De Silva Sheraya, Neto Ary Serpa, Sathe Aditya, Higgins Alisa M, Hodgson Carol L
Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia.
Crit Care Med. 2025 Jan 1;53(1):e151-e160. doi: 10.1097/CCM.0000000000006516. Epub 2024 Nov 15.
The EuroQol 5D five level (EQ-5D-5L) instrument is a standardized measure of health-related quality of life and is routinely used in survivors of critical illness. However, information on its psychometric properties and minimal clinically important difference (MCID) in this patient group is lacking.
Secondary analysis of data from the previously published PREDICT (a registry in critically ill patients to determine predictors of disability-free survival) study, a prospective, multicenter cohort study.
Six ICUs in the state of Victoria, Australia.
Four hundred fifty adult patients admitted to the ICU and ventilated for over 24 hours.
None.
The EQ-5D-5L was administered by telephone at 6 months following ICU admission. Internal consistency (inter-item correlations, Cronbach's α, and split-half reliability coefficients), construct validity (against age, body mass index, and other outcome measures), responsiveness (observing change over time and effect sizes), percentage of participants presenting no change, and MCID (triangulation of distribution-based and anchor-based estimates) were evaluated. The EQ-5D-5L showed high internal consistency, Cronbach α coefficients of 0.82 (between dimensions) and 0.79 (between the EuroQol-Visual Analogue Scale [EQ-VAS] and utility score), and average split-half coefficients of 0.79 each (between dimensions and between EQ-VAS and utility score). Construct validity was confirmed with a strong correlation between the EQ-5D-5L and the World Health Organization Disability Assessment Schedule 2.0 (EQ-VAS: r = 0.72; p < 0.001 and utility score: r = 0.81; p < 0.001). Effect sizes for change over time for EQ-VAS and utility score were low. The final MCID estimates were 10 (EQ-VAS) and 0.11 (utility score).
The EQ-5D-5L, using the Australian value set, demonstrated evidence of good internal consistency and validity, but poor responsiveness in a critically ill population.
欧洲五维度健康量表五级版（EQ-5D-5L）是一种用于衡量健康相关生活质量的标准化工具，常用于危重症幸存者。然而，目前缺乏该患者群体中其心理测量特性及最小临床重要差异（MCID）的相关信息。
对先前发表的PREDICT（一项旨在确定危重症患者无残疾生存预测因素的登记研究）研究的数据进行二次分析，该研究为前瞻性多中心队列研究。
澳大利亚维多利亚州的6个重症监护病房。
450名入住重症监护病房且机械通气超过24小时的成年患者。
无。
在患者入住重症监护病房6个月后通过电话方式进行EQ-5D-5L评估。评估内容包括内部一致性（条目间相关性、Cronbach's α系数及分半信度系数）、结构效度（与年龄、体重指数及其他结局指标对比）、反应度（观察随时间的变化及效应量）、无变化参与者的百分比以及MCID（基于分布法和锚定法估计值的三角验证）。EQ-5D-5L显示出较高的内部一致性，维度间Cronbach α系数为0.82，欧洲五维度视觉模拟量表（EQ-VAS）与效用值评分间的Cronbach α系数为0.79，维度间及EQ-VAS与效用值评分间的平均分半系数均为0.79。EQ-5D-5L与世界卫生组织残疾评定量表2.0之间存在强相关性，证实了其结构效度（EQ-VAS：r = 0.72；p < 0.001；效用值评分：r = 0.81；p < 0.001）。EQ-VAS和效用值评分随时间变化的效应量较低。最终MCID估计值为10（EQ-VAS）和0.11（效用值评分）。
采用澳大利亚赋值集的EQ-5D-5L显示出良好的内部一致性和效度，但在危重症人群中的反应度较差。
