How does the EQ-5D-5L perform in asthma patients compared with an asthma-specific quality of life questionnaire?
Abstract Background Asthma patients experience impairments in health-related quality of life (HRQL). Interventions are available to improve HRQL. EQ-5D-5L is a common generic tool used to evaluate health interventions. However, there is debate over whether the use of this measure is adequate in asth...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12890-020-01205-8 |
| _version_ | 1831837863221657600 |
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| author | Boglárka L. Szentes Konrad Schultz Dennis Nowak Michael Schuler Larissa Schwarzkopf |
| author_facet | Boglárka L. Szentes Konrad Schultz Dennis Nowak Michael Schuler Larissa Schwarzkopf |
| author_sort | Boglárka L. Szentes |
| collection | DOAJ |
| description | Abstract Background Asthma patients experience impairments in health-related quality of life (HRQL). Interventions are available to improve HRQL. EQ-5D-5L is a common generic tool used to evaluate health interventions. However, there is debate over whether the use of this measure is adequate in asthma patients. Methods We used data from 371 asthma patients participating in a pulmonary rehabilitation (PR) program from the EPRA randomized controlled trial. We used four time points: T0 randomization, T1 start PR, T2 end PR, T3 3 months follow-up. We calculated floor and ceiling effects, intra-class correlation (ICC), Cohen’s d, and regression analysis to measure the sensitivity to changes of EQ-5D-5 L (EQ-5D index and Visual Analog Scale (VAS)) and the disease-specific Asthma Quality of Life Questionnaire (AQLQ). Furthermore, we estimated the minimally important difference (MID). Based on the Asthma Control Test (ACT) scores, we defined three groups: 1. ACT-A (ACT> 19) controlled asthma, 2. ACT-B (14 < ACT≤19) not well-controlled asthma, and 3. ACT-C (ACT≤14) very poorly controlled asthma. Results Only the EQ-5D index showed ceiling effects at T2 and T3 (32%). ICC (between T0 and T1) was moderate or good for all measures. Cohen’s d at T2 and T3 was better at differentiating between ACT-A and ACT-B than between ACT-B and ACT-C. The EQ-5D index showed moderate effect sizes (0.63–0.75), while AQLQ showed large effect sizes (0.74–1,48). VAS was responsive to pronounced positive and negative ACT changes in every period, and AQLQ mostly to the positive changes, whereas the EQ-5D index was less responsive. We estimated a MID of 0.08 for the EQ-5D index, 12.3 for VAS, and 0.65 for AQLQ. Conclusion All presented HRQL tools had good discriminatory power and good reliability. However, EQ-5D-5 L did not react very sensitively to small changes in asthma control. Therefore, we would suggest using supplementary measures in addition to EQ-5D-5 L to evaluate asthma-specific interventions more comprehensively. Trial registration German Clinical Trial Register, DRKS00007740 (date of registration: 05/15/2015), https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00007740 . The registration took place prospectively. |
| first_indexed | 2024-12-23T05:22:54Z |
| format | Article |
| id | doaj.art-de0b48c28595467bb767b969dc0fbabc |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-12-23T05:22:54Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-de0b48c28595467bb767b969dc0fbabc2022-12-21T17:58:39ZengBMCBMC Pulmonary Medicine1471-24662020-06-0120111110.1186/s12890-020-01205-8How does the EQ-5D-5L perform in asthma patients compared with an asthma-specific quality of life questionnaire?Boglárka L. Szentes0Konrad Schultz1Dennis Nowak2Michael Schuler3Larissa Schwarzkopf4Institute of Health Economics and Health Care Management, Helmholtz Zentrum München (GmbH) – German Research Center for Environmental Health, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL)Klinik Bad Reichenhall, Center for Rehabilitation, Pulmonology and OrthopedicsLMU University of München, Institute and Outpatient Clinic for Occupational, Social and Environmental MedicineUniversity of Würzburg, Institute of Clinical Epidemiology and BiometryInstitute of Health Economics and Health Care Management, Helmholtz Zentrum München (GmbH) – German Research Center for Environmental Health, Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL)Abstract Background Asthma patients experience impairments in health-related quality of life (HRQL). Interventions are available to improve HRQL. EQ-5D-5L is a common generic tool used to evaluate health interventions. However, there is debate over whether the use of this measure is adequate in asthma patients. Methods We used data from 371 asthma patients participating in a pulmonary rehabilitation (PR) program from the EPRA randomized controlled trial. We used four time points: T0 randomization, T1 start PR, T2 end PR, T3 3 months follow-up. We calculated floor and ceiling effects, intra-class correlation (ICC), Cohen’s d, and regression analysis to measure the sensitivity to changes of EQ-5D-5 L (EQ-5D index and Visual Analog Scale (VAS)) and the disease-specific Asthma Quality of Life Questionnaire (AQLQ). Furthermore, we estimated the minimally important difference (MID). Based on the Asthma Control Test (ACT) scores, we defined three groups: 1. ACT-A (ACT> 19) controlled asthma, 2. ACT-B (14 < ACT≤19) not well-controlled asthma, and 3. ACT-C (ACT≤14) very poorly controlled asthma. Results Only the EQ-5D index showed ceiling effects at T2 and T3 (32%). ICC (between T0 and T1) was moderate or good for all measures. Cohen’s d at T2 and T3 was better at differentiating between ACT-A and ACT-B than between ACT-B and ACT-C. The EQ-5D index showed moderate effect sizes (0.63–0.75), while AQLQ showed large effect sizes (0.74–1,48). VAS was responsive to pronounced positive and negative ACT changes in every period, and AQLQ mostly to the positive changes, whereas the EQ-5D index was less responsive. We estimated a MID of 0.08 for the EQ-5D index, 12.3 for VAS, and 0.65 for AQLQ. Conclusion All presented HRQL tools had good discriminatory power and good reliability. However, EQ-5D-5 L did not react very sensitively to small changes in asthma control. Therefore, we would suggest using supplementary measures in addition to EQ-5D-5 L to evaluate asthma-specific interventions more comprehensively. Trial registration German Clinical Trial Register, DRKS00007740 (date of registration: 05/15/2015), https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00007740 . The registration took place prospectively.http://link.springer.com/article/10.1186/s12890-020-01205-8EQ-5D-5 LAQLQACTAsthmaHealth-related quality of lifeResponsiveness |
| spellingShingle | Boglárka L. Szentes Konrad Schultz Dennis Nowak Michael Schuler Larissa Schwarzkopf How does the EQ-5D-5L perform in asthma patients compared with an asthma-specific quality of life questionnaire? BMC Pulmonary Medicine EQ-5D-5 L AQLQ ACT Asthma Health-related quality of life Responsiveness |
| title | How does the EQ-5D-5L perform in asthma patients compared with an asthma-specific quality of life questionnaire? |
| title_full | How does the EQ-5D-5L perform in asthma patients compared with an asthma-specific quality of life questionnaire? |
| title_fullStr | How does the EQ-5D-5L perform in asthma patients compared with an asthma-specific quality of life questionnaire? |
| title_full_unstemmed | How does the EQ-5D-5L perform in asthma patients compared with an asthma-specific quality of life questionnaire? |
| title_short | How does the EQ-5D-5L perform in asthma patients compared with an asthma-specific quality of life questionnaire? |
| title_sort | how does the eq 5d 5l perform in asthma patients compared with an asthma specific quality of life questionnaire |
| topic | EQ-5D-5 L AQLQ ACT Asthma Health-related quality of life Responsiveness |
| url | http://link.springer.com/article/10.1186/s12890-020-01205-8 |
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