EQ-5D and SF-6D health utility scores in patients with spinal and bulbar muscular atrophy

Comparison of health-related quality of life in atopic dermatitis, hidradenitis suppurativa, pemphigus and psoriasis

This study aims to explore the measurement agreement between direct and indirect health utility measures in four chronic dermatological conditions (atopic dermatitis, hidradenitis suppurativa, pemphigus, psoriasis). Outpatients survey data collected between 2015 and 2021 were analysed. Health-related quality of life (HRQoL) outcome measures included time trade-off (TTO), EQ-5D-5L and Dermatology Life Quality Index (DLQI). Descriptive statistics were computed for the pooled sample and four diseases. Mean, standard deviation (SD), median, interquartile range (IQR), ceiling and floor effects were calculated for TTO, EQ-5D-5L and DLQI utilities. Bland‒Altman plots and intraclass correlation coefficients (ICC) were applied to investigate the agreement between health utility measures. Sociodemographic characteristics (age, sex, educational level, employment status) and health-related information (disease duration, outpatient care visits in the past 3 months and disease severity) impact on utilities was investigated by Tobit regressions. The sample includes N = 765 patient responses with a mean age of 41.5 (SD = 16.2), majority being males (52.7%). Total sample mean utilities were the highest according to TTO (0.83), followed by EQ-5D-5L and vDLQI (0.81 and 0.81) and lowest in mDLQI (0.77). Measurement agreement was found only between TTO and EQ-5D-5L. Skin-disease severity impacted all health state utilities, though only TTO differentiated utility values according to disease type. The discrepancies between the TTO and DLQI warn to compare DLQI-based utilities in different dermatological conditions with extreme caution.

Measurement properties of the EQ-5D-3L, EQ-5D-5L, and SF-6Dv2 in patients with late-onset Pompe disease

OBJECTIVE

The objective of this study was to evaluate the psychometric properties of the EQ-5D (3L and 5L) and SF-6Dv2 in a group of Chinese patients with late-on Pompe disease (PD), and compare their performance in this patient group.

METHODS

The data used in this study were obtained from a web-based and cross-sectional survey conducted in China. All participants completed the 3L, 5L, and SF-6Dv2. Information about their sociodemographic status and health conditions was also collected. The measurement properties were assessed by examining ceiling and floor effects, evaluating convergent validity, known-group validity, and test-retest reliability (Intraclass correlation coefficient [ICC] and Gwet's AC).

RESULTS

A total of 117 PD patients completed the questionnaire. All dimensions of the 3L showed strong ceiling effects, ranging between 17.1 and 42.7%. All three measures showed good test-retest reliability, with ICC values ranging from 0.85 to 0.87. The Gwet's AC values showed that four out of five dimensions of the 3L showed very good agreement. All hypothesized correlations between the 3L, 5L, SF-6Dv2, and items of WHODAS were supported, indicating satisfactory convergent validity. The 5L showed stronger correlations (|r|= 0.53-0.84) with WHODAS than the other two measures. The outcomes of ANOVA indicated that the 5L had higher F-statistics than the 3L and SF-6Dv2, indicating a stronger discriminant ability to differentiate most condition groups.

CONCLUSION

The 5L demonstrates lower ceiling and floor effects, higher discriminant ability, and better convergent validity than the SF-6Dv2 and 3L in patients with PD. In addition, the 5L may generate a larger utility gain compared to the other two instruments when conducting cost-effectiveness analysis.

Measurement properties of the EQ-5D-5L and PROPr in patients with spinal muscular atrophy

OBJECTIVES

Spinal muscular atrophy (SMA) is a rare monogenic neuromuscular disorder caused by loss of function mutations. Measuring health-related quality of life to support economic evaluations in this population is encouraged. However, empirical evidence on the performance of preference-based measures (PBMs) in individuals with SMA is limited. This study aimed to assess the psychometric properties of the EQ-5D-5L and the Patient-Reported Outcomes Measure Information System Preference measure (PROPr) in individuals with SMA.

METHODS

The data used in this study were obtained via a web-based, cross-sectional survey. All participants completed the self-reporting EQ-5D-5L and PROMIS-29 questionnaires. Information about their socioeconomic and health status was also obtained. Ceiling and floor effects, convergent and divergent validity, known-group validity, and the agreement between the two measures were assessed.

RESULTS

Strong ceiling and floor effects were observed for four dimensions of the EQ-5D-5L and three subscales, including pain intensity, pain interference, and physical function, of the PROMIS-29. All hypothesized associations between EQ-5D-5L/PROMIS-29 and other neuromuscular questions were confirmed, supporting good convergent validity. Moreover, both EQ-5D-5L and PROPr scores differentiated between impaired functional groups, demonstrating good discriminative ability. Poor agreement between the EQ-5D-5L and PROPr utility scores was observed.

CONCLUSIONS

The EQ-5D-5L and PROPr both appear to be valid PBMs for individuals with SMA. However, PROPr yielded considerably lower utility scores than EQ-5D-5L and their agreement was poor. Therefore, these two PBMs may not be used interchangeably in economic evaluations of SMA-related interventions.