Kamilla Koszorú1,2, Krisztina Hajdu3,4, Valentin Brodszky5, Alex Bató2,5, L Hunor Gergely1, Anikó Kovács1, Zsuzsanna Beretzky5, Miklós Sárdy1, Andrea Szegedi3,4, Fanni Rencz6. 1. Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary. 2. Károly Rácz Doctoral School of Clinical Medicine, Semmelweis University, Budapest, Hungary. 3. Department of Dermatological Allergology, University of Debrecen, Debrecen, Hungary. 4. Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary. 5. Department of Health Economics, Corvinus University of Budapest, 8 Fővám tér, Budapest, 1093, Hungary. 6. Department of Health Economics, Corvinus University of Budapest, 8 Fővám tér, Budapest, 1093, Hungary. fanni.rencz@uni-corvinus.hu.
Abstract
BACKGROUND: Atopic dermatitis (AD) is a common chronic inflammatory skin disorder affecting up to 10% of adults. The EQ-5D is the most commonly used generic preference-accompanied measure to generate quality-adjusted life years (QALYs) for economic evaluations. OBJECTIVES: We aimed to compare psychometric properties of the three-level and five-level EQ-5D (EQ-5D-3L and EQ-5D-5L) in adult patients with AD. METHODS: In a multicentre cross-sectional study, 218 AD patients with a broad range of severity completed the EQ-5D-3L, EQ-5D-5L, Dermatology Life Quality Index (DLQI) and Skindex-16. Disease severity outcomes included the Investigator Global Assessment, Eczema Area and Severity Index and the objective SCORing Atopic Dermatitis. RESULTS: A good agreement was established between the two EQ-5D versions with an intraclass correlation coefficient of 0.815 (95% CI 0.758-0.859, p < 0.001). Overall, 33 different health state profiles occurred in the EQ-5D-3L and 84 in the EQ-5D-5L. Compared to the EQ-5D-3L, ceiling effect was reduced for the mobility, self-care, usual activities and pain/discomfort dimensions by 4.6-11.5%. EQ-5D-5L showed higher average relative informativity (Shannon's evenness index: 0.64 vs. 0.59). EQ-5D-5L demonstrated better convergent validity with EQ VAS, DLQI and Skindex-16. The two measures were similar in distinguishing between groups of patients based on disease severity and skin-specific quality of life with a moderate or large effect size (η2 = 0.083-0.489). CONCLUSION: Both instruments exhibited good psychometric properties in AD; however, the EQ-5D-5L was superior in terms of ceiling effects, informativity and convergent validity. We recommend the use of the EQ-5D-5L to measure health outcomes in clinical settings and for QALY calculations in AD.
BACKGROUND: Atopic dermatitis (AD) is a common chronic inflammatory skin disorder affecting up to 10% of adults. The EQ-5D is the most commonly used generic preference-accompanied measure to generate quality-adjusted life years (QALYs) for economic evaluations. OBJECTIVES: We aimed to compare psychometric properties of the three-level and five-level EQ-5D (EQ-5D-3L and EQ-5D-5L) in adult patients with AD. METHODS: In a multicentre cross-sectional study, 218 AD patients with a broad range of severity completed the EQ-5D-3L, EQ-5D-5L, Dermatology Life Quality Index (DLQI) and Skindex-16. Disease severity outcomes included the Investigator Global Assessment, Eczema Area and Severity Index and the objective SCORing Atopic Dermatitis. RESULTS: A good agreement was established between the two EQ-5D versions with an intraclass correlation coefficient of 0.815 (95% CI 0.758-0.859, p < 0.001). Overall, 33 different health state profiles occurred in the EQ-5D-3L and 84 in the EQ-5D-5L. Compared to the EQ-5D-3L, ceiling effect was reduced for the mobility, self-care, usual activities and pain/discomfort dimensions by 4.6-11.5%. EQ-5D-5L showed higher average relative informativity (Shannon's evenness index: 0.64 vs. 0.59). EQ-5D-5L demonstrated better convergent validity with EQ VAS, DLQI and Skindex-16. The two measures were similar in distinguishing between groups of patients based on disease severity and skin-specific quality of life with a moderate or large effect size (η2 = 0.083-0.489). CONCLUSION: Both instruments exhibited good psychometric properties in AD; however, the EQ-5D-5L was superior in terms of ceiling effects, informativity and convergent validity. We recommend the use of the EQ-5D-5L to measure health outcomes in clinical settings and for QALY calculations in AD.
Authors: C R Hamann; A Egeberg; A Wollenberg; G Gislason; L Skov; J P Thyssen Journal: J Eur Acad Dermatol Venereol Date: 2018-10-08 Impact factor: 6.166
Authors: Stephan Weidinger; Lisa A Beck; Thomas Bieber; Kenji Kabashima; Alan D Irvine Journal: Nat Rev Dis Primers Date: 2018-06-21 Impact factor: 52.329
Authors: Lieneke F M Ariëns; Abhijit Gadkari; Harmieke van Os-Medendorp; Rajeev Ayyagari; Emi Terasawa; Andreas Kuznik; Zhen Chen; Gaëlle Bégo-Le Bagousse; Yufang Lu; Elena Rizova; Neil M H Graham; Gianluca Pirozzi; Marjolein De Bruin-Weller; Laurent Eckert Journal: Acta Derm Venereol Date: 2019-09-01 Impact factor: 4.437