Center of Excellence for Rehabilitation Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht University, Utrecht, The Netherlands.
Department of Rehabilitation, Physical Therapy Science & Sports, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Clin Rehabil. 2020 Apr;34(4):545-550. doi: 10.1177/0269215520907990. Epub 2020 Feb 19.
The 5-level EuroQoL (EQ-5D-5L) is a patient-reported outcome measure frequently used in stroke research. However, it does not assess the cognitive problems many patients with stroke experience. The aim of this article is to compare the content validity, internal consistency and discriminative ability of the EQ-5D-5L with and without an additional cognitive domain (EQ-5D-5L+C), administered three months post-stroke.
Cross-sectional study.
Six general hospitals in the Netherlands.
In all, 360 individuals with stroke three months after the event.
Not applicable.
The modified Rankin Scale and EQ-5D-5L+C were administered in telephone interviews three months post-stroke.
A total of 360 patients with stroke were included. Mean age was 68.8 years (standard deviation (SD) = 11.7), 143 (40%) were female, 334 (93%) had had an ischemic stroke, 165 (46%) had a National Institutes of Health Stroke Scale (NIHSS) score ⩽ 4 at presentation and the Barthel Index was 17.2 (SD = 4) four days post-stroke. Cognitive problems were reported by 199 (55%) patients three months post-stroke. Internal consistencies of the EQ-5D-5L and EQ-5D-5L+C were 0.75 and 0.77, respectively. Adding a cognitive domain resulted in a decrease of the ceiling effect from 22% to 14%. Both EQ-5D-5L and EQ-5D-5L+C showed good discriminative ability, but differences between patients with different modified Rankin Scale scores and with/without reported decrease in health and daily activities were slightly larger with the EQ-5D-5L+C compared to the EQ-5D-5L.
The EQ-5D-5L+C, which includes a cognitive domain that is highly significant for stroke patients, showed increased content validity and good discriminative ability, without losing internal consistency.
欧洲五维健康量表（EQ-5D-5L）是一种常用于中风研究的患者报告结局测量工具。然而，它并未评估许多中风患者经历的认知问题。本文旨在比较中风后 3 个月时使用和不使用额外认知域的 EQ-5D-5L（EQ-5D-5L+C）的内容效度、内部一致性和区分能力。
横断面研究。
荷兰的 6 家综合医院。
共 360 名中风后 3 个月的个体。
无。
中风后 3 个月通过电话访谈进行改良 Rankin 量表和 EQ-5D-5L+C 评估。
共纳入 360 例中风患者。平均年龄为 68.8 岁（标准差[SD] = 11.7），143 例（40%）为女性，334 例（93%）为缺血性中风，165 例（46%）发病时 NIHSS 评分 ⩽ 4，Barthel 指数为 4 天发病后 17.2（SD = 4）。3 个月后，199 例（55%）患者报告存在认知问题。EQ-5D-5L 和 EQ-5D-5L+C 的内部一致性分别为 0.75 和 0.77。增加认知域可将天花板效应从 22%降低至 14%。EQ-5D-5L 和 EQ-5D-5L+C 均具有良好的区分能力，但与 EQ-5D-5L 相比，EQ-5D-5L+C 用于评估不同改良 Rankin 量表评分和报告健康和日常活动下降的患者时，差异略大。
包含对中风患者非常重要的认知域的 EQ-5D-5L+C 具有更高的内容效度和良好的区分能力，同时不丧失内部一致性。
