Department of Dermatology, Venereology and Oncodermatology, Medical School, University of Pécs, 1 Akác Street, Pécs, Hungary.
Department of Health Policy, Corvinus University of Budapest, Budapest, Hungary.
Qual Life Res. 2024 Jan;33(1):101-111. doi: 10.1007/s11136-023-03519-6. Epub 2023 Oct 3.
Two bolt-on dimensions (skin irritation, self-confidence) have been developed for the EQ-5D-5L to improve its content validity and responsiveness in psoriasis. However, the two bolt-ons are not strictly psoriasis-specific and are potentially relevant in other skin conditions. This study aims to explore the content validity of the EQ-5D-5L with two bolt-ons in patients with atopic dermatitis (AD).
In 2021-2022, qualitative, semi-structured interviews were conducted with 20 adult AD patients at a university dermatology clinic in Hungary. We aimed for a heterogeneous sample in terms of age, gender, education and disease severity. Patients completed the EQ-5D-5L with two bolt-ons using a think-aloud protocol. Probing questions were posed to investigate item relevance, potential conceptual overlaps, missing concepts and the appropriateness of the recall period. Interview transcripts were subjected to thematic analysis.
The EQ-5D-5L with the two bolt-ons covered the most important aspects of health-related quality of life in AD patients. Most patients found both the skin irritation and self-confidence bolt-ons relevant. Fifteen potential missing concepts were identified, but only two (social relationships, judgement by others) were identified by more than one patient. A smaller conceptual overlap was found between the skin irritation and pain/discomfort dimensions in 7 patients (35%). Half the patients expressed a preference for a recall period of 1 week rather than of 'today'.
The EQ-5D-5L with skin irritation and self-confidence bolt-ons showed good relevance, comprehensiveness and comprehensibility in patients with AD. However, in terms of comprehensiveness, social relationships and judgement by others (stigma) may be missing from the questionnaire.
为了提高 EQ-5D-5L 在银屑病中的内容效度和反应度，已经开发了两个附加维度（皮肤刺激、自信心）。然而，这两个附加维度并非严格针对银屑病，在其他皮肤疾病中也可能相关。本研究旨在探讨 EQ-5D-5L 附加两个维度在特应性皮炎（AD）患者中的内容效度。
2021-2022 年，在匈牙利一所大学皮肤科诊所对 20 名成年 AD 患者进行了定性、半结构化访谈。我们旨在针对年龄、性别、教育程度和疾病严重程度等方面进行异质性样本。患者使用出声思维法完成 EQ-5D-5L 附加两个维度的评估。提出了探究性问题，以调查项目的相关性、潜在的概念重叠、缺失的概念以及回忆期的适宜性。对访谈记录进行主题分析。
EQ-5D-5L 附加两个维度涵盖了 AD 患者健康相关生活质量的最重要方面。大多数患者认为皮肤刺激和自信心两个附加维度都相关。确定了 15 个潜在缺失的概念，但只有两个（社会关系、他人判断）被超过一位患者提及。在 7 名患者（35%）中发现皮肤刺激和疼痛/不适维度之间的概念重叠较小。一半的患者表示更喜欢 1 周的回忆期，而不是“今天”。
EQ-5D-5L 附加皮肤刺激和自信心维度在 AD 患者中表现出良好的相关性、全面性和可理解性。然而，就全面性而言，问卷可能缺失了社会关系和他人判断（耻辱感）这两个概念。
