Abstract
PurposeMeasuring health-related quality of life (HRQoL) with the EQ-5D-5L might lack sensitivity for disease-specific health complaints. This cross-sectional study analyzed whether fatigue and cognitive problems are captured by the EQ-5D-5L in a Q-fever patient population with persistent fatigue/cognitive problems, and whether addition of fatigue/cognition improved the explained variance for HRQoL.MethodsA Dutch sample of Q-fever patients filled out the EQ-5D-5L and EQ VAS, the fatigue subscale of the Checklist Individual Strength, and a cognition dimension in the EQ-5D-5L format. The extent to which fatigue and cognition were captured by the EQ-5D-5L was determined based on distributional effects, head-to-head comparisons, Spearman rank correlation coefficients, and regression analyses. Explanatory power was determined of the EQ-5D-5L for the EQ VAS with and without a fatigue and cognition dimension.ResultsOut of 432 respondents, 373(86%) reported severe fatigue, 387(90%) cognitive problems. EQ-5D-5L utility and EQ VAS scores of respondents reporting severe fatigue/cognitive problems were significantly lower. Fatigue was strongly correlated with EQ-5D-5L dimensions usual activities and pain/discomfort (r = 0.602 and r = 0.510) and moderately with other EQ-5D-5L dimensions (r = 0.305–0.476). Cognition was strongly correlated with usual activities (r = 0.554) and moderately with other dimensions (r = 0.291–0.451). Adding fatigue to the EQ-5D-5L increased explanatory power for the EQ VAS with 6%.ConclusionFatigue and cognitive problems in Q-fever patients were partially captured by the EQ-5D-5L dimensions. The addition of fatigue to the EQ-5D-5L slightly improved explained variance for the EQ VAS. This potentially also accounts for patients who experience sequelae of other infectious diseases, such as COVID-19.
Highlights
Infectious diseases, such as Q-fever or COVID-19, are caused by organisms such as bacteria, viruses, fungi, or parasites, and can lead to illness, disability, and even death [1, 2]
The improvement in explanatory power of the EQ-5D with cognition dimension for the EQ5D-5L and visual analogue scale (EQ VAS) was negligible, our results showed that cognition was captured partially in the EQ-5D dimension
The results of our study suggested that fatigue was moderately captured in the EQ-5D-5L, but inclusion of a fatigue dimension in the EQ-5D could potentially improve the coverage of health-related quality of life (HRQoL)
Summary
Infectious diseases, such as Q-fever or COVID-19, are caused by organisms such as bacteria, viruses, fungi, or parasites, and can lead to illness, disability, and even death [1, 2]. 3 Q-support, ʹs‐Hertogenbosch, The Netherlands been an outbreak of Q-fever from 2007 until 2011 with over 3000 notified cases [3]. 40% of all people that get infected with Q-fever experience health complaints that can vary in duration from days to lifelong [4]. One of the eminent characteristic health complaints of Q-fever is fatigue [5]. Approximately 90% of Q-fever patients reported fatigue complaints [6], which is more than respondents who were not exposed to Q-fever [7]. Apart from fatigue, a vast majority of Q-fever patients reported long-term problems with cognition [6, 8]. Two studies reported reduced work participation in Q-fever patients twelve months after infection, mainly due to concentration-, memory problems [9], and reduced cognitive
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