Department of Family Medicine, The University of Hong Kong Shenzhen Hospital, Shenzhen, China.
Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161 Main Street, Ap Lei Chau, Hong Kong, SAR, China.
Health Qual Life Outcomes. 2021 Dec 18;19(1):266. doi: 10.1186/s12955-021-01898-3.
BACKGROUND: Electronic measurement of health-related quality of life (HRQOL) may facilitate timely and regular assessments in routine clinical practice. This study evaluated the validity and psychometric properties of an electronic version of the EQ-5D-5L (e-EQ-5D-5L) in Chinese patients with chronic knee and/or back problems. METHODS: 151 Chinese subjects completed an electronic version of the Chinese (Hong Kong) EQ-5D-5L when they attended a primary care or orthopedics specialist out-patient clinic in Hong Kong. They also completed the Chinese Western Ontario and McMaster University Osteoarthritis Index (WOMAC), a Pain Rating Scale, and a structured questionnaire on socio-demographics, co-morbidities and health service utilization. 32 subjects repeated the e-EQ-5D-5L two weeks after the baseline. 102 subjects completed e-EQ-5D-5L and 99 completed the Global Rating on Change Scale at three-month clinic follow up. Construct validity was assessed by the association of EQ-5D-5L scores with external criterion of WOMAC scores. We tested mean differences of WOMAC scores between adjacent response levels of the EQ-5D-5L dimensions by one-way ANOVA, test-retest reliability by intra-class correlation, sensitivity by known group comparisons and responsiveness by changes in EQ-5D-5L scores over 3 months. RESULTS: There was an association between EQ-5D-5L and WOMAC scores. Mean WOMAC scores increased with the increase in adjacent response levels of EQ-5D-5L dimensions. Test-retest intraclass correlation coefficient (ICC) of EQ-5D-5L utility and EQ-VAS scores were 0.76 and 0.83, respectively, indicating good reliability. There were significant differences in the proportions reporting limitations in the EQ-5D-5L dimensions, the utility and VAS scores between the mild and severe pain groups (utility = 0.28, p = 0.001; VAS = 11.46, p < 0.001), and between primary care and specialist out-patient clinic patients (utility = 0.15, p = 0.001; VAS = 10.21, p < 0.001), supporting sensitivity. Among those reporting 'better' global health at three-months, their EQ-5D-5L utility and EQ-VAS scores were significantly increased from baseline (utility = 0.18, p < 0.001; VAS = 10.75, p = 0.005). CONCLUSIONS: The electronic version of the EQ-5D-5L is valid, reliable, sensitive and responsive in the measurement of HRQOL in Chinese patients with chronic knee or back pain in routine clinical practice.
背景：电子测量健康相关生活质量（HRQOL）可能有助于在常规临床实践中进行及时和定期评估。本研究评估了电子版 EQ-5D-5L（e-EQ-5D-5L）在有慢性膝和/或腰背问题的中国患者中的有效性和心理测量学特性。
方法：151 名中国受试者在香港的基层医疗或矫形外科专科门诊就诊时，填写了电子版的香港中文 EQ-5D-5L。他们还填写了中文版的 Western Ontario 和 McMaster 大学骨关节炎指数（WOMAC）、疼痛评分量表以及一份关于社会人口统计学、合并症和卫生服务利用情况的结构化问卷。32 名受试者在基线后两周重复填写 e-EQ-5D-5L。102 名受试者在三个月的诊所随访时完成了 e-EQ-5D-5L 和 99 名完成了全球变化量表评分。结构效度通过 EQ-5D-5L 评分与 WOMAC 评分的外部标准的相关性来评估。我们通过单向方差分析检验了 WOMAC 评分在 EQ-5D-5L 各维度相邻反应水平之间的差异，通过组内相关系数（ICC）检验了测试-重测信度，通过已知组间比较检验了敏感性，通过 EQ-5D-5L 在 3 个月内的评分变化检验了反应度。
结果：EQ-5D-5L 与 WOMAC 评分之间存在相关性。WOMAC 评分随 EQ-5D-5L 各维度相邻反应水平的增加而增加。EQ-5D-5L 效用和 EQ-VAS 评分的测试-重测 ICC 分别为 0.76 和 0.83，表明具有良好的可靠性。在 EQ-5D-5L 各维度、效用和 VAS 评分报告受限的比例、轻至重度疼痛组之间（效用=0.28，p=0.001；VAS=11.46，p<0.001）以及基层医疗和专科门诊患者之间（效用=0.15，p=0.001；VAS=10.21，p<0.001）存在显著差异，支持敏感性。在报告“改善”全球健康的患者中，他们的 EQ-5D-5L 效用和 EQ-VAS 评分与基线相比显著增加（效用=0.18，p<0.001；VAS=10.75，p=0.005）。
结论：电子版 EQ-5D-5L 在常规临床实践中测量中国慢性膝或腰背疼痛患者的 HRQOL 是有效、可靠、敏感和有反应的。
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