Dataset Information

Examining the psychometric properties of a split version of the EQ-5D-5L anxiety/depression dimension in patients with anxiety and/or depression.

ABSTRACT:

Purpose

This study explored differences in self-reported responses and the psychometric performance of the composite EQ-5D-5L anxiety/depression (A/D) dimension compared with a split version of the dimension where 'anxiety' and 'depression' are measured separately.

Methods

People with anxiety and/or depression who visited the Amanuel Mental Specialized Hospital in Ethiopia completed the standard EQ-5D-5L with the added subdimensions. Correlation analysis was used to examine convergent validity with validated measures of depression (PHQ-9) and anxiety (GAD-7), while ANOVA was used to assess known-groups' validity. Agreement between ratings for composite and split dimensions was compared using percent agreement and Cohen's Kappa, while the proportion of 'no problems' reports was compared using the chi-square test. Discriminatory power analysis was undertaken using the Shannon index (H') and Shannon Evenness index (J'). Open-ended questions explored participants' preferences.

Results

Of the 462 respondents, 30.5% reported no problems with the composite A/D, while 13.2% reported no problems on both subdimensions. Agreement between ratings for composite and split dimensions was highest for respondents with comorbid anxiety and depression. The depression subdimension had higher correlation with PHQ-9 (r = 0.53) and GAD-7 (r = 0.33) than the composite A/D dimension (r = 0.36 and r = 0.28, respectively). The split subdimensions and composite A/D could adequately differentiate respondents based on their severity of anxiety or depression. Slightly better informativity was observed in EQ-4D-5L + anxiety (H' = 5.4; J' = 0.47) and EQ-4D-5L + depression (H' = 5.31; J' = 0.46) than EQ-5D-5L (H' = 5.19; J' = 0.45).

Conclusions

Adopting two subdimensions within the EQ-5D-5L tool appears to perform slightly better than the standard EQ-5D-5L.

SUBMITTER: Belay YB

PROVIDER: S-EPMC10241678 | biostudies-literature | 2023 Jul

REPOSITORIES: biostudies-literature

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Publications

Examining the psychometric properties of a split version of the EQ-5D-5L anxiety/depression dimension in patients with anxiety and/or depression.

Belay Yared Belete YB Mihalopoulos Cathrine C Lee Yong Yi YY Mulhern Brendan B Engel Lidia L

Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 20230221 7

<h4>Purpose</h4>This study explored differences in self-reported responses and the psychometric performance of the composite EQ-5D-5L anxiety/depression (A/D) dimension compared with a split version of the dimension where 'anxiety' and 'depression' are measured separately.<h4>Methods</h4>People with anxiety and/or depression who visited the Amanuel Mental Specialized Hospital in Ethiopia completed the standard EQ-5D-5L with the added subdimensions. Correlation analysis was used to examine conver ...[more]

PMID: 36809437

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Project description:PurposeThis cross-sectional study aims to understand the relationship between responses on the Anxiety/Depression (A/D) dimension of the EQ-5D-5L and symptoms of anxiety and depression on the GAD-7 and PHQ-9 instruments. In doing so, we investigate the comparative performance of the dimension between diagnostic groups (i.e. anxiety (GAD-7); depression (PHQ-9); anxiety & depression versus none). We additionally investigate the discriminatory performance between sub-populations based on gender, age, education and self-reported chronic conditions.Methods19,902 general population participants completed a health survey in May/June 2020, from five European countries and the United States. Performance of A/D was calculated using the Area Under the Receiver Operating Characteristic curve (AUROC), and was compared to having anxiety (GAD-7 ≥ 8), depression (PHQ-9 ≥ 10) and both versus none for the total population and sub-populations. Several additional sensitivity analyses were conducted, including calculations of the optimal A/D cut-off.ResultsThe performance in the total sample was good (AUROC > 0.8) and did not differ significantly between diagnostic groups. The performance differed significantly between the age groups, with worse performance in the younger groups, and differed between those with a singular chronic condition, with worse performance in those indicating having an anxiety or depression disorder. The performance did not differ significantly by gender, education, nor total chronic conditions.ConclusionThe A/D dimension captures symptoms of anxiety, depression or both equally well. Performance is worse in the younger population. Interpretation in those with a self-reported anxiety or depression disorder should be further investigated. This is the first-of-its-kind large population sample performance analysis, where we present evidence that the performance of the A/D dimension differs between ages, and thus intra-age comparative results may be flawed.

Project description:BackgroundFor many decision makers in Health Technology Assessment the EQ-5D-5L is the standard measure of health-related quality of life (HRQL). However, evidence has shown the limitations of the measure in certain disease areas, including dermatology. Alopecia areata (AA) is associated with a significant HRQL impact, partly due to the emotional impact of hair loss.ObjectivesThis study explores the psychometric properties of the EQ-5D-5L in people with AA in reference to the short-form 36 version 2 (SF-36v2), the Alopecia Areata Patient Priority Outcomes (AAPPO), the Severity of Alopecia Tool (SALT) and the Patient Global Impressions of Change (PGI-C).MethodsData from participants with AA enrolled in the ALLEGRO-2b/3 trial (NCT03732807) of ritlecitinib were analysed. Participants completed the AAPPO measure (an AA-specific measure assessing emotional symptoms and activity limitations), PGI-C, EQ-5D-5L and SF-36v2 across 48-weeks of follow up. Extent of scalp hair loss was assessed using the SALT. Ceiling effects, known groups validity, convergent validity and responsiveness were examined. Known groups were defined by SALT score and a PGI-C defined response from baseline. Exploratory factor analysis was also performed.ResultsData were available from 612 adult participants. Ceiling effects were observed for the EQ-5D-5L (55.3-61.2%) and analyses suggested that the EQ-5D did not capture important differences between patients that the SF-36v2 did. The EQ-5D-5L very weakly correlated with SALT score, whereas the AAPPO correlated more strongly with the extent of hair loss. Compared with the EQ-5D-5L, the AAPPO was better able to discriminate between known groups defined by SALT and PGI-C. An exploratory factor analysis suggested that the EQ-5D-5L had limitations in content validity compared with the AAPPO.ConclusionsThe EQ-5D-5L may not adequately measure the burden of AA on patients' HRQL. Insensitivity to the burden of AA suggests that the EQ-5D-5L may not measure treatment-related benefit with hair regrowth. Data from other measures could be considered if they are shown to be more relevant.

Project description:BackgroundEQ-5D is widely used for valuing changes in quality of life for economic evaluation of interventions for people with dementia. There are concerns about EQ-5D-3L in terms of content validity, poor inter-rater agreement and reliability in the presence of cognitive impairment, but there is also evidence to support its use with this population. An evidence gap remains regarding the psychometric properties of EQ-5D-5L.ObjectivesTo report psychometric evidence around EQ-5D-5L in people with dementia.MethodsA systematic review identified primary studies reporting psychometric properties of EQ-5D-5L in people with dementia. Searches were completed up to November 2020. Study selection, data extraction and quality assessment were undertaken independently by at least 2 researchers.ResultsEvidence was extracted from 20 articles from 14 unique studies covering a range of dementia severity. Evidence of known group validity from 5 of 7 studies indicated that EQ-5D-5L distinguishes severity of disease measured by cognitive impairment, depression, level of dependence and pain. Convergent validity (9 studies) showed statistically significant correlations of weak and moderate strengths, between EQ-5D-5L scores and scores on other key measures. Statistically significant change was observed in only one of 6 papers that allowed this property to be examined. All seven studies showed a lack of inter-rater reliability between self and proxy reports with the former reporting higher EQ-5D-5L scores than those provided by proxies. Five of ten studies found EQ-5D-5L to be acceptable, assessed by whether the measure could be completed by the PwD and/or by the amount of missing data. As dementia severity increased, the feasibility of self-completing EQ-5D-5L decreased. Three papers reported on ceiling effects, two found some evidence in support of ceiling effects, and one did not.ConclusionsEQ-5D-5L seems to capture the health of people with dementia on the basis of known-group validity and convergent validity, but evidence is inconclusive regarding the responsiveness of EQ-5D-5L. As disease progresses, the ability to self-complete EQ-5D-5L is diminished.

Project description:BackgroundThe majority of patient reported outcome measures (PROMs) don't have population norms in Romania. This is the case with the EQ-5D as well. Therefore, we aimed to estimate population norms for the Romanian versions of the EQ-5D-5L, EQ-5D-3L, their indexes, and the EQ-VAS.MethodsA cross-sectional survey was conducted in all regions of Romania from November 2018 to November 2019. A three-stage probability sampling procedure stratified by region and settlement size was used to select a representative sample. Interviews were computer-assisted and conducted in respondents' homes by trained interviewers. Health status was assessed with the EQ-5D-5L, the EQ-5D-3L and the EQ VAS. Descriptive statistics were used to estimate population norms by age groups and sex for the EQ-5D-5L, the EQ-5D-3L, their indexes and the EQ VAS. Population norms were weighted using survey weights. Indexes for the EQ-5D questionnaires were estimated using the recently developed Romanian value sets.ResultsData from 1,649 interviews was analysed in the present study. Survey weights were used so that sex and place of residence ratios for the weighted sample matched the Romanian general population distribution. Participants' mean age was 47.4 years (SE = 1.157) and 50.3% of them reported being in good health. The dimension for which people reported the highest number of problems for both questionnaires was the pain/discomfort dimension. Men aged 35 plus reported fewer problems with pain/discomfort than women for both the EQ-5D-5L and EQ-5D-3L. Health decreased with age as shown by the decrease from age group 18-24 to age group 75 plus in the indexes of both questionnaires: from 0.977 (SE = 0.005) to 0.765 (SE = 0.017) for EQ-5D-5L and from 0.981 (SE = 0.005) to 0.784 (SE = 0.019) for EQ-5D-3L. There was 29.9 points drop in the EQ VAS score between the youngest and oldest group.ConclusionsPopulation norms for the Romanian versions of the EQ-5D-5L, EQ-5D-3L, their indexes, and the EQ VAS are now available. These can now be used as reference values by healthcare professionals, researchers and decision-makers leading to a further development of health-related quality of life research in Romania.

Dataset Information

Examining the psychometric properties of a split version of the EQ-5D-5L anxiety/depression dimension in patients with anxiety and/or depression.

Purpose

Methods

Results

Conclusions

Publications

Examining the psychometric properties of a split version of the EQ-5D-5L anxiety/depression dimension in patients with anxiety and/or depression.

Similar Datasets

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