Chua Ai-Ping, Cheng Ling Jie, Soh Zhi Yi, Chen Le Ann, Luo Nan
Department of Medicine, JurongHealth Campus, National University Health System, 1 Jurong East Street 21, Singapore, 609606, Singapore.
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Patient. 2025 Jan;18(1):35-47. doi: 10.1007/s40271-024-00711-9. Epub 2024 Sep 7.
We aimed to synthesize the evidence on the construct validity and responsiveness of the EQ-5D and compare them with asthma-specific health-related quality-of-life scales, to guide further research and clinical applications in asthma.
We searched key databases from inception to 1 June, 2024 and used the COnsensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) method to appraise the evidence. The effect size estimates were aggregated using the inverse variance method to evaluate the relative efficiency of EQ-5D measures against the Asthma Quality of Life Questionnaire (AQLQ) and/or its corresponding preference-based index, Asthma Quality of Life-5 Dimensions (AQL-5D).
There were 493 tests (construct validity: 428; responsiveness: 65) drawn from 37 selected articles (validation: 7; clinical: 30). Overall, 78.4% and 76.9% of the a priori hypotheses for assessing construct validity (convergent validity: 56.4%; known groups: 88.5%) and responsiveness, respectively, were satisfied. The methodological quality was "very good" or "adequate" in 78.2% of construct validity tests and 92.3% of responsiveness tests. The pooled correlation coefficient between EQ-5D index and AQLQ total scores was 0.52 (95% confidence interval 0.43-0.59), and between EQ visual analog scale and AQLQ total scores was 0.53 (95% confidence interval 0.34-0.69). The Cohen's d ratios for the index, level sum scores, and visual analog scale compared to AQLQ were 0.56 (n = 27), 1.16 (n = 16), and 0.75 (n = 37). The EQ-5D index's Cohen's d ratio compared to AQL-5D was 0.49 (n = 5). The standardized response mean ratios for the index and visual analog scale compared to AQLQ were 0.26 (n = 11) and 0.63 (n = 9).
The EQ-5D demonstrated overall good validity and responsiveness in the adult asthma population. However, a comparison against disease-specific instruments suggested scope for improvement in its psychometric performance for this population.
我们旨在综合关于EQ-5D的结构效度和反应度的证据，并将其与哮喘特异性健康相关生活质量量表进行比较，以指导哮喘领域的进一步研究和临床应用。
我们检索了从起始到2024年6月1日的主要数据库，并使用基于共识的健康测量工具选择标准（COSMIN）方法来评估证据。使用逆方差法汇总效应量估计值，以评估EQ-5D测量相对于哮喘生活质量问卷（AQLQ）和/或其相应的基于偏好的指数哮喘生活质量-5维度（AQL-5D）的相对效率。
从37篇选定文章（验证：7篇；临床：30篇）中提取了493项测试（结构效度：428项；反应度：65项）。总体而言，评估结构效度（收敛效度：56.4%；已知组：88.5%）和反应度的先验假设分别有78.4%和76.9%得到满足。在78.2%的结构效度测试和92.3%的反应度测试中，方法学质量为“非常好”或“充分”。EQ-5D指数与AQLQ总分之间的合并相关系数为0.52（95%置信区间0.43 - 0.59），EQ视觉模拟量表与AQLQ总分之间的合并相关系数为0.53（95%置信区间0.34 - 0.69）。与AQLQ相比，指数、水平总和分数和视觉模拟量表的科恩d比率分别为0.56（n = 27）、1.16（n = 16）和0.75（n = 37）。与AQL-5D相比，EQ-5D指数的科恩d比率为0.49（n = 5）。与AQLQ相比，指数和视觉模拟量表的标准化反应均值比率分别为0.26（n = 11）和0.63（n = 9）。
EQ-5D在成年哮喘人群中总体显示出良好的效度和反应度。然而，与疾病特异性工具的比较表明，其在该人群中的心理测量性能仍有改进空间。
