The construct validity and responsiveness of the EQ-5D, SF-6D and Diabetes Health Profile-18 in type 2 diabetes

Health and Quality of Life Outcomes

Keith Meadows¹  Brendan Mulhern² 

[1] DHP Research and Consultancy, Bloxham Mill Business Centre, Barford Road, Bloxham, Banbury OX15 4FF, UK;Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Regent Court S1 4DA, UK

关键词: Validity;    Psychometrics;    DHP;    SF-6D;    EQ-5D;   

Others  :  815036
DOI  :  10.1186/1477-7525-12-42

 received in 2013-12-12, accepted in 2014-03-13,  发布年份 2014

【 摘 要 】

Background

Interest in the measurement of health related quality of life and psychosocial functioning from the patient’s perspective in diabetes mellitus has grown in recent years. The aim of this study is to investigate the psychometric performance of and agreement between the generic EQ-5D and SF-6D and diabetes specific DHP-18 in Type 2 diabetes. This will support the future use of the measures by providing further evidence regarding their psychometric properties and the conceptual overlap between the instruments. The results will inform whether the measures can be used with confidence alongside each other to provide a more holistic profile of people with Type 2 diabetes.

Methods

A large longitudinal dataset (n = 1,184) of people with Type 2 diabetes was used for the analysis. Convergent validity was tested by examining correlations between the measures. Known group validity was tested across a range of clinical and diabetes severity indicators using ANOVA and effect size statistics. Agreement was examined using Bland-Altman plots. Responsiveness was tested by examining floor and ceiling effects and standardised response means.

Results

Correlations between the measures indicates that there is overlap in the constructs assessed (with correlations between 0.1 and 0.7 reported), but there is some level of divergence between the generic and condition specific instruments. Known group validity was generally good but was not consistent across all indicators included (with effect sizes from 0 to 0.74 reported). The EQ-5D and SF-6D displayed a high level of agreement, but there was some disagreement between the generic measures and the DHP-18 dimensions across the severity range. Responsiveness was higher in those who self-reported change in health (SRMs between 0.06 and 0.25).

Conclusions

The psychometric assessment of the relationship between the EQ-5D, SF-6D and DHP-18 shows that all have a level of validity for use in Type 2 diabetes. This suggests that the measures can be used alongside each other to provide a more holistic assessment of with the quality of life impacts of Type 2 diabetes.

【 授权许可】

   
2014 Mulhern and Meadows; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】

• [1]Kohen D, Burgess AP, Catalan J, Lant A: The role of anxiety and depression in quality of life and symptom reporting in people with diabetes mellitus. Qual Life Res 1998, 1998(7):197-204.
• [2]Polonsky WH: Emotional and quality of life aspects of diabetes management. Curr Diabetes Rev 2002, 2:153.
• [3]Wexler DJ, Grant RW, Wittenberg E, Bosch JL, Cagliero E, Delahanty L, Blais MA, Meigs JB: Correlates of health related quality of life in type 2 diabetes. Diabetologia 2006, 2006(49):1489-1497.
• [4]Brooks R: EuroQol: the current state of play. Health Policy 1996, 37(1):53-72.
• [5]Dolan P: Modeling valuations for EuroQol health states. Med Care 1997, 35(11):1095-1108.
• [6]Brazier J, Roberts J, Deverill M: The estimation of a preference-based measure of health from the SF 36. J Health Econ 2002, 21(2):271-292.
• [7]Brazier JE, Roberts J: Estimating a preference-based index from the SF-12. Med Care 2004, 42(9):851-859.
• [8]Meadows K, Abrams C, Sandaek A: Adaptation of the diabetes health profile (DHP-1) for use with patients with type2 diabetes mellitus: psychometric evaluation and cross-cultural comparison. Diabet Med 2000, 17:572-580.
• [9]Peters M, Crocker H, Dummett S, Jenkinson C, Fitzpatrick R: Patient-reported outcomes in long term conditions: a cohort survey in England. Qual Life Res 2013, S103.
• [10]Janssen M, Lubetkin EI, Sekhobo JP, Pickard AS: The use of the EQ-5D preference-based health status measure in adults with type 2 diabetes mellitus. Diabet Med 2011, 28(4):393-413.
• [11]Kontodimopoulos N, Pappa E, Chadjiapostolou Z, Arvanitaki E, Papadopoulos AA, Niakas D: Comparing the sensitivity of EQ-5D, SF-6D and 15D utilities to the specific effect of diabetic complications. Eur J Health Econ 2012, 13(1):111-120.
• [12]National Institute of Health and Care Excellence: Guide to the Methods of Technology Appraisal. London: NICE; 2013.
• [13]Pharmaceutical Benefits Advisory Committee: Guidelines for preparing submissions to the Pharmaceutical Benefits Advisory Committee (PBAC). Canberra: Commonwealth of Australia; 2008.
• [14]Canadian Agency for Drugs and Technologies in Health: Guidelines for the Economic Evaluation of Health Technologies: Canada. 3rd edition. Ottawa: Canadian Agency for Drugs and Technologies in Health; 2006.
• [15]Meadows KA, Steen N, McColl E, Eccles M, Shiels C, Hewison J, Hutchinson A: The Diabetes Health Profile (DHP): a new instrument for assessing the psychosocial profile of insulin requiring patients - development and psychometric evaluation. Qual Life Res 1996, 5:242-254.
• [16]Erpelding ML, Boini S, Fagot-Campagna A, Mesbah M, Chwalow J, Penfornis A, Coliche V, Mollet É, Meadows K, Briançon S: Health related quality of life reference values (DHP) in people with diabetes living in France - entred study, 2001–2003. Journal Bulletin Épidémiologique Hebdomadaire 2009, 34:368-371.
• [17]Hippisley-Cox J, Yates J, Pringle M: Sex inequalities in access to care for patients with diabetes in primary care: questionnaire survey. Brit J Gen Pract 2006, 56(526):342-348.
• [18]Farr A, Phillips CJ, Davies S, Morgan S: Changes in health status of diabetic patients in Bridgend – Final Report. Swansea: University of Swansea; 2010.
• [19]Ruddock S, Fosbury J, Smith A, Meadows K, Crown A: Measuring psychological morbidity for diabetes commissioning: a cross-sectional survey of patients attending a secondary care diabetes clinic. Practical Diabetes International 2010, 27(1):22-26.
• [20]Meadows K: Scoring the DHP-18. DHP Research and Consultancy; 2010.
• [21]Cohen J: Statistical power analysis for the behavioral sciences. 2nd edition. Hillsdale, NJ: Erlbaum; 1988.
• [22]Bland JM, Altman DG: Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986, 1:307-310.
• [23]Herdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D, Bonsel G, Badia X: Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res 2011, 20(10):1727-1736.
• [24]Brazier J, Roberts J, Tsuchiya A, Busschbach J: A comparison of the EQ-5D and SF-6D across seven patient groups. Health Econ 2004, 13(9):873-884.
• [25]Whitehurst D, Bryan S: Another study showing that two preference-based measures of health-related quality of life (EQ-5D and SF-6D) are not interchangeable. But why should we expect them to be? Value Health 2011, 14(4):531-538.
• [26]Mulhern B, Mukuria C, Barkham M, Knapp M, Byford S, Soeteman D, Brazier J: Using preference based measures in mental health conditions: The psychometric validity of the EQ-5D and SF-6D. HEDS Discussion paper; 2013. in press
• [27]Brazier JE, Connell J, Papaioannou D, Mukuria C, Mulhern B, O’Cathain A, Barkham M, Knapp M, Byford S, Gilbody S, Parry G: Validating generic preference-based measures of health in mental health populations and estimating mapping functions for widely used specific measures. Health Technol Assess 2014. in press