Validation of the EQ-5D in a general population sample in urban China.
ABSTRACT To evaluate the reliability and validity of the EQ-5D in a general population sample in urban China.
Thousand and eight hundred respondents in 18 communities of Hangzhou, China were recruited by multi-stage stratified random sampling. Respondents self-administered a questionnaire including the EQ-5D, the SF-36, and demographic questions. Test-retest reliability at 2-week intervals was evaluated using Kappa coefficient, the intraclass correlation coefficient. The standard error of measurement (SEM) was used to indicate the absolute measurement error. Construct validity was established using convergent, discriminant, and known groups analyses.
Complete data for all EQ-5D dimensions were available for 1,747 respondents (97%). Kappa values were from 0.35 to 1.0. The ICCs of test-retest reliability were 0.53 for the EQ-5D index score and 0.87 for the EQ VAS score. The SEM values were 0.13 (9.22% range) and 4.20 (4.20% range) for the EQ-5D index and EQ VAS scores, respectively. The Pearson's correlation coefficients between the EQ-5D and the SF-36 were stronger between comparable dimensions than those between less comparable dimensions, demonstrating convergent and discriminant evidence of construct validity. The Chinese EQ-5D distinguished well between known groups: respondents who reported poor general health and chronic diseases had worse HRQoL than those without. Older people, females, people widowed or divorced, and those with a lower socioeconomic status reported poorer HRQoL. Respondents reporting no problems on any EQ-5D dimension had better scores on the SF-36 summary scores than those reporting problems.
The Chinese version of the EQ-5D demonstrated acceptable construct validity and fair to moderate levels of test-retest reliability in an urban general population in China.
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ABSTRACT: Background Childhood obesity is a growing public health concern in China. It not only compromises physical health, but also has negative impacts on psychosocial well-being. As obesity rates increase, finding out what the perceptions of Chinese youth are regarding their weight is important for intervention planning and evaluation. However, there is a paucity of available obesity-specific instruments for children and adolescents in China and youth weight-specific quality of life (QOL) has been little reported. This study aimed to evaluate the measurement properties of the Chinese version of the Youth Quality of Life Instrument – Weight Module (YQOL-W). Methods The Chinese version of the YQOL-W was administered to 840 youth aged 11–18 from nine schools. Measurement properties including measurement model, reliability, validity and burden were evaluated. Results Confirmatory factor analysis showed that a three-factor model had acceptable model fit. The instrument had robust internal consistency reliability with Cronbach's α ranging from 0.84 to 0.96 and acceptable test-retest reliability with the intraclass correlation coefficients (ICCs) all higher than 0.7. The standard error of measurement (SEM) values for the Self, Social and Environment factors and total score were 10.352, 9.526, 12.086 and 8.425, respectively. The small real differences (SRDs) for the Self, Social and Environment factors and total score were 28.675, 26.387, 33.478, and 23.337, respectively. The Pearson's correlation coefficients between the YQOL-W and the PedsQL4.0 General Core Scales were stronger between comparable dimensions than those between less comparable dimensions, demonstrating convergent and discriminant evidence of construct validity. Significant differences were found in subscale and total scores across weight status, age and genders (P<0.01), supporting the known-groups validity of the instrument. Conclusion The Chinese version of the YQOL-W has acceptable measurement properties and can be used to assess the weight-specific QOL of children and adolescents in China.PLoS ONE 09/2014; 9(9):e109221. DOI:10.1371/journal.pone.0109221 · 3.53 Impact Factor
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ABSTRACT: Background Most previous studies concerning the validity of the EQ-5D-3L items refer to applications of only a single language version of the EQ-5D-3L in only one country. Therefore, there is little information concerning the extent to which the results can be generalised across different language versions and/or different countries. Here the validity of the EQ-5D-3L items is investigated for six different language versions in six different countries.Methods Data came from 1341 type 2 diabetes patients (England: 289; Finland: 177; Germany: 255; Greece: 165; the Netherlands: 354; Spain: 101). The relationships of the five EQ-5D-3L items with seven different test variables (age, gender, education, previous stroke, problems with heart, problems with lower extremities, problems with eyes), were analysed for each combination of item and test variable. For each combination two logistic regression models with the dichotomised EQ-5D-3L item as dependent variable were computed. The first model contained the test variable and dummy coded countries as independent variables, the second model additionally the terms for the interaction between country and test variable. Statistically significant better fit of the second model was taken as evidence for country specific differences regarding the relationship. When such differences could be attributed mainly to one country the analyses were repeated without the data from this country. Validity was investigated with the remaining data using results of the first models.ResultsDue to lack of variation in the Spanish data only 31 of the originally intended 35 interaction tests could be performed. Only three of these yielded a significant result. In all three cases the Spanish data deviated most. Without the Spanish data only 1 of the 35 interaction tests yielded a significant result. With 3 exceptions, the tendency of reporting problems increased with age, female gender, lower education, previous stroke, heart problems, problems with lower extremities and problems with eyes for all EQ-5D-3L items.Conclusion The results concerning the European Spanish version are ambiguous. However, the items of the English, Finnish, German, Greek and Dutch versions of the EQ-5D-3L relate in substantially the same way to the test variables. Mostly, these relationships indicate the items¿ validity.Health and Quality of Life Outcomes 12/2014; 12(1):181. DOI:10.1186/s12955-014-0181-5 · 2.10 Impact Factor
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ABSTRACT: Background Based on the 24-week, prospective, non-interventional, observational study, A1chieve®, we investigated how health-related quality of life (HRQoL) changed, and the predictors of such changes, in Chinese people with type 2 diabetes mellitus (T2DM) after starting with, or switching to, biphasic insulin aspart 30 (BIAsp 30).Methods In total, 8,578 people with T2DM starting treatment with, or switching to, BIAsp 30 were recruited from 130 urban hospitals in China. HRQoL was assessed at baseline and 24 weeks using the EuroQol-5 dimensions (EQ-5D) questionnaire. Descriptive statistics, paired t-test, and chi-square test were conducted and the linear ordinary least squares regression model was used to determine predictors for changes in EQ-5D score.ResultsHaemoglobin A1c (HbA1c) decreased from 9.5% to 7.0% after 24 weeks. The reported HRQoL measured by the EQ-5D visual analogue scale score increased by 6.2 (p¿<¿0.001) from 75.8 to 82.0, and EQ-5D index score increased by 0.018 (p¿<¿0.001) from 0.875 to 0.893 for the cohort over 24 weeks. The percentage of patients reporting no problems in the mobility, pain/discomfort, and anxiety/depression dimensions of EQ-5D increased significantly (p¿<¿0.001) from 88.4% to 91.4%, 77.3% to 82.8%, and 74.2% to 77.1%, respectively. Patients with higher HbA1c levels at baseline, major hypoglycaemia or micro-complications exhibited significantly larger changes in EQ-5D scores than those with lower baseline HbA1c levels, without major hypoglycaemia or micro-complications after controlling for demographics and other baseline characteristics.ConclusionsBIAsp 30 treatment was associated with improved glycaemic control and HRQoL in T2DM patients in China. Patients with worse health conditions were more likely to experience larger improvements in HRQoL than those with better health conditions.Trial registrationClinicalTrials.gov, NCT00869908.Health and Quality of Life Outcomes 11/2014; 12(1):137. DOI:10.1186/s12955-014-0137-9 · 2.10 Impact Factor