Abstract
BackgroundThere is little information of the validity of generic instruments in measuring health-related quality of life (HRQOL) in patients with dyspepsia. We aimed to assess the reliability and validity of the EQ-5D, a brief and simple instrument, in measuring HRQOL in adult patients with dyspepsia.MethodsConsecutive adults with dyspepsia attending the Gastroenterology clinic in a tertiary referral center were interviewed with the EQ-5D (both English and Malay versions), the short-form Nepean Dyspepsia Index (SF-NDI), the SF-36 and Leeds Dyspepsia Questionnaire (LDQ). Known-groups and convergent construct validity were investigated by testing hypotheses at attribute and overall levels. A repeat telephone interview was conducted 2 weeks later to assess test-retest reliability.ResultsA total of 113 patients (mean (SD) age: 53.7 (14) years; 49.5% male; 24.8% Malays, 37.2% Chinese; 70.8% functional dyspepsia) were recruited. Response rate was 100% with nil missing data. Known-groups validation revealed 20/26 hypotheses fulfillment. Patients with more severe dyspepsia reported more problems with their usual activity (p = 0.07) and pain (p = 0.06) and demonstrated lower median VAS scores (60 vs 70, p = 0.002) and EQ-5D utility scores (0.72 vs 0.78, p = 0.002). Those reporting problems in various EQ-5D dimensions had significantly lower scores in relevant SF-36 and SF-NDI dimensions. The overall EQ-5D utility score also demonstrated good correlation with the SF-36 summary physical and mental scores and the SF-NDI total score. Intraclass correlation coefficient for test-retest reliability was 0.66 (95% CI = 0.55 – 0.76).ConclusionThe EQ-5D is an acceptable, valid and reliable generic instrument for measuring HRQOL in adult patients with dyspepsia.
Highlights
There is little information of the validity of generic instruments in measuring healthrelated quality of life (HRQOL) in patients with dyspepsia
Several disease-specific HRQOL instruments for dyspepsia have been developed including the quality of life in reflux and dyspepsia (QOLRAD) questionnaire [4] and the Nepean Dyspepsia Index [5], both of which are valid and reliable tools for assessing HRQOL in patients with dyspepsia
The median Leeds Dyspepsia Questionnaire (LDQ) score in patients was 16 (11 – 22), indicating that most patients had fairly severe or poorly-controlled symptoms despite many years of treatment
Summary
There is little information of the validity of generic instruments in measuring healthrelated quality of life (HRQOL) in patients with dyspepsia. Several disease-specific HRQOL instruments for dyspepsia have been developed including the quality of life in reflux and dyspepsia (QOLRAD) questionnaire [4] and the Nepean Dyspepsia Index [5], both of which are valid and reliable tools for assessing HRQOL in patients with dyspepsia. The EQ-5D is another generic HRQOL instrument that has been shown to be valid and reliable in the general population and various patient groups [7,8,9] It is brief, comprising of five questions and a visual analogue scale, which makes it easy to use and attractive in large scale population surveys, for surveys in the elderly and those with lower educational levels. It has the additional advantage of allowing incorporation of HRQOL data into pharmacoeconomic analyses
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