Müller Eszter Mercédesz, Nikl Anna, Krebs Máté, Holló Péter, Brodszky Valentin, Kemény Lajos Vince, Rencz Fanni
Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 42 Mária utca, Budapest, H-1085, Hungary.
Károly Rácz Conservative Medicine Division, Semmelweis University Doctoral School, 26 Üllői út, Budapest, H-1085, Hungary.
Eur J Health Econ. 2025 Mar 13. doi: 10.1007/s10198-025-01772-9.
There is growing interest in measuring health outcomes associated with minimally invasive cosmetic procedures (MICPs), such as botulinum toxin and hyaluronic acid injections. However, the EQ-5D may have limited content validity for this purpose. This study aims to psychometrically test five additional dimensions ('bolt-ons') for the EQ-5D-5L in individuals planning or undergoing MICPs.
In 2023, a cross-sectional, online survey was conducted with 149 women planning MICPs and 215 who had recently undergone them. Respondents completed the EQ-5D-5L, five bolt-ons (skin irritation, self-confidence, sleep, social relationships, tiredness), the Rosenberg Self-Esteem Scale (RSES) and the Brief Fear of Negative Evaluation Scale-Straightforward Items (BFNE-S). The following psychometric properties were tested for the EQ-5D-5L + bolt-on(s): ceiling, convergent and divergent validity, explanatory power and known-groups validity.
Adding tiredness (22%), self-confidence (23%) or sleep bolt-ons (27%) substantially reduced the ceiling of the EQ-5D-5L (47%). The self-confidence and social relationships bolt-ons showed a moderate or strong correlation with the RSES and BFNE-S total scores (-0.462 to -0.679). The tiredness and self-confidence bolt-ons improved the EQ-5D-5L's explained variance in EQ VAS scores from 37% to 45%. The self-confidence and social relationships bolt-ons improved the EQ-5D-5L's discrimination between known groups based on self-esteem and bodily appearance (relative efficiency: 2.72 to 2.82).
Relevant bolt-ons substantially enhance the psychometric performance of the EQ-5D-5L in MICP populations. The self-confidence and tiredness bolt-ons may be recommended as primary choices for use alongside the EQ-5D-5L, both in clinical studies and as part of sensitivity analyses in economic evaluations of MICPs.
人们对测量与微创美容手术（MICP）相关的健康结果的兴趣日益浓厚，如肉毒杆菌毒素和透明质酸注射。然而，EQ-5D在此目的上的内容效度可能有限。本研究旨在对计划进行或正在接受MICP的个体的EQ-5D-5L的另外五个维度（“附加项”）进行心理测量测试。
2023年，对149名计划进行MICP的女性和215名最近接受过MICP的女性进行了一项横断面在线调查。受访者完成了EQ-5D-5L、五个附加项（皮肤刺激、自信心、睡眠、社会关系、疲劳）、罗森伯格自尊量表（RSES）和简明负面评价恐惧量表-直接项目（BFNE-S）。对EQ-5D-5L +附加项测试了以下心理测量特性：天花板效应、收敛效度和区分效度、解释力和已知群体效度。
添加疲劳（22%）、自信心（23%）或睡眠附加项（27%）大幅降低了EQ-5D-5L的天花板效应（47%）。自信心和社会关系附加项与RSES和BFNE-S总分显示出中度或强相关性（-0.462至-0.679）。疲劳和自信心附加项将EQ-5D-5L在EQ VAS评分中的解释方差从37%提高到了45%。自信心和社会关系附加项提高了EQ-5D-5L基于自尊和身体外观对已知群体的区分能力（相对效率：2.72至2.82）。
相关附加项显著提高了EQ-5D-5L在MICP人群中的心理测量性能。自信心和疲劳附加项可能被推荐作为与EQ-5D-5L一起使用的主要选择，无论是在临床研究中还是作为MICP经济评估中敏感性分析的一部分。
