EQ-5D-3L 和 5L 在一般人群健康调查中的天花板效应：系统评价和荟萃分析。

The Ceiling Effects of EQ-5D-3L and 5L in General Population Health Surveys: A Systematic Review and Meta-Analysis.

机构信息

Saw Swee Hock School of Public Health, National University of Singapore, Singapore.

Health Economics Unit, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.

出版信息

Value Health. 2024 Jul;27(7):986-997. doi: 10.1016/j.jval.2024.02.018. Epub 2024 Mar 10.

DOI:10.1016/j.jval.2024.02.018

PMID:38467187

Abstract

OBJECTIVES

This review aims to examine the ceiling effects of EQ-5D-3L (3L) and EQ-5D-5L (5L) in general adult populations and identify the factors influencing these effects.

METHODS

We searched 8 databases for observational studies published in English from inception to 24 July 2023. Ceiling effects were calculated by dividing the number of participants reporting full health at dimension or profile level by the total sample size. Subgroup analysis and meta-regression using the metafor package in R software were performed.

RESULTS

We identified 94 studies from 70 articles, including 4 543 647 adults across 37 countries. The global pooled proportion of individuals reporting full health ("11111") was 56% (95% CI 51%-62%) for 3L and 49% (95% CI 44%-54%) for 5L. The self-care dimension showed the highest ceiling effects (3L: 97%; 5L: 94%), whereas pain/discomfort had the lowest (3L: 69%; 5L: 60%). The ceiling effects in East/South-East Asia were higher than in Europe by 25% (95% CI 18%-32%) in 3L and 9% (95% CI -2%-20%) in 5L. Adjusting for mean age and proportion of males, significant regional differences persisted in the overall profile level of 3L, in all 3L dimensions (except for self-care), and 5L dimensions (except for pain/discomfort and anxiety/depression).

CONCLUSIONS

This review highlights significant ceiling effects in the EQ-5D, especially in Asian populations. The 5L version exhibited fewer ceiling effects than the 3L, indicating its superiority for general population surveys. Further research is crucial to understand the disparities in self-reported health outcomes between Asians and other populations.

摘要

目的

本综述旨在考察 EQ-5D-3L（3L）和 EQ-5D-5L（5L）在一般成年人群中的天花板效应，并确定影响这些效应的因素。

方法

我们检索了 8 个英文数据库，从建库到 2023 年 7 月 24 日，共检索到 94 项观察性研究。使用 R 软件中的 metafor 包进行亚组分析和荟萃回归，天花板效应通过将维度或轮廓水平报告完全健康的参与者人数除以总样本量来计算。

结果

我们从 70 篇文章中确定了 94 项研究，涉及 37 个国家的 4543647 名成年人。3L 报告完全健康（“11111”）的个体全球 pooled 比例为 56%（95%CI 51%-62%），5L 为 49%（95%CI 44%-54%）。自我护理维度的天花板效应最高（3L：97%；5L：94%），而疼痛/不适的天花板效应最低（3L：69%；5L：60%）。东亚/东南亚的天花板效应比欧洲高 25%（3L 的 95%CI 为 18%-32%）和 9%（95%CI -2%-20%）。在 3L 的整体轮廓水平、3L 的所有 3 个维度（自我护理除外）和 5L 的所有 4 个维度（疼痛/不适和焦虑/抑郁除外）中，调整平均年龄和男性比例后，仍存在显著的区域差异。