Outcome after injury-a systematic literature search of studies using the EQ-5D

Information is required about recovery after injury, including general health measures such as the EQ-5D. This project aimed to: (1) search for studies of injury outcome using the EQ-5D, (2) describe EQ-5D administration and analysis, (3) summarize reliability and validity, and (4) report EQ-5D outcomes.

A systematic search was undertaken for publications (January 1990 to May 2008). Studies were excluded if the EQ-5D was not used or if injury was a secondary outcome or resulted from a degenerative condition.

Of 79 potentially eligible articles retrieved, 35 were excluded and 44 remained. Sample sizes ranged between n = 14 and n = 3,231. Two thirds of studies described injury outcomes, the remainder focused on specific treatments after injury. Of studies reporting EQ-5D index scores, most used the UK value set, and 29% did not specify a value set. In 16 studies, the EQ-5D was self-completed by participants, and in others, administration was by interviewer, proxy, or unspecified. Time of administration varied between 6 days and 7 years after injury. The absence of a cognitive dimension in the EQ-5D was a concern.

Given the global impact of injury-related disability, our search supports calls for comprehensive population-level research exploring outcomes. Many studies considered only specific treatments after injury, had small sample sizes, or were undertaken in wealthy countries. Although noting reservations about the EQ-5D, such as the absence of a cognitive dimension; the EQ-SD being freely available to nonprofit-making organizations, and with many language versions available, seems suitable for studies in wealthy and poorer nations alike.