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Systematic review reveals that EQ-5D minimally important differences vary with treatment type and may decrease with

Ling Jie Cheng1, Le Ann Chen1, Jing Ying Cheng2

  • 1Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.

Journal of Clinical Epidemiology
|July 31, 2024
PubMed
Summary
This summary is machine-generated.

The Minimally Important Difference (MID) for EQ-5D scores varies by baseline score and treatment, not a single value. Researchers recommend using adjusted MIDs for better health status assessment.

Keywords:
Anchor basedMeta-regressionMinimally Important DifferencePatient-reported outcomeQuality of lifeSystematic review

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Area of Science:

  • Health Economics
  • Patient-Reported Outcomes
  • Psychometrics

Background:

  • The EQ-5D is a widely used instrument for measuring generic health status.
  • Minimally Important Difference (MID) estimates are crucial for interpreting EQ-5D score changes.
  • Previous MID estimates lack a comprehensive, updated summary and analysis of influencing factors.

Purpose of the Study:

  • To synthesize published anchor-based Minimally Important Difference (MID) estimates for EQ-5D index and EQ Visual Analog Scale (EQ VAS) scores.
  • To identify factors that influence these MID estimates.

Main Methods:

  • Systematic literature search of eight databases (January 1990–March 2023).
  • Analysis of associations between MID estimates and variables like baseline score, score change, data source, value set, disease, treatment type, and anchor type.
  • Development of prediction formulas for MID using linear and nonlinear regression models.

Main Results:

  • 47 articles were included, providing MID ranges for improved scores: EQ-5D-3L (-0.13 to 0.68), EQ-5D-5L (0.01–0.41), and EQ VAS (0.42–23.0).
  • Higher MIDs were associated with surgical intervention and lower baseline scores for EQ indices, but not EQ VAS.
  • Nonlinear models better predicted MIDs; data for score deterioration was insufficient for synthesis.

Conclusions:

  • MID estimates for EQ-5D scores are not uniform and depend on baseline score and treatment type.
  • A single, universal MID value for the EQ-5D may be inappropriate.
  • Recommendations include using baseline-adjusted and treatment-specific MIDs, and further research on MID for health deterioration.