Cross-cultural measurement equivalence of the 5-level EQ-5D (EQ-5D-5L) in patients with type 2 diabetes mellitus in Singapore

Health and Quality of Life Outcomes

Nan Luo²  Julian Thumboo¹  Ee-Guan Tay³  Ngiap-Chuan Tan³  Ye Wang⁴ 

[1] Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore, Singapore;Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Block MD 1, Singapore, 117597, Singapore;SingHealth Polyclinics, 167 Jalan Bukit Merah, Singapore, Singapore;Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, 1620 Tremont Street, Boston, MA, USA

关键词: Singapore;    EQ-5D-5L;    Diabetes mellitus;    Cross-cultural measurement equivalence;   

Others  :  1223861
DOI  :  10.1186/s12955-015-0297-2

 received in 2015-02-15, accepted in 2015-07-03,  发布年份 2015

【 摘 要 】

Background

This study aimed to assess the measurement equivalence of the 5-level EQ-5D (EQ-5D-5L) among the English, Chinese, and Malay versions.

Methods

A convenience sample of patients with type 2 diabetes mellitus were enrolled from a public primary health care institution in Singapore. The survey questionnaire comprised the EQ-5D-5L and questions assessing participants’ socio-demographic and clinical characteristics. Multiple linear regression models were used to assess the difference in EQ-5D-5L index (calculated using an interim algorithm) and EQ-visual analog scale (EQ-VAS) scores across survey language (Chinese vs. English, Malay vs. English, and Malay vs. Chinese). Measurement equivalence was examined by comparing the 90 % confidence interval of difference in the EQ-5D-5L index and EQ-VAS scores with a pre-determined equivalence margin. Multiple logistic regression models were used to assess the response patterns of the 5 Likert-type items of the EQ-5D-5L across survey language.

Results

Equivalence was demonstrated between the Chinese and English versions and between the Malay and English versions of the EQ-5D-5L index scores. Equivalence was also demonstrated between the Chinese and English versions and between the Malay and Chinese versions of the EQ-VAS scores. Equivalence could not be determined between the Malay and Chinese versions of the EQ-5D-5L index score and between the Malay and English versions of the EQ-VAS score. No significant difference was found in responses to EQ-5D-5L items between any languages, except that patients who chose to complete the Chinese version were more likely to report “no problems” in mobility compared to those who completed the Malay version of the questionnaire.

Conclusions

This study provided evidence for the measurement equivalence of the different language versions of EQ-5D-5L in Singapore.

【 授权许可】

   
2015 Wang et al.

【 图 表 】

Fig. 1.

【 参考文献 】

• [1]Herdman M, Fox-Rushby J, Badia X. ‘Equivalence’ and the translation and adaptation of health-related quality of life questionnaires. Qual Life Res. 1997; 6:237-47.
• [2]Jiang W. The relationship between culture and language. ELT J. 2000; 54:328-34.
• [3]Herdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D et al.. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5 L). Qual Life Res. 2011; 20:1727-36.
• [4]Janssen MF, Pickard AS, Golicki D, Gudex C, Niewada M, Scalone L et al.. Measurement properties of the EQ-5D-5 L compared to the EQ-5D-3 L across eight patient groups: a multi-country study. Qual Life Res. 2013; 22:1717-27.
• [5]Jia YX, Cui FQ, Li L, Zhang DL, Zhang GM, Wang FZ, et al. Comparison between the EQ-5D-5L and the EQ-5D-3L in patients with hepatitis B. Qual Life Res. 2014;23:2355–63.
• [6]Kim TH, Jo MW, Lee SI, Kim SH, Chung SM. Psychometric properties of the EQ-5D-5 L in the general population of South Korea. Qual Life Res. 2013; 22:2245-53.
• [7]Pickard AS, De Leon MC, Kohlmann T, Cella D, Rosenbloom S. Psychometric comparison of the standard EQ-5D to a 5 level version in cancer patients. Med Care. 2007; 45:259-63.
• [8]EQ-5D-5L User Guide: basic information on how to use the EQ-5D-5L instrument. 2015.
• [9]van Hout B, Janssen MF, Feng YS, Kohlmann T, Busschbach J, Golicki D et al.. Interim scoring for the EQ-5D-5 L: mapping the EQ-5D-5 L to EQ-5D-3 L value sets. Value Health. 2012; 15:708-15.
• [10]Szende A, Oppe M, Devlin N. EQ-5D Value Sets: Inventory, Comparative Review and User Guide. Springer, Dordrecht; 2007.
• [11]Dolan P. Modeling valuations for EuroQol health states. Med Care. 1997; 35:1095-108.
• [12]Drasgow F, Kanfer R. Equivalence of psychological measurement in heterogeneous populations. J Appl Psychol. 1985; 70:662-80.
• [13]Chadwick D. Monotherapy comparative trials: equivalence and differences in clinical trials. Epilepsy Res. 2001; 45:101-7.
• [14]Jones B, Jarvis P, Lewis JA, Ebbutt AF. Trials to assess equivalence: the importance of rigorous methods. BMJ. 1996; 313:36-9.
• [15]Luo N, Chew LH, Fong KY, Koh DR, Ng SC, Yoon KH,et al. Do English and Chinese EQ-5D versions demonstrate measurement equivalence? An exploratory study. Health Qual Life Outcomes. 2003;1:7.
• [16]Johnson MJ, Bland JM, Oxberry SG, Abernethy AP, Currow DC. Clinically important differences in the intensity of chronic refractory breathlessness. J Pain Symptom Manage. 2013; 46:957-63.
• [17]Norman GR, Sloan JA, Wyrwich KW. Interpretation of changes in health-related quality of life the remarkable universality of half a standard deviation. Med Care. 2003; 41:582-92.
• [18]Zisapel N, Nir T. Determination of the minimal clinically significant difference on a patient visual analog sleep quality scale. J Sleep Res. 2003; 12:291-8.
• [19]Pickard AS, Neary MP, Cella D. Estimation of minimally important differences in EQ-5D utility and VAS scores in cancer. Health Qual Life Outcomes. 2007; 5:70. BioMed Central Full Text
• [20]Luo N, Johnson JA, Coons SJ. Using instrument-defined health state transitions to estimate minimally important differences for four preference-based health-related quality of life instruments. Med Care. 2010; 48:365-71.
• [21]Lee CF, Ng R, Luo N, Wong NS, Yap YS, Lo SK et al.. The English and Chinese versions of the five-level EuroQoL Group’s five-dimension questionnaire (EQ-5D) were valid and reliable and provided comparable scores in Asian breast cancer patients. Support Care Cancer. 2013; 21:201-9.
• [22]Abdin E, Subramaniam M, Vaingankar JA, Luo N, Chong SA. Measuring health-related quality of life among adults in Singapore: population norms for the EQ-5D. Qual Life Res. 2013; 22:2983-91.
• [23]Wee HL, Li SC, Cheung YB, Fong KY, Thumboo J. The influence of ethnicity on health-related quality of life in diabetes mellitus: a population-based, multiethnic study. J Diabetes Complications. 2006; 20:170-8.
• [24]Whynes DK. Does the correspondence between EQ-5D health state description and VAS score vary by medical condition? Health Qual Life Outcomes. 2013; 11:155. BioMed Central Full Text
• [25]Leow MK, Griva K, Choo R, Wee HL, Thumboo J, Tai ES et al.. Determinants of Health-Related Quality of Life (HRQoL) in the Multiethnic Singapore Population - A National Cohort Study. PLoS One. 2013; 8:e67138.