College of Pharmacy, Korea University, 2511 Sejong-ro, Sejong, 30019, South Korea.
University of Maryland School of Pharmacy, Baltimore, MD, USA.
BMC Pulm Med. 2020 Mar 23;20(1):73. doi: 10.1186/s12890-020-1116-z.
The discriminatory ability of multi-attribute utility (MAU) measures compared to condition-specific measures (CSM) in assessing health-related quality of life (HRQoL) among patients with chronic obstructive pulmonary disease (COPD) is an unsettled issue. This study investigated the quality of life of patients with COPD with three different HRQoL instruments and examined whether they could differentiate between adjacent severity groups in a statistically and clinically meaningful manner. In the process, the minimal clinically important differences (MCID) of the EQ-5D utility index were estimated.
Cross-sectional survey data were collected from patients with mild to very severe COPD in South Korea. In addition to demographic and clinical information, the following HRQoL questionnaires were used: The three-level five-dimensional Euro-Quality of Life tool (EQ-5D-3L), the EQ-Visual Analog Scale (EQ-VAS), and the Chronic Obstructive Pulmonary Disease Assessment Test (CAT). Patients' health-related quality of life was analyzed with reference to severity groups based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification. To investigate the discriminatory ability of the HRQoL instruments between COPD severity groups, tests examining variance, covariance, and standardized mean difference were performed. After estimating the MCID of the EQ-5D utility index using the anchor-based method, we investigated whether the differences in the EQ-5D utility scores between groups exceeded the clinically meaningful minimum level.
A total of 298 patients completed this study. All the quality of life scores showed statistically significant differences between the GOLD severity groups. The pooled MCID estimate for the EQ-5D utility index was 0.028 (range: 0.017-0.033). Even after adjusting for other factors affecting quality of life, the EQ-5D utility index differentiated the GOLD groups well.
We conclude that the EQ-5D utility index is a valid instrument for measuring the quality of life of patients with COPD, and the pooled MCID estimate for the EQ-5D utility index was 0.028.
在评估慢性阻塞性肺疾病（COPD）患者的健康相关生活质量（HRQoL）方面，多属性效用（MAU）测量与特定条件测量（CSM）相比的区分能力是一个悬而未决的问题。本研究使用三种不同的 HRQoL 工具评估了 COPD 患者的生活质量，并检验了它们是否能够以统计学和临床有意义的方式区分相邻严重程度组。在此过程中，还估计了 EQ-5D 效用指数的最小临床重要差异（MCID）。
横断面调查数据来自韩国的轻至重度 COPD 患者。除了人口统计学和临床信息外，还使用以下 HRQoL 问卷：三级五维欧洲生命质量量表（EQ-5D-3L）、EQ-视觉模拟量表（EQ-VAS）和慢性阻塞性肺疾病评估测试（CAT）。根据全球慢性阻塞性肺疾病倡议（GOLD）分类，患者的健康相关生活质量与严重程度组进行了分析。为了研究 HRQoL 工具在 COPD 严重程度组之间的区分能力，进行了方差检验、协方差检验和标准化均数差检验。在使用基于锚定的方法估计 EQ-5D 效用指数的 MCID 后，我们检验了组间 EQ-5D 效用评分的差异是否超过了临床有意义的最低水平。
共有 298 名患者完成了本研究。所有生活质量评分在 GOLD 严重程度组之间均存在统计学显著差异。EQ-5D 效用指数的汇总 MCID 估计值为 0.028（范围：0.017-0.033）。即使在调整了其他影响生活质量的因素后，EQ-5D 效用指数仍能很好地区分 GOLD 组。
我们得出结论，EQ-5D 效用指数是评估 COPD 患者生活质量的有效工具，EQ-5D 效用指数的汇总 MCID 估计值为 0.028。
