Abstract
BackgroundScoliosis is a common spinal deformity that occurs often during adolescence. Previous studies suggested that adolescent idiopathic scoliosis (AIS) patients can have various aspects of their lives being affected, due to disease presentation and/or treatment received. It is important to define a reliable instrument based on which the affected patients’ health-related quality of life can be assessed. This study aims to assess the validity, reliability and sensitivity of the EuroQoL 5-dimension 5-level (EQ-5D-5L) in Chinese patients with AIS.MethodsAdolescent idiopathic scoliosis patients of Chinese descent were prospectively recruited to complete both the traditional Chinese versions of the EQ-5D-5L and the refined Scoliosis Research Society-22 (SRS-22r) questionnaires. Patients’ demographic profiles and corresponding clinical parameters including treatment modalities, spinal curve pattern and magnitude, and duration of bracing were recorded. Telephone interviews were then conducted at least two weeks later for the assessment of test-retest reliability. Statistical analysis was performed: construct validity of the EQ-5D-5L domains were assessed using Spearman’s correlation test against the SRS-22r; whereas intra-class correlation coefficient (ICC) was used to assess the test-retest reliability, and agreement over the test-retest period was expressed in percentages. Also, the sensitivity of the EQ-5D-5L in differentiating various clinical known groups was determined by effect size, independent t-test and analysis of variance.ResultsA total of 227 AIS patients were recruited. Scores of domains of the EQ-5D-5L correlated significantly (r: 0.57-0.74) with the scores of the SRS-22r domains that were intended to measure similar constructs, supporting construct validity. The EQ-5D-5L domain responses and utility scores showed good test-retest reliability (ICC: 0.777; agreement: 76.4 -98.1 %). Internal consistency was good (Cronbach’s α: 0.78) for the EQ-5D-5L utility score. The EQ-5D-5L utility score was sensitive in detecting differences between subjects who had different treatment modalities and bracing duration, but not for curve pattern and its magnitude.ConclusionsThe EQ-5D-5L is found to be a valid, reliable and sensitive measure to assess the health-related quality of life in Chinese AIS patients. This potentiates the possibility of utilizing the EQ-5D-5L to estimate AIS patients’ health-related quality of life, based on which the outcome of various treatment options can eventually be evaluated.Electronic supplementary materialThe online version of this article (doi:10.1186/s13013-016-0083-x) contains supplementary material, which is available to authorized users.
Highlights
Scoliosis is a common spinal deformity that occurs often during adolescence
Scoliosis can be defined as a torsional spinal deformity, in which the 3-dimensional geometry of the spine is changed as a result of the combination of a translation and rotation of variable number of vertebrae [1]
A majority of scoliosis is idiopathic and presents during adolescence [2]. These patients with adolescent idiopathic scoliosis (AIS) often present at variable curve magnitudes upon the first consultation and the curvature may progress depending on the initial magnitude of curve and status of skeletal maturity [3, 4]
Summary
Previous studies suggested that adolescent idiopathic scoliosis (AIS) patients can have various aspects of their lives being affected, due to disease presentation and/or treatment received. It is necessary to explore patients’ quality of life This is important in AIS as previous reports suggest that these patients experience relatively poorer psychosocial functioning, self-perception of body image, and health-related quality of life versus their nonscoliotic peers [6]. When compared to their healthy peers, AIS patients undergoing brace treatment may be negatively affected in terms of psychosocial well-being [7, 8]. There are studies suggesting that there are no differences in the quality of life between patients treated with bracing and those under monitoring only [11]; and even between braced/operated patients and the general population in the long-term [12]
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