Bernhard Michalowsky1, Feng Xie2, Thomas Kohlmann3, Johannes Gräske4, Markus Wübbeler5, Jochen René Thyrian6, Wolfgang Hoffmann7. 1. German Center for Neurodegenerative Diseases, Rostock/Greifswald site, Greifswald, Germany; Program for Health Economics and Outcome Measures, Hamilton, Ontario, Canada. 2. Program for Health Economics and Outcome Measures, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, Ontario, Canada. Electronic address: fengxie@mcmaster.ca. 3. Institute for Community Medicine, Section Methods in Community Medicine, University Medicine Greifswald, Greifswald, Germany. 4. Alice Salomon University of Applied Sciences Berlin, Berlin, Germany. 5. University of Applied Sciences-Bochum, Department of Nursing Science, Bochum, Germany. 6. German Center for Neurodegenerative Diseases, Rostock/Greifswald site, Greifswald, Germany. 7. German Center for Neurodegenerative Diseases, Rostock/Greifswald site, Greifswald, Germany; Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, Greifswald, Germany.
Abstract
OBJECTIVES: To assess the acceptability and validity of the 3 levels of the EQ-5D (EQ-5D-3L) compared with the Quality of Life in Alzheimer's Diseases (QoL-AD) in patients living with dementia. METHODS: The analysis was based on 560 dyads of persons with dementia and their caregivers of the multicenter observational study of dementia care networks in Germany (DemNet-D). Health-related quality of life was assessed by face-to-face interviews using the EQ-5D-3L (self-rating) and the QoL-AD (self- and proxy-rating). The number of missing values, the score ranges (observed vs possible range) and the floor and ceiling effects were used to assess the acceptability. We used one-way analyses of variance and multivariate linear regression models to evaluate the discriminative ability. The convergent validity was assessed using Spearman's correlation coefficient (rs) and multivariate regression models. RESULTS: The EQ-5D index had a higher response rate (89% vs 84%) and a comparable floor (>1%) but a higher ceiling effect (18% vs >1%) compared with the QoL-AD. Both measures can significantly differentiate between different stages of general health, instrumental activities of daily living, and depression. The EQ-5D index and the visual analog scale self-rating scores strongly correlated with the QoL-AD self-rating (rs = 0.644 and 0.553, respectively) but not with the proxy-rating score (rs = 0.314 and rs = 0.170, respectively), which was confirmed by multivariate regression analyses. CONCLUSION: The results satisfy acceptability, discriminative ability, and convergent validity for moderately cognitively and functionally impaired patients living with dementia. The EQ-5D-3L performed comparably with the QoL-AD, and could, therefore, be used in economic evaluations in dementia. The differences between self- and proxy-ratings should be evaluated and considered in the interpretation of health-related quality of life scores.
OBJECTIVES: To assess the acceptability and validity of the 3 levels of the EQ-5D (EQ-5D-3L) compared with the Quality of Life in Alzheimer's Diseases (QoL-AD) in patients living with dementia. METHODS: The analysis was based on 560 dyads of persons with dementia and their caregivers of the multicenter observational study of dementia care networks in Germany (DemNet-D). Health-related quality of life was assessed by face-to-face interviews using the EQ-5D-3L (self-rating) and the QoL-AD (self- and proxy-rating). The number of missing values, the score ranges (observed vs possible range) and the floor and ceiling effects were used to assess the acceptability. We used one-way analyses of variance and multivariate linear regression models to evaluate the discriminative ability. The convergent validity was assessed using Spearman's correlation coefficient (rs) and multivariate regression models. RESULTS: The EQ-5D index had a higher response rate (89% vs 84%) and a comparable floor (>1%) but a higher ceiling effect (18% vs >1%) compared with the QoL-AD. Both measures can significantly differentiate between different stages of general health, instrumental activities of daily living, and depression. The EQ-5D index and the visual analog scale self-rating scores strongly correlated with the QoL-AD self-rating (rs = 0.644 and 0.553, respectively) but not with the proxy-rating score (rs = 0.314 and rs = 0.170, respectively), which was confirmed by multivariate regression analyses. CONCLUSION: The results satisfy acceptability, discriminative ability, and convergent validity for moderately cognitively and functionally impaired patients living with dementia. The EQ-5D-3L performed comparably with the QoL-AD, and could, therefore, be used in economic evaluations in dementia. The differences between self- and proxy-ratings should be evaluated and considered in the interpretation of health-related quality of life scores.
Authors: Tara Peseschkian; Isabell Cordts; René Günther; Benjamin Stolte; Daniel Zeller; Carsten Schröter; Ute Weyen; Martin Regensburger; Joachim Wolf; Ilka Schneider; Andreas Hermann; Moritz Metelmann; Zacharias Kohl; Ralf A Linker; Jan Christoph Koch; Boriana Büchner; Ulrike Weiland; Erik Schönfelder; Felix Heinrich; Alma Osmanovic; Thomas Klopstock; Johannes Dorst; Albert C Ludolph; Matthias Boentert; Tim Hagenacker; Marcus Deschauer; Paul Lingor; Susanne Petri; Olivia Schreiber-Katz Journal: Brain Sci Date: 2021-03-14