Abstract
ObjectiveTo investigate the construct and criterion validity of the Euro Qol-5D (EQ-5D), which allows quality-adjusted life-years to be calculated, in patients with systemic lupus erythematosus (SLE).MethodsConsecutive SLE patients who had been followed at the Renji Hospital, School of Medicine, Shanghai Jiao Tong University were recruited. Cross-sectional correlations of the EQ-5D with equivalent domains in disease-specific health-related quality of life (HRQoL), LupusQol, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) measures, the Systemic Lupus International Collaborating Clinics Damage Index (SDI), and patient characteristics were tested. Discriminant validity to assess the ability to distinguish between patients of different disease severity was assessed. There also were evaluations of ceiling and floor effects.Results240 patients were recruited in total. The EQ-5D correlated moderately to strongly with all domains of the LupusQoL (r: 0.44–0.7) apart from intimate relationships (r = 0.25) and body image (r = 0.18). There was moderate negative correlation between EQ-5D and clinical assessment of disease, SLEDAI (r = −0.589) and SDI (r = −0.509). When compared with equivalent domains on LupusQoL, there was good construct validity in EQ-5D (r: 0.631–0.812). EQ-5D could also discriminate patients with varied disease severity (according SLEDAI and SDI). There was no floor effect in EQ-5D but the ceiling effect remains strong (34%).ConclusionOur results provide sufficient evidence that the EQ-5D displays construct and criterion validity for use in SLE patients. Disease-specific measures of HRQoL used alongside may be a better choice.
Highlights
Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease characterised by the deposition of immune complexes in various tissues, which is found mainly in women during the childbearing years and is common in Asian, and African American/Caribbean individuals [1,2,3]
The health related quality of life (HRQoL) of patients with SLE is under increasing attention [4] as the HRQoL among SLE patients is worse than the general population, even compared with other rheumatic diseases [5]
Among the 240 patients who participated in this study, complete data were available for 214 patients. 201(93.9%) patients were women; all are Chinese
Summary
Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease characterised by the deposition of immune complexes in various tissues, which is found mainly in women during the childbearing years and is common in Asian, and African American/Caribbean individuals [1,2,3]. The health related quality of life (HRQoL) of patients with SLE is under increasing attention [4] as the HRQoL among SLE patients is worse than the general population, even compared with other rheumatic diseases [5]. A series of novel therapies are being developed for SLE [6]. Before widespread use in clinics, new therapies require evaluation for cost utility, which is of vital concern to policy makers
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