Faculty of Rehabilitation Medicine, University of Alberta, 3-44 Corbett Hall, Edmonton, AB, T6G 2G4, Canada.
School of Public Health, University of Alberta, 2-040 Li Ka Shing Center for Health Research Innovation, Edmonton, AB, T6G 2E1, Canada.
Health Qual Life Outcomes. 2019 Apr 17;17(1):68. doi: 10.1186/s12955-019-1129-6.
The EQ-5D-5 L and the SF-12 are the most commonly used generic measures of health-related quality of life among people with arthritis. However, there is little evidence on the extent to which the individual dimensions and domains of these instruments perform among this population. The objective was to examine the discriminative validity of the EQ-5D-5 L and the SF-12 version 2 (and SF-6D) in capturing the burden of arthritis on health-related quality of life in older adults.
Cross-sectional data from the Alberta Retired Teachers Association survey were used. A known-groups approach, with a-priori hypotheses, was used to examine the discriminative validity of the domain and summary scores of the EQ-5D-5 L and the SF-12 version 2 (and SF-6D). Groups were defined based on self-reported of arthritis, chronic pain level, presence and number of comorbidities, and self-reported health status.
Mean age of respondents (N = 2844) was 68.6 (standard deviation [SD] 5.9) years; 54.8% were female, with mean body mass index (BMI) of 27.2 kg/m (SD 4.8), and 36.6% reported having arthritis. The overall mean EQ-5D-5 L index score was 0.86 (SD 0.11) and that of SF-6D was 0.79 (SD 0.13). Participants with arthritis had lower EQ-5D-5 L index score (0.83, SD 0.13) and SF-6D index score (0.75, SD 0.13) compared to those without arthritis (0.88, SD 0.09 and 0.81, SD 0.12, respectively). EQ-5D-5 L and SF-6D index scores demonstrated moderate discriminative validity with a moderate effect size (0.5). Related dimensions and domains between the EQ-5D-5 L and SF-12 (e.g., mobility with physical functioning score, pain/discomfort with bodily pain and anxiety/depression with mental health) were moderately to strongly correlated (r = 0.6-0.7). Both instruments could not adequately discriminate between participants with moderate and severe chronic pain of 6-month duration.
Overall, the EQ-5D-5 L pain/discomfort and mobility dimensions, and the SF-12 bodily pain scale had moderate discriminative ability among older adults with arthritis. However, both instruments had limited discriminative ability for chronic pain. The importance and nature of chronic pain assessment in a given application need to be considered when choosing any of these instruments for measuring health-related quality of life in this patient population.
EQ-5D-5L 和 SF-12 是关节炎患者中最常用的健康相关生活质量通用测量工具。然而，关于这些工具的各个维度和领域在该人群中的表现程度，证据甚少。本研究旨在探讨 EQ-5D-5L 和 SF-12 版本 2（和 SF-6D）在捕捉老年人关节炎对健康相关生活质量的负担方面的区分效度。
使用了艾伯塔省退休教师协会调查的横断面数据。采用了一种已知群组的方法，有先验假设，来检验 EQ-5D-5L 和 SF-12 版本 2（和 SF-6D）的域和综合评分的区分效度。群组是根据自我报告的关节炎、慢性疼痛程度、共存疾病的存在和数量以及自我报告的健康状况来定义的。
受访者（n=2844）的平均年龄为 68.6（标准差[SD]5.9）岁；54.8%为女性，平均体重指数（BMI）为 27.2kg/m（SD 4.8），36.6%报告患有关节炎。总体平均 EQ-5D-5L 指数评分为 0.86（SD 0.11），SF-6D 指数评分为 0.79（SD 0.13）。患有关节炎的参与者的 EQ-5D-5L 指数评分（0.83，SD 0.13）和 SF-6D 指数评分（0.75，SD 0.13）低于没有关节炎的参与者（分别为 0.88，SD 0.09 和 0.81，SD 0.12）。EQ-5D-5L 和 SF-6D 指数评分具有中等的区分效度，具有中等的效应量（0.5）。EQ-5D-5L 与 SF-12 之间的相关维度和领域（例如，移动性与身体功能评分、疼痛/不适与身体疼痛、焦虑/抑郁与心理健康）具有中度至高度相关性（r=0.6-0.7）。这两种工具都不能充分区分有中度和严重的 6 个月慢性疼痛的参与者。
总体而言，EQ-5D-5L 的疼痛/不适和移动性维度以及 SF-12 的身体疼痛量表在关节炎老年患者中有中等的区分能力。然而，这两种工具对慢性疼痛的区分能力有限。在为该患者群体测量健康相关生活质量时，需要考虑在选择这些工具中的任何一种时，慢性疼痛评估的重要性和性质。
