Yang Fan, Lau Titus, Lee Evan, Vathsala A, Chia Kee Seng, Luo Nan
Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, MD 1, Singapore, 117549, Singapore.
Division of Nephrology, University Medicine Cluster, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Singapore, 119228, Singapore.
Eur J Health Econ. 2015 Dec;16(9):1019-26. doi: 10.1007/s10198-014-0664-7. Epub 2014 Dec 18.
The objective of this study was to compare the performance of the 5-level EuroQol 5-dimension (EQ-5D-5L) and the Short Form 6-dimension (SF-6D) instruments in assessing patients with end-stage renal disease (ESRD) in Singapore.
In a cross-sectional study, ESRD patients attending a tertiary hospital were interviewed using a battery of questionnaires including the EQ-5D-5L, the kidney disease quality of life instrument (KDQOL-36), and questions assessing dialysis history and socio-demographic characteristics. We reviewed patients' medical records for their clinical information. We assessed the construct validity of the EQ-5D-5L and SF-6D index scores and compared their ability to distinguish between patients differing in health status and the magnitude of between-group difference they quantified.
One hundred and fifty ESRD patients on dialysis (mean age, 60.1 years; female, 48.7%) participated in the study. Both EQ-5D-5L and SF-6D demonstrated satisfactory known-groups validity; the EQ-5D-5L was more sensitive to differences in clinical outcomes and the SF-6D was more sensitive to differences in health outcomes measured by KDQOL scales. The intraclass correlation coefficient between the measures was 0.36. The differences in the EQ-5D-5L index score for patients in better and worse health status were greater than those measured by the SF-6D index score.
Both EQ-5D-5L and SF-6D are valid instruments for assessing ESRD patients. However, the two preference-based measures cannot be used interchangeably and it appears that EQ-5D-5L would lead to more favorable cost-effectiveness results than SF-6D if they are used in economic evaluations of interventions for ESRD.
本研究旨在比较5级欧洲五维健康量表（EQ-5D-5L）和简明健康调查简表6维度（SF-6D）在评估新加坡终末期肾病（ESRD）患者方面的表现。
在一项横断面研究中，使用一系列问卷对一家三级医院的ESRD患者进行访谈，这些问卷包括EQ-5D-5L、肾病生活质量量表（KDQOL-36）以及评估透析史和社会人口学特征的问题。我们查阅患者的病历以获取其临床信息。我们评估了EQ-5D-5L和SF-6D指数得分的结构效度，并比较了它们区分不同健康状况患者的能力以及它们所量化的组间差异大小。
150名接受透析的ESRD患者（平均年龄60.1岁；女性占48.7%）参与了本研究。EQ-5D-5L和SF-6D均表现出令人满意的已知群组效度；EQ-5D-5L对临床结局差异更敏感，而SF-6D对KDQOL量表所测量的健康结局差异更敏感。两种测量方法之间的组内相关系数为0.36。健康状况较好和较差的患者在EQ-5D-5L指数得分上的差异大于SF-6D指数得分所测量的差异。
EQ-5D-5L和SF-6D都是评估ESRD患者的有效工具。然而，这两种基于偏好的测量方法不能互换使用，并且如果将它们用于ESRD干预措施的经济评估中，EQ-5D-5L似乎会比SF-6D产生更有利的成本效益结果。
