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Validity of the EQ-5D in assessing and valuing health status in patients with schizophrenic, schizotypal or delusional disorders

Published online by Cambridge University Press:  16 April 2020

Hans-Helmut König ,
Christiane Roick  and
Matthias C. Angermeyer
Hans-Helmut König*
Affiliation:
Health Economics Research Unit, Department of Psychiatry, University of Leipzig, 04317Leipzig, Germany Department of Psychiatry, University of Leipzig, Leipzig, Germany
Christiane Roick
Affiliation:
Department of Psychiatry, University of Leipzig, Leipzig, Germany
Matthias C. Angermeyer
Affiliation:
Department of Psychiatry, University of Leipzig, Leipzig, Germany
*
*Corresponding author. Health Economics Research Unit, Department of Psychiatry, University of Leipzig, Johannisallee 20, 04317 Leipzig, Germany. Tel.: +49 341 97 24560; fax: +49 341 97 24569. E-mail address:[email protected] (H.-H.Känig).
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Abstract

Purpose

The EQ-5D is a generic questionnaire generating a health profile and a single index score for health-related quality of life. This study aimed to analyse the discriminative ability and validity of the EQ-5D in patients with schizophrenic, schizotypal or delusional disorders.

Subjects and methods

One hundred sixty-six patients with schizophrenic, schizotypal or delusional disorders (ICD-10 F2) completed the EQ-5D. Measures of quality of life (WHOQOL-BREF), utility (TTO), subjective (SCL-90R) and objective (PANSS, CGI-S) psychopathology, and functioning (GAF, GARF, SOFAS, HoNOS) provided comparison. Discriminative ability was analysed by assessing frequency distributions of EQ-5D scores. Validity of the EQ-5D self-classifier was analysed by assessing differences in related other scores grouped by response levels of EQ-5D items. Validity of the visual analogue scale (EQ VAS) and the EQ-5D index (UK social tariff) was analysed by assessing their correlation with all other scores.

Results

Seventy-nine percent of respondents reported problems in at least one of the EQ-5D dimensions (anxiety/depression 57%, usual activities 45%, pain/discomfort 44%, self-care 29%, mobility 22%). The mean EQ VAS score/EQ-5D index was 65.7/0.71. The four most frequently reported EQ-5D health states covered 45% of all respondents. For almost all EQ-5D dimensions, different response levels were associated with significantly different scores of measures used for comparison. Correlation of EQ VAS score and EQ-5D index were largest with scores of subjective measures (SCL-90R: −0.50 and −0.73; WHOQOL mental subscore 0.62 and 0.58; always P < 0.001).

Discussion and conclusion

The EQ-5D showed a moderate ceiling effect and seems to be reasonably valid in this patient group.

Keywords

EQ-5DQuality of lifeSchizophreniaValidityEuroQol
Type
Schizophrenia and Psychotic Disorder
Information
European Psychiatry , Volume 22 , Issue 3 , April 2007 , pp. 177 - 187
Copyright
Copyright © Elsevier Masson SAS 2007

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References

American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders. 4th ed.Washington, DC: American Psychiatric Press; 1994.Google Scholar
American Psychological Association, Standard for educational and psychological tests. Washington, DC: American Psychological Association; 1974.Google Scholar
Angermeyer, M.C.Kilian, R.Matschinger, H.WHOQOL-100 und WHOQOL-BREF. Handbuch für die deutschsprachige Version der WHO-Instrumente zur Erfassung von Lebensqualität. Göttingen: Hogrefe-Verlag; 2000.Google Scholar
Awad, A.G.Voruganti, L.N.Impact of atypical antipsychotics on quality of life in patients with schizophrenia. CNS Drugs 2004;18:877–893.10.2165/00023210-200418130-00004CrossRefGoogle ScholarPubMed
Awad, A.G.Voruganti, L.N.Heslegrave, R.J.Measuring quality of life in patients with schizophrenia. Pharmacoeconomics 1997;11:32–47.10.2165/00019053-199711010-00005CrossRefGoogle ScholarPubMed
Bobes, J.Garcia-Portilla, P.Saiz, P.A.Bascaran, T.Bousono, M.Quality of life measures in schizophrenia. Eur Psychiatry 20Suppl. 32005 S313–S317.10.1016/S0924-9338(05)80182-8CrossRefGoogle Scholar
Bowling, A.Measuring disease. Buckingham: Open University Press; 1995.Google Scholar
Brazier, J.Deverill, M.Green, C.Harper, R.Booth, A.A review of the use of health status measures in economic evaluation. Health Technol Assess 1999;3(i-iv):1–164.10.3310/hta3090CrossRefGoogle ScholarPubMed
Brazier, J.Roberts, J.Tsuchiya, A.Busschbach, J.A comparison of the EQ-5D and SF-6D across seven patient groups. Health Econ 2004;13:873–884.10.1002/hec.866CrossRefGoogle ScholarPubMed
Brooks, R.EuroQol: the current state of play. Health Policy 1996;37:53–72.10.1016/0168-8510(96)00822-6CrossRefGoogle ScholarPubMed
Ciudad, A.Montes, J.M.Olivares, J.M.Gomez, J.C.Safety and tolerability of olanzapine compared with other antipsychotics in the treatment of elderly patients with schizophrenia: a naturalistic study. Eur Psychiatry 2004;19:358–365.10.1016/j.eurpsy.2004.06.008CrossRefGoogle ScholarPubMed
Cohen, J.Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Earlbaum Associates; 1988.Google Scholar
Corrigan, P.W.Buican, B.The construct validity of subjective quality of life for the severely mentally ill. J Nerv Ment Dis 1995;183:281–285.10.1097/00005053-199505000-00001CrossRefGoogle ScholarPubMed
Cronbach, L.J.Meehl, P.E.Construct validity in psychological tests. Psychol Bull 1955;52:281–302.10.1037/h0040957CrossRefGoogle ScholarPubMed
Dernovsek, M.Z.Prevolnik Rupel, V.Rebolj, M.Tavcar, R.Quality of life and treatment costs in schizophrenic outpatients, treated with depot neuroleptics. Eur Psychiatry 2001;16:474–482.10.1016/S0924-9338(01)00609-5CrossRefGoogle ScholarPubMed
Derogatis, L.R.SCL-90-R: administration, scoring and procedures manual. Minneapolis, MN: National Computer Systems; 1994.Google Scholar
Dolan, P.Modeling valuations for EuroQol health states. Med Care 1997;35:1095–1108.10.1097/00005650-199711000-00002CrossRefGoogle ScholarPubMed
Drummond, M.F.O'Brien, B.Stoddart, G.L.Torrance, G.W.Methods for the economic evaluation of health care programmes. Oxford, UK: Oxford University Press; 1997.Google Scholar
EuroQol Group. Complete list of references. EuroQol Group, http://www.euroqol.org.Google Scholar
Franz, M.Meyer, T.Reber, T.Gallhofer, B.The importance of social comparisons for high levels of subjective quality of life in chronic schizophrenic patients. Qual Life Res 2000;9:481–489.10.1023/A:1008938011554CrossRefGoogle ScholarPubMed
Gold, M.Siegel, J.Russel, L.Weinstein, M.Cost-effectiveness in health and medicine. New York: Oxford University Press; 1996.Google ScholarPubMed
Green, C.Brazier, J.Deverill, M.Valuing health-related quality of life. A review of health state valuation techniques. Pharmacoeconomics 2000;17:151–165.10.2165/00019053-200017020-00004CrossRefGoogle ScholarPubMed
Greiner, W.Claes, C.Busschbach, J.J.Graf von der Schulenburg, J.M.Validating the EQ-5D with time trade off for the German population. Eur J Health Econom 2005;6:124–130.10.1007/s10198-004-0264-zCrossRefGoogle ScholarPubMed
Herrman, H.Hawthorne, G.Thomas, R.Quality of life assessment in people living with psychosis. Soc Psychiatry Psychiatr Epidemiol 2002;37:510–518.10.1007/s00127-002-0587-yCrossRefGoogle ScholarPubMed
Kaiser, W.Priebe, S.Barr, W.Hoffmann, K.Isermann, M.Roder-Wanner, U.U.et al.Profiles of subjective quality of life in schizophrenic in- and out-patient samples. Psychiatry Res 1997;66:153–166.10.1016/S0165-1781(96)02958-7CrossRefGoogle ScholarPubMed
Karow, A.Naber, D.Subjective well-being and quality of life under atypical antipsychotic treatment. Psychopharmacology (Berl) 2002;162:3–10.10.1007/s00213-002-1052-zCrossRefGoogle ScholarPubMed
Katschnig, H.Schizophrenia and quality of life. Acta Psychiatr Scand Suppl 2000;33–37.10.1034/j.1600-0447.2000.00006.xCrossRefGoogle ScholarPubMed
Kay, S.R.Fiszbein, A.Opler, L.A.The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987;13:261–276.10.1093/schbul/13.2.261CrossRefGoogle Scholar
König, H.H.Messung von Patientenpräferenzen in der Psychiatrie. Eine Literaturübersicht über den Einsatz von Standard Gamble, Time Trade-Off und Contingent Valuation bei Depression und Schizophrenie. Psychiatr Prax 2004;31:118–127.Google Scholar
König, H.H.Bernert, S.Angermeyer, M.C.Gesundheitszustand der deutschen Bevölkerung: Ergebnisse einer repräsentativen Befragung mit dem EuroQol-Instrument. Gesundheitswesen 2005;67:173–182.10.1055/s-2005-857991CrossRefGoogle Scholar
Lamers, L.M.Stalmeier, P.F.Krabbe, P.F.Busschbach, J.J.Inconsistencies in TTO and VAS V1alues for EQ-5D Health States. Med Decis Making 2006;26:173–181.10.1177/0272989X06286480CrossRefGoogle ScholarPubMed
Montes, J.M.Ciudad, A.Gascon, J.Gomez, J.C.Safety, effectiveness, and quality of life of olanzapine in first-episode schizophrenia: a naturalistic study. Prog Neuropsychopharmacol Biol Psychiatry 2003;27:667–674.10.1016/S0278-5846(03)00077-0CrossRefGoogle ScholarPubMed
National Institute of Mental Health 12—CGI. Clinical global impressions. In: Guy, W. editor. EDCEU assessment in psychopharmacology Rockville, MD: National Institute of Mental Health; 1970. p. 217–222.Google Scholar
Patrick, D.L.Deyo, R.A.Generic and disease-specific measures in assessing health status and quality of life. Med Care 1989;27:S217–S232.10.1097/00005650-198903001-00018CrossRefGoogle ScholarPubMed
Patrick, D.L.Erickson, P.Health status and health policy. New York: Oxford University Press; 1993.Google Scholar
Priebe, S.Oliver, J.P.J.Kaiser, W.Quality of life and mental health care. Petersfield: Wrightson Biomedical; 1999.Google Scholar
Prieto, L.Novick, D.Sacristan, J.A.Edgell, E.T.Alonso, J.A Rasch model analysis to test the cross-cultural validity of the EuroQoL-5D in the Schizophrenia Outpatient Health Outcomes Study. Acta Psychiatr Scand Suppl 2003 24–29.10.1034/j.1600-0447.107.s416.6.xCrossRefGoogle ScholarPubMed
Prieto, L.Sacristan, J.A.Hormaechea, J.A.Casado, A.Badia, X.Gomez, J.C.Psychometric validation of a generic health-related quality of life measure (EQ-5D) in a sample of schizophrenic patients. Curr Med Res Opin 2004;20:827–835.10.1185/030079904125003674CrossRefGoogle Scholar
Rasanen, P.Roine, E.Sintonen, H.Semberg-Konttinen, V.Ryynanen, O.P.Roine, R.Use of quality-adjusted life years for the estimation of effectiveness of health care: A systematic literature review. Int J Technol Assess Health Care 2006;22:235–241.10.1017/S0266462306051051CrossRefGoogle ScholarPubMed
Revicki, D.A.Kaplan, R.M.Relationship between psychometric and utility-based approaches to the measurement of health-related quality of life. Qual Life Res 1993;2:477–487.10.1007/BF00422222CrossRefGoogle ScholarPubMed
Roick, C.Deister, A.Zeichner, D.Birker, T.Konig, H.H.Angermeyer, M.C.Das Regionale Psychiatriebudget: Ein neuer Ansatz zur effizienten Verknüpfung stationärer und ambulanter Versorgungsleistungen. Psychiatr Prax 2005;32:177–184.10.1055/s-2004-834736CrossRefGoogle Scholar
Roick, C.Thierfelder, K.Heider, D.Klemm, T.Paschke, R.Angermeyer, M.C.Untersuchung der Aussagefähigkeit psychometrischer und präferenzbasierter Lebensqualitätsindizes bei psychisch und somatisch Kranken. Psychiatr Prax 2004;31:128–137.Google Scholar
Sapin, C.Fantino, B.Nowicki, M.L.Kind, P.Usefulness of EQ-5D in assessing health status in primary care patients with major depressive disorder. Health Qual Life Outcomes 2004;2:20.10.1186/1477-7525-2-20CrossRefGoogle ScholarPubMed
The EuroQol Group EuroQol: a new facility for the measurement of health-related quality of life. Health Policy 1990;16:199–208.10.1016/0168-8510(90)90421-9CrossRefGoogle Scholar
The WHOQOL Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med 1998;28:551–558.10.1017/S0033291798006667CrossRefGoogle Scholar
Torrance, G.W.Measurement of health state utilities for economic appraisal. J Health Econ 1986;5:1–30.10.1016/0167-6296(86)90020-2CrossRefGoogle ScholarPubMed
van de Willige, G.Wiersma, D.Nienhuis, F.J.Jenner, J.A.Changes in quality of life in chronic psychiatric patients: a comparison between EuroQol (EQ-5D) and WHOQoL. Qual Life Res 2005;14:441–451.10.1007/s11136-004-0689-yCrossRefGoogle ScholarPubMed
von der Schulenburg, J.M.Claes, C.Greiner, W.Uber, A.Die deutsche Version des Euro-Qol-Fragebogens. Zeitschrift für Gesundheitswissenschaften 1998;6:3–20.Google Scholar
Weinstein, M.C.Siegel, J.E.Gold, M.R.Kamlet, M.S.Russell, L.B.Recommendations of the Panel on Cost-effectiveness in Health and Medicine. JAMA 1996;276:1253–1258.10.1001/jama.1996.03540150055031CrossRefGoogle ScholarPubMed
WHOQOL Group. Measuring quality of life: The development of the World Health Organization quality of life Instrument (WHOQOL). Geneva: WHO; 1993.Google Scholar
Wing, J.K.Beevor, A.S.Curtis, R.H.Park, S.B.Hadden, S.Burns, A.Health of the Nation Outcome Scales (HoNOS). Research and development. Br J Psychiatry 1998;172:11–18.10.1192/bjp.172.1.11CrossRefGoogle ScholarPubMed
World Health Organisation, The ICD-10 classification of mental and behavioral disorders: clinical descriptions and diagnostic guidelines. Geneva: World Health Organisation; 1992.Google Scholar
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