Seng Jun Jie Benjamin, Kwan Yu Heng, Fong Warren, Phang Jie Kie, Lui Nai Lee, Thumboo Julian, Leung Ying Ying
Department of Medicine, Duke-NUS Medical School, 8 College Road, Singapore.
Program in Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore.
Eur J Rheumatol. 2020 Apr;7(2):71-78. doi: 10.5152/eurjrheum.2020.19043. Epub 2020 Apr 1.
This study aims to evaluate the reliability and validity of EuroQOL-5 Dimensions-5 Levels (EQ-5D-5L) among patients with axial spondyloarthritis (SpA) in Singapore.
A cross-sectional study was conducted involving patients with axial SpA in an Asian tertiary hospital from 2017 to 2018. This study followed the COnsensus-based Standards for selection of health Measurement Instruments framework. Construct validity was evaluated by testing 22 a priori hypotheses with other patient-reported outcomes measures. Cronbach's alpha was used to estimate the internal consistency of the EQ-5D-5L, while its test-retest reliability was assessed using weighted kappa and the intraclass correlation coefficient (ICC). The measurement error was assessed by analyzing minimal detectable change (MDC).
The median age of included patients (n=118) was 35 years (interquartile range: 28, 49). Ninety-six (81.4%) patients were male, while 112 (94.9%) patients were of Chinese ethnicity. The EQ-5D-5L demonstrated good internal consistency with a Cronbach's alpha of 0.79. The test-retest reliability of the EQ-5D-5L was good with a weighted kappa of ≥0.61 for mobility, self-care, usual activities, and anxiety/depression; the ICC was 0.92 and 0.99 for the EQ-5D-5L index and visual analog scale (VAS) scores, respectively. The weighted kappa for the EQ-5D-5L pain/discomfort was moderate [0.53, 95% confidence interval: 0.41-0.60]. The MDC for EQ-5D-5L index and VAS scores was 0.06 and 4.5, respectively. Convergent validity was supported as all hypotheses were confirmed in the results.
This study supports EQ-5D-5L as a valid and reliable instrument for assessing health-related quality of life among patients with axial SpA in Singapore.
本研究旨在评估欧洲五维健康量表-5级（EQ-5D-5L）在新加坡轴性脊柱关节炎（SpA）患者中的可靠性和有效性。
2017年至2018年在一家亚洲三级医院对轴性SpA患者进行了一项横断面研究。本研究遵循基于共识的健康测量工具选择标准框架。通过用其他患者报告的结局指标检验22个先验假设来评估结构效度。Cronbach's α用于估计EQ-5D-5L的内部一致性，而其重测信度则使用加权kappa和组内相关系数（ICC）进行评估。通过分析最小可检测变化（MDC）来评估测量误差。
纳入患者（n = 118）的中位年龄为35岁（四分位间距：28，49）。96名（81.4%）患者为男性，112名（94.9%）患者为华裔。EQ-5D-5L表现出良好的内部一致性，Cronbach's α为0.79。EQ-5D-5L的重测信度良好，活动能力、自我护理、日常活动以及焦虑/抑郁方面的加权kappa≥0.61；EQ-5D-5L指数和视觉模拟量表（VAS）评分的ICC分别为0.92和0.99。EQ-5D-5L疼痛/不适方面的加权kappa为中等[0.53，95%置信区间：0.41 - 0.60]。EQ-5D-5L指数和VAS评分的MDC分别为0.06和4.5。结果中所有假设均得到证实，支持了收敛效度。
本研究支持EQ-5D-5L作为评估新加坡轴性SpA患者健康相关生活质量的有效且可靠工具。
