Psychometric evaluation of EQ-5D-5L in OHCA survivors from the TTM2 trial: a post hoc analysis

IF 2.1 Q3 CRITICAL CARE MEDICINE

Resuscitation plus Pub Date : 2025-05-29 DOI:10.1016/j.resplu.2025.100994

Mattias Bohm , Kristofer Årestedt , Susann Ullén , Niklas Nielsen , Josef Dankiewicz , Hans Friberg , Erik Blennow Nordström , Alain Cariou , Janus Christian Jakobsen , Anders Morten Grejs , Matthias Haenggi , Naomi E. Hammond , Katarina Heimburg , Thomas R. Keeble , Christoph Leithner , Christian Rylander , Johan Undén , Matt P. Wise , Tobias Cronberg , Gisela Lilja

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Abstract

Aims

Our aim was to investigate the psychometric properties of the health assessment instrument EQ-5D-5L in OHCA survivors.

Methods

We included survivors from the Targeted Hypothermia versus Targeted Normothermia after OHCA (TTM2) trial, who completed EQ-5D-5L at 6 months. Confirmatory factor analysis was used to evaluate the hypothesised unidimensional latent structure of EQ level sum score (EQ LSS), summarizing scores across Mobility, Self-care, Usual activities, Pain/discomfort, and Anxiety/depression. Differential item functioning was evaluated for age. We examined internal consistency and precision for the EQ LSS. We evaluated construct validity of EQ LSS, EQ value and EQ VAS, using the modified Rankin Scale and Montreal Cognitive Assessment, representing functional outcome and cognitive function—two common health challenges experienced by OHCA survivors.

Results

783 of 939 (84%) eligible survivors were included. Confirmatory factor analysis showed good model fit and strong factor loadings for all dimensions (0.61–0.90). We observed a significant but negligible effect of age on Mobility (β = 0.29, p < 0.001, ΔR² = 0.019). Internal consistency was 0.88. The floor effect was 35%. Survivors with more functional dependency and/or cognitive problems reported significantly worse health by EQ LSS, EQ value, and EQ VAS (all, p < 0.001).

Conclusion

The psychometric properties of EQ LSS support its use to measure health status in OHCA research. The strong association between health and functional dependency indicate robust and comparable construct validity for EQ LSS, EQ value, and EQ VAS in this sample.

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TTM2试验中OHCA幸存者EQ-5D-5L的心理测量评估：事后分析

目的研究OHCA幸存者健康评估工具EQ-5D-5L的心理测量特性。方法我们纳入了OHCA （TTM2）试验后靶向低温与靶向常温的幸存者，他们在6个月时完成了EQ-5D-5L。验证性因子分析用于评估假设的情商水平总和得分（EQ LSS）的单维潜在结构，总结了行动能力、自我照顾、日常活动、疼痛/不适和焦虑/抑郁的得分。根据年龄对不同项目功能进行评估。我们检查了EQ LSS的内部一致性和精度。我们使用改进的Rankin量表和蒙特利尔认知评估量表来评估EQ LSS、EQ值和EQ VAS的结构效度，代表OHCA幸存者经历的两种常见健康挑战——功能结局和认知功能。结果939例符合条件的幸存者中有783例（84%）入选。验证性因子分析显示模型拟合良好，各维度因子负荷均较强（0.61-0.90）。我们观察到年龄对活动能力的影响显著但可以忽略不计(β = 0.29, p <；0.001， Δr2 = 0.019)。内部一致性为0.88。地板效应为35%。功能依赖和/或认知问题较多的幸存者通过EQ LSS、EQ值和EQ VAS报告的健康状况明显较差(all, p <；0.001)。结论EQ LSS的心理测量特性支持其在OHCA研究中用于健康状况的测量。健康和功能依赖之间的强关联表明，本样本中EQ LSS、EQ值和EQ VAS的结构效度稳健且可比较。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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