乳腺癌患者中EQ-HWB和EQ-HWB-S的心理测量特性：与EQ-5D-5L、FACT-8D和SWEMWBS的比较分析

The Psychometric Properties of the EQ-HWB and EQ-HWB-S in Patients With Breast Cancer: A Comparative Analysis With EQ-5D-5L, FACT-8D, and SWEMWBS.

作者信息

Pangestu Stevanus, Purba Fredrick Dermawan, Setyowibowo Hari, Azhar Yohana, Mukuria Clara, Rencz Fanni

机构信息

Department of Health Policy, Corvinus University of Budapest, Budapest, Hungary; Doctoral School of Business and Management, Corvinus University of Budapest, Budapest, Hungary; Faculty of Economics and Business, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.

Department of Psychology, Faculty of Psychology, Universitas Padjadjaran, Bandung, Indonesia.

出版信息

Value Health. 2025 Mar;28(3):449-459. doi: 10.1016/j.jval.2024.12.003. Epub 2024 Dec 27.

DOI:10.1016/j.jval.2024.12.003

PMID:39733837

Abstract

OBJECTIVES

The EQ Health and Wellbeing (EQ-HWB) is a new generic measure that captures constructs beyond health-related quality of life, with a 25-item long form and a shorter 9-item version (EQ-HWB-S). This study aimed to assess the psychometric performance of both versions in breast cancer, which is the most prevalent cancer worldwide, and compare them with other instruments.

METHODS

A longitudinal survey in Indonesia (2023-2024) with 300 female patients used the EQ-HWB, 5-level EQ-5D (EQ-5D-5L), Functional Assessment of Cancer Therapy - General (from which Functional Assessment of Cancer Therapy Eight Dimension [FACT-8D] was derived), and Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS, from which the Short WEMWBS was derived). Distributional characteristics, convergent validity, known-group validity (Student's t test or analysis of variance), test-retest reliability, and responsiveness were assessed.

RESULTS

All patients reported problems in at least 1 EQ-HWB item. The EQ-HWB-S index (11%) had a lower ceiling than the EQ-5D-5L (35%) and the Short WEMWBS (15.3%), but not the FACT-8D (5%). EQ-HWB-S index values correlated strongly with EQ-5D-5L (r = 0.73) and FACT-8D index values (r = 0.70), whereas EQ-HWB level sum scores correlated strongly with Functional Assessment of Cancer Therapy - General (r = 0.69) and moderately with WEMWBS (r = 0.49). The EQ-HWB and EQ-HWB-S discriminated across known groups comparably with the EQ-5D-5L and FACT-8D with large effect sizes according to EuroQol visual analog scale groups, number of symptoms, and general health and exhibited excellent instrument-level test-retest reliability (intraclass correlations, 0.79-0.83) and acceptable responsiveness (standardized response means, |0.24| to |0.97|).

CONCLUSIONS

This study represents one of the first validations of the EQ-HWB and EQ-HWB-S in any clinical population. Both instrument versions demonstrate robust psychometric performance. The EQ-HWB-S can be recommended to inform resource allocation decisions of breast cancer treatments.

摘要

目的

欧洲五维健康量表（EQ-HWB）是一种新的通用测量工具，涵盖了与健康相关生活质量之外的概念，有25项的长式版本和较短的9项版本（EQ-HWB-S）。本研究旨在评估这两个版本在乳腺癌患者中的心理测量性能，乳腺癌是全球最常见的癌症，并将它们与其他工具进行比较。

方法

在印度尼西亚进行的一项纵向调查（2023 - 2024年），对300名女性患者使用了EQ-HWB、5级欧洲五维健康量表（EQ-5D-5L）、癌症治疗功能评估通用版（从中衍生出癌症治疗功能评估八维度量表[FACT-8D]）以及沃里克 - 爱丁堡心理健康量表（WEMWBS，从中衍生出简短WEMWBS）。评估了分布特征、收敛效度、已知组效度（学生t检验或方差分析）、重测信度和反应度。

结果

所有患者至少在1项EQ-HWB项目中报告有问题。EQ-HWB-S指数（11%）的天花板效应低于EQ-5D-5L（35%）和简短WEMWBS（15.3%），但不低于FACT-8D（5%）。EQ-HWB-S指数值与EQ-5D-5L（r = 0.73）和FACT-8D指数值（r = 0.70）强烈相关，而EQ-HWB水平总分与癌症治疗功能评估通用版（r = 0.69）强烈相关，与WEMWBS中度相关（r = 0.49）。根据欧洲五维健康量表视觉模拟量表分组、症状数量、总体健康状况，EQ-HWB和EQ-HWB-S在已知组间的区分度与EQ-5D-5L和FACT-8D相当，效应量较大，并且表现出出色的工具层面重测信度（组内相关系数，0.79 - 0.83）和可接受的反应度（标准化反应均值，|0.24|至|0.97|）。