JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
Eur J Health Econ. 2021 Jun;22(4):547-557. doi: 10.1007/s10198-021-01273-5. Epub 2021 Mar 24.
The aim of this study was to evaluate the psychometric properties of the EQ-5D-5L and SF-6D, and to compare their performance among patients living with haemophilia in China.
A total of 875 Chinese patients completed the EQ-5D-5L, SF-6D, and Haem-A-QoL questionnaires. Construct validity of the EQ-5D-5L and SF-6D dimensions and indices was assessed by testing hypotheses relating these measures to Haem-A-QoL and clinical measures. The Spearman correlation coefficient was used to assess convergent validity, and one-way analysis of variance (F statistic) was used to assess the known-groups validity (discriminatory power). The agreement between EQ-5D-5L and SF-6D indices was assessed using the intraclass correlation coefficient (ICC) and the Bland-Altman plot.
Both the EQ-5D-5L and SF-6D indices showed acceptable ceiling and floor effects. As hypothesised, both EQ-5D-5L and SF-6D were significantly correlated with Haem-A-QoL (both dimensions and overall score). EQ-5D-5L and SF-6D indices as well as EQ-VAS differentiated patients are known to differ in severity of haemophilia, bleeding status, disabling levels, and comorbidity. The F statistics in the known-groups comparisons suggested that the EQ-5D-5L was slightly more discriminative than the SF-6D. ICC (0.41) and Bland-Altman plot confirmed that the agreement between the EQ-5D-5L and SF-6D indices was poor.
Both EQ-5D-5L and SF-6D showed satisfactory construct validity in the measurement of the HRQoL among patients with haemophilia. However, the two instruments may not be used interchangeably in this patient population due to their poor agreement and differing discriminatory power.
本研究旨在评估 EQ-5D-5L 和 SF-6D 的心理测量特性，并比较它们在中国血友病患者中的表现。
共有 875 名中国患者完成了 EQ-5D-5L、SF-6D 和 Haem-A-QoL 问卷。通过检验这些措施与 Haem-A-QoL 和临床措施的关系，评估 EQ-5D-5L 和 SF-6D 维度和指标的结构效度。使用 Spearman 相关系数评估收敛效度，使用单因素方差分析（F 统计量）评估已知组别的有效性（判别能力）。使用组内相关系数（ICC）和 Bland-Altman 图评估 EQ-5D-5L 和 SF-6D 指数之间的一致性。
EQ-5D-5L 和 SF-6D 指数均显示出可接受的上限和下限效应。正如假设的那样，EQ-5D-5L 和 SF-6D 与 Haem-A-QoL 均呈显著相关（均为维度和总分）。EQ-5D-5L 和 SF-6D 指数以及 EQ-VAS 区分了已知在血友病严重程度、出血状态、致残程度和合并症方面存在差异的患者。在已知组比较中的 F 统计量表明，EQ-5D-5L 的判别能力略优于 SF-6D。ICC（0.41）和 Bland-Altman 图证实，EQ-5D-5L 和 SF-6D 指数之间的一致性较差。
EQ-5D-5L 和 SF-6D 在测量血友病患者的 HRQoL 方面均表现出令人满意的结构效度。然而，由于这两种工具之间的一致性较差且判别能力不同，在该患者群体中可能不能互换使用。
