Department of Health Economics, Corvinus University of Budapest, 8 Fővám tér, 1093, Budapest, Hungary.
School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.
Qual Life Res. 2022 Oct;31(10):3049-3060. doi: 10.1007/s11136-022-03141-y. Epub 2022 Apr 26.
A number of bolt-ons have been proposed for the EQ-5D, including two psoriasis-specific bolt-ons, skin irritation and self-confidence. The study investigates and compares the relevance and comprehensiveness of these psoriasis-specific bolt-ons and the EQ-5D-5L and explores the potential conceptual overlaps between the existing five dimensions and the two bolt-ons.
Psoriasis patients were purposively sampled according to age and gender. Semi-structured interviews, where participants were asked to complete the EQ-5D-5L and the bolt-ons while thinking aloud, were conducted. Probes were used to investigate the thought processes of patients regarding the dimensions, wording, recall period and relevant concepts not captured by the EQ-5D-5L and bolt-ons. Data were analysed thematically. A focus group was used to confirm the findings.
Overall, 16 patients completed the interviews. Sixteen and fifteen patients considered skin irritation and self-confidence relevant areas to describe psoriasis problems. Three patients considered itching a form of discomfort, and thus, pointed out a potential overlap between pain/discomfort and skin irritation. Twelve patients reported overall 10 general health- or psoriasis-related concepts that are not captured by the EQ-5D-5L, including itching, social relationships and sex life. Eleven patients reported that the recall period of the EQ-5D-5L might be subject to bias because of the daily or within-day fluctuations of their symptoms.
The skin irritation and self-confidence bolt-ons contribute to improve content validity of the EQ-5D-5L in patients with psoriasis. The qualitative approach taken in this study expands the existing methodological framework for the development and testing validity of bolt-ons for the EQ-5D.
EQ-5D 已经提出了一些附加模块，包括两个特定于银屑病的附加模块，皮肤刺激和自信心。本研究调查和比较了这些特定于银屑病的附加模块与 EQ-5D-5L 的相关性和全面性，并探讨了现有五个维度与两个附加模块之间的潜在概念重叠。
根据年龄和性别，有目的地对银屑病患者进行抽样。进行半结构化访谈，要求参与者在完成 EQ-5D-5L 和附加模块的同时进行思考。使用探针调查患者对维度、措辞、回忆期以及 EQ-5D-5L 和附加模块未涵盖的相关概念的思维过程。对数据进行主题分析。使用焦点小组来确认研究结果。
共有 16 名患者完成了访谈。16 名和 15 名患者认为皮肤刺激和自信心是描述银屑病问题的相关领域。3 名患者认为瘙痒是一种不适形式，因此指出了疼痛/不适和皮肤刺激之间的潜在重叠。12 名患者报告了总共 10 个未被 EQ-5D-5L 涵盖的与整体健康或银屑病相关的概念，包括瘙痒、社会关系和性生活。11 名患者报告 EQ-5D-5L 的回忆期可能会因症状的日常或日内波动而存在偏差。
皮肤刺激和自信心附加模块有助于提高 EQ-5D-5L 在银屑病患者中的内容有效性。本研究采用的定性方法扩展了现有的 EQ-5D 附加模块开发和验证有效性的方法论框架。
