Abstract
ObjectiveEQ-5D-3L is a generic QOL tool used mainly in economic evaluations. Burden of Chronic Kidney Disease (CKD) is rising in Sri Lanka. Assessing the validity of generic QOL tools creates new opportunities of their utilization among patients with CKD.MethodsA cross-sectional study was conducted among 1036 CKD patients, selected using the simple random sampling technique. The validity was tested with six a-priori hypotheses. These included construct validity assessments, evaluating convergent validity and performing known group comparisons. EQ-5D-3L, Short Form-36 (SF-36) were used to assess QOL. Center for Epidemiological Studies Depression Scale (CES-D-20) and General Health Questionnaire-12 (GHQ-12) were used to assess the presence of depression and psychological distress respectively. Internal consistency of the whole tool and when each item is removed was assessed by Cronbach alpha.ResultsThe response rate was 99.2%. Majority of participants were males (n = 646,62.4%) in the age category of 41–60 (n = 530; 51.2%). Most were in either stage 4 or 5 of CKD (n = 646,75.1%). The summary measures of SF-36, positively and significantly correlated with the EQ-5D-3L index and VAS scores (p<0.001). EQ-5D-3L QOL scores were significantly different between the group with depression and without as measured by CES-D-20 (p<0.001). Assessed using GHQ-12, similar significance was detected between the group with psychological distress and without (p<0.001). The Cronbach alpha was 0.834 and when each item was removed, ranged from 0.782 to 0.832.ConclusionEQ-5D-3L is a valid generic QOL tool with satisfactory internal consistency to be used among CKD patients in the pre-dialysis stage.
Highlights
Chronic Kidney Disease (CKD) has become a major global burden of disease accounting for a significant mortality and disability adjusted life years [1]
Most were in either stage 4 or 5 of CKD (n = 646,75.1%)
EQ-5D-3L Quality of life (QOL) scores were significantly different between the group with depression and without as measured by CES-D-20 (p
Summary
Chronic Kidney Disease (CKD) has become a major global burden of disease accounting for a significant mortality and disability adjusted life years [1]. In the Global Burden of Disease Study-2015, it was ranked as the “12th most common cause of death” with an increased overall mortality over 30% in the previous decade [2]. This rise has been “alarming” in the low- and middle-income settings [3]. Sri Lanka which is an agricultural lower-middle-income country, is affected by the rising trend of chronic non-communicable diseases (NCDs) due to demographic and epidemiological transitions [4,5]. CKD has become a major burden of the healthcare system in Sri Lanka [6]. CKD impose numerous social and economic threats in Sri Lanka [8]
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