Abstract
Background: We assessed cross-sectional validity of EQ-5D after myocardial infarction (MI). Methods: We compared EQ-5D, SF-36, quality of life After MI (QLMI), and Canadian Cardiovascular Society Anginal Classification (CCSG) scores. Correlation and regression techniques were used to assess convergent validity. SF-36 and alternate Rand-36 scoring were compared. CCSG class was used to evaluate discriminative validity and clinical difference in health state scores. Results: Of 99 patients: mean age 64; median 176.5 days post-MI; 80% had one MI; 74% were CCSG I. 1/3 to 1/2 reported mobility, self-care, pain, and emotional difficulties on EQ-5D. Median health state was 0.73. EQ-5D and SF-36 (or Rand-36) strongly correlate in overall health (0.75), emotional health (0.75), pain (0.68), and activity/ functional (0.5–0.63). EQ-5D and QLMI strongly correlate in activities/ self esteem (0.56), emotional health (0.64), anxiety/depression – restriction (0.53), and overall health (0.5–0.57). EQ-5D self-care correlates weakly with all domains. Domain scores from each general instrument contributed to each other’s overall health score (adjusted R2 0.61–0.69) and to disease specific score (0.45 adjusted R2). EQ-5D discriminates among CCSG classes (p < 0.000). Physicians detected a 0.16 difference in health state scores. Conclusion: The EQ-5D provides valid general HrQOL measurement post-MI.
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References
HJ Smith R Taylor A Mitchell (2000) ArticleTitleA comparison of four quality of life instruments in cardiac patients: SF-36, QLI, QLMI, and SEIQoL. Heart 84 390–394 Occurrence Handle10.1136/heart.84.4.390 Occurrence Handle10995407
TK Hillers GH Guyatt N Oldridge et al. (1994) ArticleTitleQuality of life after myocardial infarction. J Clin Epidemiol 47 IssueID11 1287–1296 Occurrence Handle10.1016/0895-4356(94)90134-1 Occurrence Handle7722565
VS Fan JR Curtis SP Tu MB McDonell SD Fihn (2002) ArticleTitleUsing quality of life to predict hospitalization and mortality in patients with obstructive lung disease. Chest 122 IssueID2 429–436 Occurrence Handle10.1378/chest.122.2.429 Occurrence Handle12171813
MAG Sprangers (2002) ArticleTitleQuality-of-life assessment in oncology: Achievements and challenges. Acta Oncol 41 IssueID3 229–237 Occurrence Handle10.1080/02841860260088764 Occurrence Handle12195741
CM Dougherty T Dewhurst WP Nichol J Spertus (1998) ArticleTitleComparison of three quality of life instruments in stable angina pectoris: Seattle Angina Questionnaire, Sort Form Health Survey (DF-36), and Quality of Life Index-Cardiac Version III. J Clin Epidemiol 51 IssueID7 569–575 Occurrence Handle10.1016/S0895-4356(98)00028-6 Occurrence Handle9674663
MJ Calvert N Freemantle (2003) ArticleTitleUse of health-related quality of life in prescribing research. Part 1: why evaluate health-related quality of life? Jr Clin Pharm Therap 28 513–521 Occurrence Handle10.1046/j.0269-4727.2003.00521.x
M Espallargues JM Valderas A Jordi (2000) ArticleTitleProvision of feedback on perceived health status to health care professionals: A systematic review of its impact. Med Care 38 IssueID2 175–186 Occurrence Handle10.1097/00005650-200002000-00007 Occurrence Handle10659691
J Greenhalgh K Meadows (1999) ArticleTitleThe effectiveness of the use of patient-based measures of health in routine practice in improving the process and outcomes of patient care: A literature review. J Eval Clin Pract 5 IssueID4 401–416 Occurrence Handle10.1046/j.1365-2753.1999.00209.x Occurrence Handle10579704
SM Gilbody AO House T Sheldon (2002) ArticleTitleRoutine administration of health related quality of life (HRQoL) and needs assessment instruments to improve psychological outcome–a systematic review. Psych Med 32 1345–1356 Occurrence Handle10.1017/S0033291702006001
SB Detmar MJ Muller JH Schornagel LDV Wever NK Aaronson (2002) ArticleTitleHealth-related quality-of-life assessments and patient-physician communication: A randomized controlled trial. JAMA 288 IssueID23 3027–3035 Occurrence Handle10.1001/jama.288.23.3027 Occurrence Handle12479768
CA McHorney DE Bricker (2002) ArticleTitleA qualitative study of patients’ and physicians’ views about practice-based functional health assessment. Med Care 40 IssueID11 1113–1125 Occurrence Handle10.1097/00005650-200211000-00012 Occurrence Handle12409856
IJ Higginson AJ Carr (2001) ArticleTitleUsing quality of life measures in the clinical setting. BMJ 322 1297–1300 Occurrence Handle10.1136/bmj.322.7297.1297 Occurrence Handle11375237
SJ Coons S Rao DL Keininger RD Hays (2000) ArticleTitleA comparative review of generic quality-of-life instruments. Pharamacoeconomics 17 IssueID1 13–35
MC Weinstein JE Siegel MR Gold et al. (1996) ArticleTitleRecommendations of the panel on cost-effectiveness in health and medicine. JAMA 276 IssueID15 1253–1258 Occurrence Handle10.1001/jama.276.15.1253 Occurrence Handle8849754
EuroQol Group The (1990) ArticleTitleEuroQol–a new facility for the measurement of health-related quality of life. Health Policy 16 199–208 Occurrence Handle10.1016/0168-8510(90)90421-9 Occurrence Handle10109801
P Kind P Dolan C Gudex et al. (1998) ArticleTitleVariations in population health status: Results from a United Kingdom national questionnaire survey. BMJ 316 736–741 Occurrence Handle9529408
K Jolly F Bradley S Sharp et al. (1999) ArticleTitleRandomized controlled trial of follow up care in general practice of patients with myocardial infarction and angina: Final results of the Southampton Heart Integrated care Project (SHIP). BMJ 318 706–711 Occurrence Handle10074017
CA Beck L Joseph P Bélisle et al. (2001) ArticleTitlePredictors of quality of life 6 months and 1 year after myocardial infarction. Am Heart J 142 271–279 Occurrence Handle10.1067/mhj.2001.116758 Occurrence Handle11479466
JE Ware (1993) SF-36 Health Survey. A manual and interpretaton guide. The Health Institute, New England Medical Center Boston, MA
MR Stockler D Osoba P Corey et al. (1999) ArticleTitleConvergent discriminative, and predictive validity of the Prostate Cancer Specific Quality of Life Instrument (PROSQOLI) assessment and comparison with analogous scales from the EORTC QLQ-C30 and a trial-specific module. J Clin Epidemiol 52 IssueID7 653–666 Occurrence Handle10.1016/S0895-4356(99)00025-6 Occurrence Handle10391659
J Brazier N Jones P Kind (1993) ArticleTitleTesting the validity of the Euroqol and comparing it with the SF-36 health survey questionnaire. Qual Life Res 2 169–180 Occurrence Handle10.1007/BF00435221 Occurrence Handle8401453
L Campeau (1976) ArticleTitleGrading of angina pectoris. Circulation 54 522–523
JA Johnson SJ Coons A Ergo et al. (1998) ArticleTitleValuation of EuroQOL (EQ-5D) health states in an adult US sample. Pharmacoeconomics 13 IssueID4 421–433 Occurrence Handle10178666
P Dolan (1997) ArticleTitleModeling valuations for EuroQol health states. Med Care 35 IssueID11 1095–1108 Occurrence Handle10.1097/00005650-199711000-00002 Occurrence Handle9366889
Hays RD. Rand-36 Health State Inventory, Orlando, The Psychological Corporation/Harcourt Brace, 1998.
BJ Winer (1962) Statistical Principles in Experimental Design. McGraw Hill New York 285–289
JA Johnson SJ Coons (1998) ArticleTitleComparison of the EQ-5D and SF-12 in an adult US sample. Qual Life Res 7 155–166 Occurrence Handle10.1023/A:1008809610703 Occurrence Handle9523497
S Macran H Weatherly P Kind (2003) ArticleTitleMeasuring population health: A comparison of three generic health status measures. Med Care 41 IssueID2 218–231
X Badia A Diaz-Prieto MT Gorriz et al. (2001) ArticleTitleUsing the EuroQol-5D to measure changes in quality of life 12 months after discharge from an intensive care unit. Intensive Care Med 27 1901–1907 Occurrence Handle10.1007/s00134-001-1137-x Occurrence Handle11797026
AM Garratt A Hutchinson I Russell (2001) ArticleTitleThe UK version of the Seattle Angina Questionnaire (SAQ-UK): Reliability, validity, and responsiveness. J Clin Epidemiol 54 907–915 Occurrence Handle10.1016/S0895-4356(01)00352-3 Occurrence Handle11520650
D Osoba (2002) ArticleTitleA taxonomy of the uses of health-related quality-of-life instruments in cancer care and the clinical meaningfulness of the results. Med Care 40 IssueID6S III-31–III-38 Occurrence Handle10.1097/00005650-200206001-00006
GR Norman FG Sridhar GH Guyatt SD Walter (2001) ArticleTitleRelation of distribution- and anchor-based approaches in interpretation of changes in health-related quality of life. Med Care 39 IssueID10 1039–1047 Occurrence Handle10.1097/00005650-200110000-00002 Occurrence Handle11567167
GR Norman JA Sloan KW Wyrwich (2003) ArticleTitleInterpretation of changes in health-related quality of life: The remarkable universality of a half a standard deviation. Med Care 41 IssueID5 582–592 Occurrence Handle10.1097/00005650-200305000-00004 Occurrence Handle12719681
RD Crosby RL Klotlin GR Williams (2003) ArticleTitleDefining clinically meaningful change in health-related quality of life. Jr Clin Epidemiol 56 395–407 Occurrence Handle10.1016/S0895-4356(03)00044-1
S Macran P Kind (2001) ArticleTitle“Death” and the valuation of health-related quality of life. Med Care 39 IssueID3 217–227 Occurrence Handle10.1097/00005650-200103000-00003 Occurrence Handle11242317
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Nowels, D., McGloin, J., Westfall, J.M. et al. Validation of the EQ-5D quality of life instrument in patients after myocardial infarction. Qual Life Res 14, 95–105 (2005). https://doi.org/10.1007/s11136-004-0614-4
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DOI: https://doi.org/10.1007/s11136-004-0614-4