An Exploratory Study of Alternative Time Frames and Descriptors for EQ-5D-5L in Obstructive Airway Diseases Using Mixed Methods

IF 4.9 2区 医学 Q1 ECONOMICS
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Abstract

Objectives

EQ-5D-5L with its recall time of “today” may limit its ability to capture episodic symptoms and exacerbations in chronic obstructive airway diseases (OAD). We examined whether longer time frames and changing the intensity response scales to frequency scales could improve the measurement properties of EQ-5D-5L.

Methods

We used a mixed-method design starting with in-depth interviews with 20 patients and clinicians to elicit preferred time frames using concept elicitation techniques and content analyses. We then administered the top 4 preferred variants using 1- and 4-weeks’ time frames with the original intensity or an alternative frequency response scale alongside EQ-5D-5L and St George Respiratory Questionnaire to OAD patients during 2 different visits. We compared the ceiling effects and construct validity by testing a priori hypotheses in relation to St George Respiratory Questionnaire and clinical outcomes via correlation and receiver operating characteristic (ROC) analyses, respectively. Follow-up patients were categorized into “better,” “stable,” and “worse” groups to assess reliability using intraclass correlation coefficient (ICC) or Cohen’s Kappa (k) and responsiveness using ROC analysis.

Results

A total of 184 patients (mean [SD] age: 54[18]; female: 37.0%) completed baseline assessments. A total of 120 patients also completed follow-up assessments (mean [SD] interval: 2.8 [1.7] months). The ceilings were lower in the variants compared with EQ-5D-5L (P < .001). Reliability of the variants were comparable to or higher than EQ-5D-5L. The c-statistic values derived from ROC analyses of the variants were consistently higher than EQ-5D-5L.

Conclusions

Use of longer time frames with the original intensity or the frequency response scales may improve EQ-5D-5L’s psychometric properties in OAD patients.
使用混合方法对阻塞性气道疾病中 EQ-5D-5L 的替代时间框架和描述符进行探索性研究。
目的:EQ-5D-5L 的回忆时间为 "今天",这可能会限制其捕捉慢性阻塞性气道疾病(OAD)中偶发症状和恶化的能力。我们研究了延长时间范围并将强度反应量表改为频率量表是否能改善 EQ-5D-5L 的测量特性:我们采用了混合方法设计,首先对 20 名患者和临床医生进行了深入访谈,利用概念诱导技术和内容分析得出了首选时间框架。然后,我们在两次不同的就诊过程中,对 OAD 患者使用一周和四周的时间框架、原始强度或替代频率响应量表以及 EQ-5D-5L 和圣乔治呼吸问卷 (SGRQ) 进行了评估,得出了前四种首选变体。我们通过相关分析和接收器操作特征(ROC)分析,分别测试了与 SGRQ 和临床结果相关的先验假设,从而比较了上限效应和构建有效性。将随访患者分为 "较好 "组、"稳定 "组和 "较差 "组,使用类内相关系数(ICC)或科恩卡帕(k)评估可靠性,使用ROC分析评估反应性:184 名患者(平均 [SD] 年龄:54[18];女性:37.0%)完成了基线评估。与 EQ-5D-5L 相比,变体的上限较低(p结论:在原始强度或频率响应量表中使用更长的时间范围可能会改善 EQ-5D-5L 在 OAD 患者中的心理测量特性。(248个字)。
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来源期刊
Value in Health
Value in Health 医学-卫生保健
CiteScore
6.90
自引率
6.70%
发文量
3064
审稿时长
3-8 weeks
期刊介绍: Value in Health contains original research articles for pharmacoeconomics, health economics, and outcomes research (clinical, economic, and patient-reported outcomes/preference-based research), as well as conceptual and health policy articles that provide valuable information for health care decision-makers as well as the research community. As the official journal of ISPOR, Value in Health provides a forum for researchers, as well as health care decision-makers to translate outcomes research into health care decisions.
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