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Measuring preference-based quality of life using the EuroQol EQ-5D in patients with cerebral aneurysms
Joseph T King1, Joel Tsevat, Mark S Roberts
1Section of Neurosurgery, VA Connecticut Healthcare System, West Haven, Connecticut 06516, USA. Joseph.KingJr@va.gov
Objective:
Cerebral aneurysms can adversely affect quality of life (QOL) via mass effect, subarachnoid hemorrhage, anxiety, or treatment sequelae. The EuroQol EQ-5D is a popular generic 5-item multiple-choice survey questionnaire that measures preference-based QOL on a 0 to 1 scale. We assessed the validity and reliability of the EQ-5D in patients with cerebral aneurysms.
Methods:
We collected data from 178 neurosurgery clinic patients with cerebral aneurysms. Patients were assigned Glasgow Outcome Scale, Rankin scale, Barthel index, and Physical Performance Test scores, and completed the Short-Form 12, Hospital Anxiety and Depression scale, and the EQ-5D. We assessed the construct validity of the EQ-5D by comparing the EQ-5D and the other scales using rank-order methods and multivariate linear regression. Reliability was assessed with Cronbach's alpha.
Results:
Patients had a mean age of 54.7 years (standard deviation, 12.6 years), 131 (74%) were women, and 98 (55%) had survived a subarachnoid hemorrhage. The mean EQ-5D score was 0.80 (standard deviation, 0.19). Construct validity of the EQ-5D was confirmed by statistically significant associations between EQ-5D and Glasgow Outcome Scale, Rankin scale, Barthel index, Physical Performance Test, Short-Form 12 Physical Component Summary, and Hospital Anxiety and Depression scores (for all, P < or = 0.05). Multivariate regression showed that the EQ-5D scores were independently associated with the Barthel index, Short-Form 12 Physical Component Summary, and Hospital Anxiety and Depression scale anxiety and depression subscales (pseudo R = 0.40). Reliability was demonstrated by Cronbach's alpha of 0.70.
Conclusion:
The EQ-5D is a valid and reliable instrument for measuring QOL in patients with cerebral aneurysms. The EQ-5D provides a single QOL value incorporating functional status, physical functioning, and mental health.
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