Validity, responsiveness, and minimal clinically important difference of EQ-5D-5L in stroke patients undergoing rehabilitation
Validity, responsiveness, and minimal clinically important difference of EQ-5D-5L in stroke patients undergoing rehabilitation
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DOI：
10.1007/s11136-015-1196-z
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发表时间：
2016-06-01
影响因子：
3.5
通讯作者：
Chang, Ku-Chou
中科院分区：
文献类型：
--
作者：
Chen, Poyu;Lin, Keh-Chung;Chang, Ku-Chou
检查EuroQoL五维问卷的标准有效性、反应性和最小临床重要差异（MCID）EQ-5D-5L，沿着四个标准测量-医学研究理事会肌肉力量量表，Fugl-Meyer评估，功能独立性测量，在治疗前和治疗3 ~ 4周后，对65例脑卒中患者进行卒中影响量表的评定。使用斯皮尔曼相关系数估计标准有效性。反应性通过效应量、标准化反应均值（SRM）和标准反应性进行分析。MCID由基于锚点和基于分布的方法确定。同时报告了超过MCID的患者百分比。EQ-指数的同时效度优于EQ-VAS。EQ-指数对日常生活活动的康复结果的预测能力优于其他运动相关的结果指标。EQ指数对变化有中度反应（SRM = 0.63），而EQ-VAS仅对变化有轻度反应。EQ指数的MCID估计（超过MCID的患者百分比）为0.10（33.8%）和0.10（33.8%），EQ-VAS估计值为8.61（41.5%）和10.82 EQ指数显示出合理的同时有效性、有限的预测有效性和可接受的反应性，用于检测接受康复的中风患者的健康相关生活质量，但不适用于EQ-VAS。未来的研究，考虑不同的恢复阶段后，中风是必要的，以验证这些估计。
To examine the criterion validity, responsiveness, and minimal clinically important difference (MCID) of the EuroQoL 5-Dimensions Questionnaire (EQ-5D-5L) and visual analog scale (EQ-VAS) in people receiving rehabilitation after stroke.The EQ-5D-5L, along with four criterion measures-the Medical Research Council scales for muscle strength, the Fugl-Meyer assessment, the functional independence measure, and the Stroke Impact Scale-was administered to 65 patients with stroke before and after 3- to 4-week therapy. Criterion validity was estimated using the Spearman correlation coefficient. Responsiveness was analyzed by the effect size, standardized response mean (SRM), and criterion responsiveness. The MCID was determined by anchor-based and distribution-based approaches. The percentage of patients exceeding the MCID was also reported.Concurrent validity of the EQ-Index was better compared with the EQ-VAS. The EQ-Index has better power for predicting the rehabilitation outcome in the activities of daily living than other motor-related outcome measures. The EQ-Index was moderately responsive to change (SRM = 0.63), whereas the EQ-VAS was only mildly responsive to change. The MCID estimation of the EQ-Index (the percentage of patients exceeding the MCID) was 0.10 (33.8 %) and 0.10 (33.8 %) based on the anchor-based and distribution-based approaches, respectively, and the estimation of EQ-VAS was 8.61 (41.5 %) and 10.82 (32.3 %).The EQ-Index has shown reasonable concurrent validity, limited predictive validity, and acceptable responsiveness for detecting the health-related quality of life in stroke patients undergoing rehabilitation, but not for EQ-VAS. Future research considering different recovery stages after stroke is warranted to validate these estimations.