Abstract
PurposeTo evaluate the correspondence of directly reported and recalled health-related quality of life (HRQL) in a heterogeneous sample of trauma patients.MethodsAdult trauma patients who attended the Emergency Department and were admitted between 03/2016 and 11/2016 were invited to participate. Postal surveys were sent 1 week (T1), 3 months (T2), and 12 months (T3) post-trauma. The EQ-5D-3L and Visual Analogue Scale (EQ-VAS) were used to assess directly reported and recalled HRQL.ResultsThe EQ-5D was completed by 446 patients at T1, T2, and T3. Directly reported mean T1 EQ-5D summary score was 0.482, whereas recalled T1 EQ-5D summary score was 0.453 (p < 0.05) at T2 and 0.363 (p < 0.001) at T3. Directly reported mean T2 EQ-5D summary score was 0.737 and mean recalled T2 EQ-5D summary score was 0.713 (p < 0.05) at T3. Directly reported mean T1 EQ-VAS was 56.3, whereas mean recalled T1 EQ-VAS at T2 and T3 was 55.4 (p = 0.304) and 53.3 (p < 0.05), respectively. Directly reported mean T2 EQ-VAS was 72.5 and recalled T2 EQ-VAS at T3 was 68.0 (p < 0.001). The correspondence between all directly reported and recalled HRQL (both EQ-5D summary and EQ-VAS) was fair (ICC = 0.518–0.598). Lowest correspondence was seen in patients with major trauma (injury severity score ≥ 16) and in patients with middle-level education.ConclusionsRecalled HRQL measured by the EQ-5D-3L and EQ-VAS was systematically lower compared to the directly reported HRQL. Patient characteristics, injury severity, subjectivity of the dimension, and time interval appear to influence correspondence between directly reported and recalled HRQL.
Highlights
An important outcome in trauma care is health-related quality of life (HRQL) of patients
– Correspondence between the directly reported and recalled score is lower with the EQ5D-3L and Visual Analogue Scale (EQ-visual analogue scale (VAS)) compared to the EQ-5D summary score as the EQ-5D descriptive system has a limited number of response options and is expected to be less prone to recall bias
– Correspondence between the directly reported and recalled score is higher with the 3-month window compared to the 9- and 12-month window as bias likely increases with longer intervals between measurements
Summary
An important outcome in trauma care is health-related quality of life (HRQL) of patients. HRQL reflects a patient’s physical, psychological, and social well-being [1] This subjective measurement is increasingly used in estimating the impact of an injury, in evaluating the quality of care provided, and in providing patient information on particular injuries [2, 3]. Measurement of HRQL changes over time may be useful to understand patterns of recovery over time and the role of rehabilitative care [4, 5]. It is, a challenge to establish reliable and valid outcomes for changes of HRQL over time. The best time frame to measure relevant changes over time may be difficult to define ex ante, data may be incomplete due to censoring (death, withdrawal) or random missings, and the event itself may be unpredictable, which makes prospectively collecting HRQL data difficult or impossible [4]
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