估）改善方面均有反应。
与一般和疾病特异性结局相比，EQ-5D表现良好。它是一种有效且有反应的测量工具，可用于生成IBS患者基于偏好的HRQoL估值，并且在临床和成本效益研究的比较中很有用。
