Fanni Rencz1,2, Peter L Lakatos3,4, László Gulácsi5, Valentin Brodszky5, Zsuzsanna Kürti3, Szilvia Lovas6, János Banai7, László Herszényi7, Tamás Cserni5,8, Tamás Molnár9, Márta Péntek5, Károly Palatka6. 1. Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary. fanni.rencz@uni-corvinus.hu. 2. Premium Postdoctoral Research Program, Hungarian Academy of Sciences, Nádor u. 7, Budapest, 1051, Hungary. fanni.rencz@uni-corvinus.hu. 3. 1st Department of Medicine, Semmelweis University, Korányi Sándor u. 2/a, Budapest, 1083, Hungary. 4. Division of Gastroenterology, McGill University, MUHC, Montreal General Hospital, 1650 Ave. Cedar, D16.173.1, Montreal, QC, H3G 1A4, Canada. 5. Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary. 6. Division of Gastroenterology, Department of Internal Medicine, University of Debrecen, Nagyerdei krt. 98., Debrecen, 4032, Hungary. 7. Medical Centre, Hungarian Defence Forces, Podmaniczky u. 109-111, Budapest, 1062, Hungary. 8. Faculty of Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary. 9. 1st Department of Internal Medicine, University of Szeged, Korányi fasor 8-10, Szeged, 6720, Hungary.
Abstract
PURPOSE: The EuroQol five-dimension questionnaire (EQ-5D) is the most commonly used instrument to obtain utility values for cost-effectiveness analyses of treatments for Crohn's disease (CD). We aimed to compare the measurement properties of the two adult versions of EQ-5D (EQ-5D-3L and EQ-5D-5L) in patients with CD. METHODS: Between 2016 and 2017, a multicentre cross-sectional survey was carried out. Consecutive outpatients with CD completed the 3L, 5L and EQ visual analogue scale (VAS). Disease severity was graded by the Crohn's Disease Activity Index (CDAI) and Perianal Disease Activity Index (PDAI). The 3L and 5L were compared in terms of feasibility, agreement, ceiling effect, redistribution properties, discriminatory power, convergent and known-groups validity. RESULTS: Two-hundred and six patients (54.9% male, mean age 35 ± 11 years) participated in the survey. For 3L, 25 unique health states were observed versus 59 for the 5L. The overall ceiling effect decreased from 29.6% (3L) to 25.5% (5L). Absolute discriminatory power improved (mean Shannon index 0.84 vs. 1.18). The 3L correlated stronger with EQ VAS and CDAI scores, whereas the 5L with PDAI. The 5L demonstrated a better known-groups validity on the basis of age, perianal fistulas, extraintestinal manifestations and disability. CONCLUSIONS: This is the first study to report the impact of CD on quality of life using the EQ-5D-5L questionnaire. The 5L seems to perform better than 3L in terms of feasibility, ceiling effect, discriminatory power and known-groups validity. Understanding the differences in psychometrics between the 3L and 5L is essential as they have substantial implications for financial decision-making about CD treatments.
PURPOSE: The EuroQol five-dimension questionnaire (EQ-5D) is the most commonly used instrument to obtain utility values for cost-effectiveness analyses of treatments for Crohn's disease (CD). We aimed to compare the measurement properties of the two adult versions of EQ-5D (EQ-5D-3L and EQ-5D-5L) in patients with CD. METHODS: Between 2016 and 2017, a multicentre cross-sectional survey was carried out. Consecutive outpatients with CD completed the 3L, 5L and EQ visual analogue scale (VAS). Disease severity was graded by the Crohn's Disease Activity Index (CDAI) and Perianal Disease Activity Index (PDAI). The 3L and 5L were compared in terms of feasibility, agreement, ceiling effect, redistribution properties, discriminatory power, convergent and known-groups validity. RESULTS: Two-hundred and six patients (54.9% male, mean age 35 ± 11 years) participated in the survey. For 3L, 25 unique health states were observed versus 59 for the 5L. The overall ceiling effect decreased from 29.6% (3L) to 25.5% (5L). Absolute discriminatory power improved (mean Shannon index 0.84 vs. 1.18). The 3L correlated stronger with EQ VAS and CDAI scores, whereas the 5L with PDAI. The 5L demonstrated a better known-groups validity on the basis of age, perianal fistulas, extraintestinal manifestations and disability. CONCLUSIONS: This is the first study to report the impact of CD on quality of life using the EQ-5D-5L questionnaire. The 5L seems to perform better than 3L in terms of feasibility, ceiling effect, discriminatory power and known-groups validity. Understanding the differences in psychometrics between the 3L and 5L is essential as they have substantial implications for financial decision-making about CD treatments.
Entities:
Keywords:
Crohn’s disease; EQ-5D; Health-related quality of life; Psychometrics
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