School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia.
Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
J Med Econ. 2024 Jan-Dec;27(1):607-617. doi: 10.1080/13696998.2024.2337563. Epub 2024 Apr 13.
This study aimed to examine the validity of EQ-5D-5L among HFrEF patients in Malaysia, and to explore the measurement equivalence of three main language versions.
We surveyed HFrEF patients from two hospitals in Malaysia, using Malay, English or Chinese versions of EQ-5D-5L. EQ-5D-5L dimensional scores were converted to utility scores using the Malaysian value set. A confirmatory factor analysis longitudinal model was constructed. The utility and visual analog scale (VAS) scores were evaluated for validity (convergent, known-group, responsiveness), and measurement equivalence of the three language versions.
200 HFrEF patients (mean age = 61 years), predominantly male (74%) of Malay ethnicity (55%), completed the admission and discharge EQ-5D-5L questionnaire in Malay (49%), English (26%) or Chinese (25%) languages. 173 patients (86.5%) were followed up at 1-month post-discharge (1MPD). The standardized factor loadings and average variance extracted were ≥ 0.5 while composite reliability was ≥ 0.7, suggesting convergent validity. Patients with older age and higher New York Heart Association (NYHA) class reported significantly lower utility and VAS scores. The change in utility and VAS scores between admission and discharge was large, while the change between discharge and 1MPD was minimal. The minimal clinically important difference for utility and VAS scores was ±0.19 and ±11.01, respectively. Malay and English questionnaire were equivalent while the equivalence of Malay and Chinese questionnaire was inconclusive.
This study only sampled HFrEF patients from two teaching hospitals, thus limiting the generalizability of results to the entire heart failure population.
EQ-5D-5L is a valid questionnaire to measure health-related quality of life and estimate utility values among HFrEF patients in Malaysia. The Malay and English versions of EQ-5D-5L appear equivalent for clinical and economic assessments.
本研究旨在检验 EQ-5D-5L 在马来西亚射血分数降低心衰（HFrEF）患者中的有效性，并探索三种主要语言版本的测量等效性。
我们调查了来自马来西亚两家医院的 HFrEF 患者，使用马来语、英语或中文版本的 EQ-5D-5L。EQ-5D-5L 维度评分使用马来西亚价值量表转换为效用评分。构建了验证性因子分析纵向模型。评估了三种语言版本的有效性（收敛性、已知组、反应性）和测量等效性，包括效用和视觉模拟量表（VAS）评分。
200 名 HFrEF 患者（平均年龄 61 岁），主要为男性（74%），马来裔（55%），在入院和出院时分别用马来语（49%）、英语（26%）或中文（25%）填写 EQ-5D-5L 问卷。173 名患者（86.5%）在出院后 1 个月（1MPD）时进行了随访。标准化因子负荷和平均方差提取均≥0.5，而综合可靠性≥0.7，提示具有收敛效度。年龄较大和纽约心脏协会（NYHA）心功能分级较高的患者报告的效用和 VAS 评分明显较低。入院和出院时的效用和 VAS 评分变化较大，而出院和 1MPD 时的变化较小。效用和 VAS 评分的最小临床重要差异分别为±0.19 和±11.01。马来语和英语问卷等效，而马来语和中文问卷的等效性不确定。
本研究仅从两家教学医院抽取 HFrEF 患者，因此研究结果对整个心力衰竭人群的推广性有限。
EQ-5D-5L 是一种有效的问卷，可用于测量马来西亚 HFrEF 患者的健康相关生活质量并估计效用值。EQ-5D-5L 的马来语和英语版本在临床和经济评估方面似乎等效。
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