Spanish and Catalan versions of the EuroQoi 5-D (EQ-5D) were included in the Catalan Health Interview Survey (CHIS) and administered to a randomly selected cross-section of 12,245 individuals from the Catalan general population. This paper analyses the feasibility, convergent validity and construct validity of three parts of the EQ-5D (the descriptive system, the visual analogue scale (VAS) and the Spanish tariff) using the results obtained in the CHIS. The feasibility was assessed by the number of missing responses. The convergent validity was based on the correlations between the EQ-5D scores and the scores on the General Health Questionnaire (GHQ) and on an index of self-perceived overall health. The construct validity was assessed by analysing the degree to which lower scores on the EQ-5D correlated positively with increasing age, being female, being in a lower social class or having a lower level of education and with increasing levels of disability, co-morbidity, restricted activity, mental health problems and poor self-perceived health. A low number of missing responses on the descriptive system and the VAS (1.5%) indicated a high level of acceptance. A marked ceiling effect was found, with 67% of the sample reporting no problem in any EQ dimension. The convergent validity with the GHQ was generally low, though moderate on the mood dimension. Self-perceived overall health correlated moderately to strongly with the mean VAS and tariff values. The positive correlations between lower scores on all three elements of the EQ-5D and increasing age, increasing levels of disability, comorbidity, restricted activity, mental health problems and poor self-perceived health provide some evidence of the instrument's construct validity, as does the fact that women reported more problems than men. Multivariate analyses using the VAS and tariff values as dependent variables and all of the sociodemographic and health variables as independent variables reached R2 values of 0.45 and 0.81, respectively. The Spanish and Catalan versions of the EQ-5D have proved to be feasible and valid for use in health interview surveys.
"No clear picture emerged as to the effect of demographic variables such as age and gender on HRQoL scores, though there was some evidence in two of the studies that female patients scored lower than males on CushingQoL and on some of the Tuebingen CD-25 dimensions. Poorer HRQoL in females is also consistent with the findings of other studies both in patients [21, 22] and the general population . Finally, as regards treatment, the two interventions studied to date (TSS and pasireotide) both showed significant gains in HRQoL, with moderate to large effect sizes. "
[Show abstract][Hide abstract] ABSTRACT: Cushing's syndrome (CS) has a considerable negative impact on patient health-related quality of life (HRQoL). Two disease-specific instruments (the CushingQoL and the Tuebingen CD-25 questionnaire) are now available to assess the impact of the disease and its treatment on HRQoL. The purpose of this review was to summarize the characteristics of the studies which have used these two instruments to date and summarize their findings regarding (a) the determinants of disease-specific HRQoL in patients with CS and (b) the impact of treatment for CS on disease-specific HRQoL. A total of 7 studies were identified, 5 with the CushingQoL and 2 with the Tuebingen CD-25. Most were observational studies, though the CushingQoL had been used in one randomized clinical trial. In terms of clinical factors, there was some evidence for an association between UFC levels and disease-specific HRQoL, though the presence and strength of the association varied between studies. There was also some evidence that a more recent diagnosis of CS could lead to poorer HRQoL, and that length of time with adrenal insufficiency may also affect HRQoL. There was no evidence for an impact on disease-specific HRQoL of etiology or of the clinical signs and symptoms associated with CS, such as bruising, rubor, and fat deposits. One factor which did have a significant negative effect on HRQoL was the presence of depression. No clear picture emerged as to the effect of demographic variables such as age and gender on HRQoL scores, though there was some evidence for poorer HRQoL in female patients. As regards treatment, the two interventions studied to date (transsphenoidal surgery and pasireotide) both showed significant gains in HRQoL, with moderate to large effect sizes. This type of review is useful in summarizing knowledge to date and suggesting future research directions.
"EQ-5D. EQ-5D is a standardized measure of health status developed by the EuroQoL Group that has demonstrated its usefulness in major therapeutic areas (Rabin and de Charro, 2001) as well as in health surveys across various general European populations (Badia et al., 1998; Kind et al., 1998). It provides a simple, generic measure of HRQoL for clinical and economic appraisal. "
[Show abstract][Hide abstract] ABSTRACT: The World Health Organization Disability Assessment Schedule II (WHODAS II) was developed for assessing disability. This study provides data on the validity and utility of the Spanish version of the WHODAS II in a large sample of patients with schizophrenia.
The sample included 352 patients with a schizophrenia spectrum disorder. They completed a comprehensive assessment battery including measures of psychopathology, functionality and quality-of-life. A sub-sample of 36 patients was retested after six months to assess its temporal stability.
Participation in society (6.3%) and Life activities (4.0%) were the domains with the highest percentage of missing data. The internal consistency (Cronbach's alpha) of the total scale was 0.94, and the test-retest stability reached an intraclass correlation coefficient of 0.92. It became apparent that the six primary factor models represent a better fit with reality than other competing models. Relationships between the WHODAS and measures of symptomatology, social and work-related functionality, and quality-of-life were in the expected direction and the scale was ultimately found to be able to differentiate among patients with different degrees of disease severity and different work status.
Assessment of disability using appropriate tools is a crucial aspect in the context of mental health and, in this regard, the Spanish version of the WHODAS II shows ample evidence of validity in patients with schizophrenia. The most important contribution of this study is that it is the first analyzing the Spanish version of the WHODAS II (36-item version) in a large sample of patients with schizophrenia.
Schizophrenia Research 04/2012; 138(2-3):240-7. DOI:10.1016/j.schres.2012.03.031 · 3.92 Impact Factor
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