Konnopka Alexander, Koenig Hans-Helmut
Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
Qual Life Res. 2017 Aug;26(8):2079-2084. doi: 10.1007/s11136-017-1551-3. Epub 2017 Mar 22.
To analyze the association between ceiling effects on the EQ-5D 5L and morbidity in a general population sample.
We used a cross-sectional sample of the German general population (n = 5007) to describe the frequency of health state "11111" and "no problems"-answers on the five single dimensions stratified by the number of diseases for which participants utilized health care during the last 6 months. For the five single dimensions we also used specific criteria to analyze their discriminative ability. A logit-model was applied for a multivariate analysis of ceiling effects.
31% of participants reported the health state "11111." This percentage strongly decreased with increasing morbidity, down to 4.9% if four or more diseases were present. The dimensions "mobility," "usual activities," and "pain/discomfort" showed good discriminative abilities. The dimensions "anxiety/depression" and "self -care" were able to discriminate between different levels of morbidity, but nevertheless showed strong ceiling effects, in particular "self-care."
When analyzing ceiling effects of the EQ-5D 5L, one has to draw attention to morbidity since high proportions of participants indicating the best health state might result from being healthy regarding the dimensions assessed by the EQ-5D, in particular in general population datasets.
分析一般人群样本中EQ-5D 5L量表的天花板效应与发病率之间的关联。
我们采用德国一般人群的横断面样本（n = 5007），按参与者在过去6个月内使用医疗保健服务的疾病数量，对五个单一维度上健康状态“11111”和“无问题”答案的频率进行描述。对于这五个单一维度，我们还使用特定标准分析其区分能力。应用logit模型对天花板效应进行多变量分析。
31%的参与者报告健康状态为“11111”。这一比例随着发病率的增加而大幅下降，若存在四种或更多疾病，该比例降至4.9%。“行动能力”“日常活动”和“疼痛/不适”维度显示出良好的区分能力。“焦虑/抑郁”和“自我护理”维度能够区分不同程度的发病率，但仍表现出强烈的天花板效应，尤其是“自我护理”维度。
在分析EQ-5D 5L量表的天花板效应时，必须关注发病率，因为高比例表明最佳健康状态的参与者可能是由于在EQ-5D评估的维度上健康，特别是在一般人群数据集中。
