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Validation of the EuroQol questionnaire in cardiac rehabilitation
B Schweikert1, H Hahmann, R Leidl
1Ludwig-Maximilians University, Munich School of Management, Health Economics and Management, Munich, Germany. schweikert@bwl.uni-muenchen.de
Insights
The EuroQol questionnaire (EQ-5D) demonstrates satisfying psychometric properties for assessing acute coronary syndromes (ACS) patients. This health status instrument is valid, reliable, and responsive for clinical research and epidemiological studies.
Area of Science:
- Cardiology
- Health Economics
- Psychometrics
Background:
- Acute coronary syndromes (ACS) necessitate robust tools for health-related quality of life (HRQoL) assessment.
- The EuroQol questionnaire (EQ-5D) is a widely used measure, but its psychometric properties in ACS populations require thorough evaluation.
Purpose of the Study:
- To analyze the psychometric properties of the EQ-5D in patients with acute coronary syndromes (ACS).
- To assess the acceptance, validity, reliability, and responsiveness of the EQ-5D in this specific patient group.
Main Methods:
- A cohort of 106 consecutive ACS patients (myocardial infarction, coronary artery bypass grafting, angina) completed the EQ-5D, SF-36, and MacNew questionnaires.
- Data were collected at admission, discharge, and three months post-rehabilitation.
- Statistical analyses were performed to evaluate acceptance, validity, reliability, and responsiveness.
Main Results:
- The EQ-5D exhibited high acceptance among ACS patients.
- While ceiling effects were noted post-rehabilitation, the EQ-5D demonstrated significant correlations with SF-36 and MacNew scores.
- The instrument showed reasonable reliability (intraclass correlation 0.54-0.91) and responsiveness (effect size 0.74-0.82) in patients reporting improved health.
Conclusions:
- The EQ-5D possesses satisfactory psychometric properties for use in ACS patients.
- It is a valid, reliable, and responsive instrument suitable for clinical research and epidemiological studies.
- The EQ-5D can generate valuable preference-based valuations of HRQoL in ACS populations.
Objective:
To analyse the psychometric properties of the EuroQol questionnaire (EQ-5D) applied to patients with acute coronary syndromes (ACS).
Setting:
Rehabilitation hospital.
Patients And Design:
106 consecutive patients with ACS (51% myocardial infarction, 42% coronary artery bypass grafting, 7% angina) completed the EQ-5D, the 36 item short form health survey (SF-36), and the MacNew questionnaire at admission, at discharge, and three months after inpatient cardiac rehabilitation. Acceptance, validity, reliability, and responsiveness of the EQ-5D were tested.
Results:
The EQ-5D was highly accepted. The EQ-5D index showed substantial ceiling effects after rehabilitation. As expected the EQ-5D visual analogue scale (VAS) score (70.3 v 57.1) and EQ-5D index (77.8 v 64.5) were significantly better for patients with myocardial infarction than for patients who underwent surgery (both p < or = 0.001). Significant correlations were found between the EQ-5D VAS score, EQ-5D index, and domains of the SF-36 (r = 0.21 to r = 0.74). The correlation with the MacNew subscores and with the global score ranged between 0.55 and 0.78. With repeated measurement the EQ-5D showed reasonable reliability in stable patients with intraclass correlation ranging between 0.91 and 0.54. EQ-5D was responsive in patients who indicated improvement in health states between admission and discharge (effect size 0.74-0.82).
Conclusion:
The psychometric properties of the EQ-5D were satisfying. It is a reasonably valid, reliable, and responsive instrument for patients with ACS. It may be useful in clinical research and epidemiological studies to generate preference based valuations of health related quality life.
