School of Health and Related Research, University of Sheffield, 30 Regent St, Sheffield, S1 4DA, UK.
Health Qual Life Outcomes. 2022 Nov 19;20(1):152. doi: 10.1186/s12955-022-02062-1.
To explore through a systematic review, the convergent validity of EQ-5D (EQ-5D-3L and EQ-5D-5L (total score and dimensions)) with core outcomes in dementia and investigate how this may be impacted by rater-type; with the aim of informing researchers when choosing measures to use in dementia trials.
To identify articles relevant to the convergent validity of EQ-5D with core dementia outcomes, three databases were electronically searched to September 2022. Studies were considered eligible for inclusion within the review if they included individual level data from people with dementia of any type, collected self and/or proxy reported EQ-5D and collected at least one core dementia outcome measure. Relevant data such as study sample size, stage of dementia and administration of EQ-5D was extracted, and a narrative synthesis was adopted.
The search strategy retrieved 271 unique records, of which 30 met the inclusion criteria for the review. Twelve different core outcome measures were used to capture dementia outcomes: cognition, function, and behaviour/mood across the studies. Most studies used EQ-5D-3L (n = 27). Evidence related to the relationship between EQ-5D and measures of function and behaviour/mood was the most robust, with unanimous directions of associations, and more statistically significant findings. EQ-5D dimensions exhibited associations with corresponding clinical outcomes, whereby relationships were stronger with proxy-EQ-5D (than self-report).
Measuring health-rated quality of life in dementia populations is a complex issue, particularly when considering balancing the challenges associated with both self and proxy report. Published evidence indicates that EQ-5D shows evidence of convergent validity with the key dementia outcomes, therefore capturing these relevant dementia outcomes. The degree of associations with clinical measures was stronger when considering proxy-reported EQ-5D and differed by EQ-5D dimension type. This review has revealed that, despite the limited targeted psychometric evidence pool and reliance on clinical and observational studies, EQ-5D exhibits convergent validity with other dementia outcome measures.
通过系统综述探索 EQ-5D（EQ-5D-3L 和 EQ-5D-5L（总分和维度））与痴呆核心结局的聚合效度，并研究评估者类型如何对此产生影响；旨在为痴呆症试验研究人员选择使用的测量方法提供信息。
为了确定 EQ-5D 与核心痴呆结局的聚合效度相关的文章，从 2022 年 9 月开始对三个数据库进行了电子检索。如果研究包括任何类型痴呆症患者的个体水平数据，收集自我和/或代理报告的 EQ-5D，并收集至少一项核心痴呆症结局测量，则认为该研究符合纳入本综述的标准。提取了相关数据，如研究样本量、痴呆症阶段和 EQ-5D 的管理，并采用了叙述性综合方法。
检索策略共检索到 271 条独特记录，其中 30 条符合本综述的纳入标准。12 项不同的核心结局测量用于捕捉痴呆症结局：认知、功能和行为/情绪。大多数研究使用 EQ-5D-3L（n=27）。与功能和行为/情绪测量相关的 EQ-5D 关系的证据最可靠，具有一致的关联方向和更具统计学意义的发现。EQ-5D 维度与相应的临床结局相关，其中代理报告的 EQ-5D（比自我报告）的相关性更强。
在痴呆人群中测量健康相关的生活质量是一个复杂的问题，特别是在考虑平衡自我和代理报告相关的挑战时。已发表的证据表明，EQ-5D 与关键的痴呆结局具有聚合效度，因此能够捕捉到这些相关的痴呆结局。当考虑代理报告的 EQ-5D 时，与临床测量的关联程度更强，并且 EQ-5D 维度类型不同，关联程度也不同。本综述表明，尽管针对特定心理测量学的证据有限，并且依赖于临床和观察性研究，EQ-5D 与其他痴呆结局测量具有聚合效度。
