Abstract
BackgroundThe EQ-5D domain pain/discomfort (PD) uses one item to capture pain and other aspects of discomfort, like itching. This study explored how pain, itching and the EQ-5D-5L PD domain relate to each other in a sample of burn patients.MethodsAdult burn patients completed the EQ-5D-5L and the Patient and Observer Scar Assessment Scale (POSAS) 5–7 years after sustaining their injury. The POSAS includes a separate pain and an itching item. Spearman’s correlation coefficient established the association between the EQ-5D-5L PD and the POSAS pain and itching item. With multivariable regression analysis the linear association between the POSAS pain and itching item and EQ-5D-5L PD domain was tested.ResultsData from 245 patients were included. Mean EQ-5D-5L index value was 0.87 and 39.2% reported at least slight problems on the EQ-5D-5L PD domain. Most patients gave corresponding answers on the EQ-5D-5L PD domain and on the POSAS pain (73%) and itching (70%) item. Spearman correlation coefficients of the EQ-5D-5L PD domain with the POSAS pain and itching were 0.468 (p < 0.001) and 0.473 (p < 0.001), respectively. Among respondents with pain and without itching and respondents with itching and without pain, Spearman correlation coefficients were 0.585 (p = 0.076) and 0.408 (p = 0.001), respectively. POSAS pain (unstandardized Beta = 0.14) and POSAS itching (unstandardized Beta = 0.08) were significantly associated with EQ-5D-5L PD domain (p < 0.001).ConclusionsOur findings indicate that, in a sample of burn patients, pain and itching are captured by the broader EQ-5D-5L PD domain. The EQ-5D-5L PD domain can thus be used to assess pain and itching in relation to HRQL, but the POSAS pain and itching items are more sensitive. The EQ-5D-5L is, however, no replacement of the POSAS when the POSAS is used for its primary aim; assessment of scar quality.Trial registrationNetherlands Trial Register (NTR6407).
Highlights
The 5-dimensional EuroQol instrument (EQ-5D) domain pain/discomfort (PD) uses one item to capture pain and other aspects of discomfort, like itching
This study investigated the sensitivity of the EQ-5D-5L PD domain for pain and itching in a sample of burn patients
EQ-5D-5L usual activities, anxiety/depression and mobility were to a lesser extent correlated to the Patient and Observer Scar Assessment Scale (POSAS) pain and/or itching item
Summary
The EQ-5D domain pain/discomfort (PD) uses one item to capture pain and other aspects of discomfort, like itching. This study explored how pain, itching and the EQ-5D-5L PD domain relate to each other in a sample of burn patients. An extensively-used instrument is the 5-dimensional EuroQol instrument (EQ-5D) This short self-report instrument has been validated for many diseases, and is available in many languages [4, 5]. Symptoms and other aspects of discomfort are captured by the EQ-5D domain ‘pain/discomfort’ (EQ5D PD). Unlike pain, other symptoms, conditions, or complaints, such as itching, nausea, or feeling breathless, are not explicitly defined. Still, these undefined aspects are assumed to be captured by this domain description. In-depth interviews with patients and clinicians, and psychometric analyses of existing sources, the ‘bolt-on’ domain ‘skin irritation (e.g. itching)’ was added to the EQ-5D to create a psoriasis-specific version of the EQ-5D
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