EuroQol-5D Index Score Research Articles

COPD severity score as a predictor of failure in exacerbations of COPD. The ESFERA study

Exacerbations are a frequent cause of morbidity and mortality in COPD. It is crucial to identify risk factors for failure after treatment of exacerbations of COPD. This study evaluates the COPD severity score (COPDSS) as a predictor of clinical failure, together with other severity, activity and quality of life measurements, in patients with exacerbated COPD. Multicenter, prospective, observational study in ambulatory patients with exacerbation of COPD. The patients completed the COPDSS, the London Chest Activities of Daily Living (LCADL) and the EuroQol 5D (EQ-5D). A follow-up visit was scheduled one month after presentation with the exacerbation to assess the clinical evolution. A total of 346 patients were included (mean age 68.5 years (SD=9.5 years and 90.7% male) and mean FEV(1)(% predicted) 46.9% (SD=17)). After one month, 28.2% of episodes were classified as failures, with half of them requiring hospital admission. Patients who failed were more frequently active smokers, with more severe dyspnoea at presentation and worse lung function. They had significantly worse scores of COPDSS, LCADL, EQ-5D index and EQ-5D visual analogue score (VAS) and shorter mean time walking per day. ROC analysis of relationship between COPDSS and failure gave AUC 0.72, which improved only to 0.77 when the other significant variables in univariate analysis were considered. Clinical failure after ambulatory treatment of exacerbation of COPD is frequent. Usual markers of severity (impaired lung function, active smoking and severe dyspnoea) are associated with failure; however, a short severity questionnaire (COPDSS) provides better predictive value than the usual variables.

Health-related quality of life in metabolic syndrome: The Korea National Health and Nutrition Examination Survey 2005

AimThis study sought to assess the association between metabolic syndrome (MS) and health-related quality of life (HRQOL) in the general population. MethodsWe analyzed data for 4463 adults, aged 30 years or older, from the Korea National Health and Nutrition Examination Survey 2005. “EuroQol 5D”, which measures two dimensions, the EuroQol 5D index score (EQ-5D) and the EuroQol visual analogue scale (EQ-VAS), was used to evaluate HRQOL. ResultsMean scores for the EQ-5D in both sexes and EQ-VAS in women decreased with increasing number of MS components, and women's means for both scores were significantly lower than men's. In individual domains of HRQOL, men with more MS components tended to have higher odds ratios for decreased self-care, and women had decreased mobility, according to the EQ-5D. In men, high blood pressure led to decreased EQ-5D, and in women, abdominal obesity and high blood pressure did so. Additionally, we found that taking medication had an impact on decreased HRQOL, especially in subjects with impaired fasting glucose. ConclusionsHRQOL was negatively associated with the number of MS components and it was decreased by taking hypoglycemic medications. This association differed by gender.

Comparison of Different Valuation Methods for Population Health Status Measured by the EQ-5D in Three European Countries

Objective The purpose of this study was to analyze and compare different valuation methods for population health status measured by the EuroQol-5D (EQ-5D) in three European countries. Methods A representative survey of the noninstitutionalized population aged 18 and above was conducted in three European countries (Germany, The Netherlands, and Spain). A total of 11,932 respondents were interviewed using the EQ-5D self-classifier. Health state values based on community preferences (EQ-5D index) were calculated for each country using four different value sets: national value sets based on the time trade-off (TTO) and the visual analogue scale (VAS), the UK TTO-based value set and the European VAS-based value set. Linear regression analysis was conducted to evaluate the factors associated with different EQ-5D index scores depending on the value set used. Loss of quality-adjusted life-years (QALYs) was calculated for each country using the four value sets by multiplying the age and gender-specific values with the respective population size. Results In all countries, means of all EQ-5D index scores were higher for men than women, and decreased with age. Index scores calculated using the national value set based on TTO were higher than those calculated using the UK TTO-based value set and, also, slightly higher than those calculated using the European VAS-based value set or the national value set based on the VAS. The mean loss of QALYs estimated for Germany per inhabitant varied between 0.062 (national value set based on TTO) and 0.094 (European VAS-based value set). In The Netherlands, the mean loss of QALYs per inhabitant ranged from 0.090 (national value set based on TTO) to 0.125 (national value set based on VAS). In Spain, the mean loss of QALYs per inhabitant ranged between 0.072 (national value set based on TTO) and 0.085 (European VAS-based value set). Conclusions In general, the differences among countries and valuations were rather small; nevertheless, some important variations should be taken into account while applying different valuation methods to the EQ-5D descriptive system. The associations between sociodemographic variables and health state scores remained the same across countries regardless of which value sets were used. Using different valuation methods lead to different QALY losses. To overcome this problem in international surveys aimed to compare health state scores or QALYs, it is advisable to use a single valuation method, making these scores comparable.

Obesity and health related quality of life in the general adult population of the Canary Islands

To explore the relationship between excess weight and health related quality of life (HRQL) in the general population by means of the EuroQol-5D questionnaire. The relationship between excess weight and HRQL was explored by the 2004 Canary Islands Health Survey. Survey participants from 16 years of age and older were classified according to their body mass index (BMI). The relationship between excess weight and the dichotomized EuroQol-5D was examined by multiple logistic regression analysis, adjusting by socio-demographic variables, smoking status, alcohol consumption, and self-reported disease status. People with excess weight were older, less educated, and had more associated diseases than the population without excess weight. Excess weight and HRQL are inversely correlated. Severely obese participants showed EuroQol-5D index scores significantly lower than those of normal weight participants (0.65 vs. 0.87). The adjusted odds ratio for the lower HRQL is 3.17 for severely obese people compared to normal weight people. Excess weight has a negative impact on HRQL, even for people without chronic diseases. A better understanding of the relationships between excess weight, its associated comorbidities, and HRQL may have important implications for the design and assessment of prevention and treatment strategies.

Impact of adalimumab treatment on health-related quality of life and other patient-reported outcomes: results from a 16-week randomized controlled trial in patients with moderate to severe plaque psoriasis

Health-related quality of life (HRQOL) and other patient-reported outcomes (PROs) are important in evaluating the impact of psoriasis and its treatment. To assess the impact of adalimumab treatment on HRQOL and other PROs in patients with moderate to severe psoriasis. A 16-week, double-blind, double-dummy, randomized controlled trial evaluated the efficacy and safety of adalimumab in 271 adults with moderate to severe chronic plaque psoriasis. Patients were randomized in a 2:2:1 ratio to adalimumab, methotrexate (MTX) or placebo. PROs were evaluated throughout the study and included the Dermatology Life Quality Index (DLQI), Patient's Global Assessment of disease severity, plaque psoriasis and psoriatic arthritis pain visual analogue scale (VAS), Psoriasis-Related Pruritus Assessment and EuroQOL 5D (EQ-5D). Statistically significant differences were observed between the adalimumab- and placebo-treated and the MTX-treated groups on mean DLQI total scores during the 16-week double-blind study (both P<0.001). Significant differences, favouring adalimumab compared with placebo, were also observed on the Patient's Global Assessment of disease severity (P<0.001), VAS for pain (P<0.001), Psoriasis-Related Pruritus Assessment (P<0.001), EQ-5D VAS (P<0.001) and EQ-5D index score (P<0.01). Compared with MTX, adalimumab resulted in statistically significantly greater improvements in the Patient's Global Assessment of disease severity (P<0.001), the VAS for pain (P<0.01) and the Psoriasis-Related Pruritus Assessment (P<0.001). Adalimumab was efficacious in improving dermatology-specific HRQOL, disease control and symptom outcomes in patients with moderate to severe psoriasis.

The validity and responsiveness of three quality of life measures in the assessment of psoriasis patients: results of a phase II study

BackgroundPatient-reported outcome (PROs) measures are being used more frequently in investigational studies of treatments for moderate to severe plaque psoriasis. The objective of this study was to examine the relationships among the Dermatology Life Quality Index (DLQI), the Short Form 36 (SF-36), and the EuroQOL 5D (EQ-5D) and to assess their validity, responsiveness, and estimates of minimum important differences.MethodsA Phase II, randomized, double-blind, parallel group, placebo-controlled, multi-center clinical trial assessed the clinical efficacy and safety of two doses of subcutaneously administered adalimumab vs. placebo for 12 weeks in the treatment of 147 patients with moderate to severe plaque psoriasis. This study provided the opportunity to evaluate the validity and responsiveness to change in clinical status of PROs instruments. Patients completed the DLQI, SF-36, and EQ-5D questionnaires at baseline and at 12 weeks. Blinded investigators assessed the Psoriasis Area and Severity Index (PASI) scores and the Physician's Global Assessment (PGA) scores of enrolled patients. The responsiveness of the measures to changes in the clinical endpoints from baseline to Week 12 was assessed. Estimates of minimum important differences (MID) were derived. All analyses were performed with blinded data; findings and conclusions were not biased based on treatment condition.ResultsThe dermatology-specific DLQI was highly correlated to clinical endpoints at baseline and at Week 12, and was the most responsive PRO to changes in endpoints. Compared with the SF-36, the EQ-5D index score and VAS scores were generally more highly correlated with clinical endpoints, but displayed about the same degree of responsiveness. The most responsive SF-36 scales were the Bodily Pain and Social Functioning scales. Estimates of the MID for the DLQI ranged from 2.3–5.7 and for the SF-36 Physical Component Summary (PCS) score ranged from 2.5–3.9.ConclusionThis study provides support for the continued use of the DLQI and SF-36 PCS in the assessment of treatments for psoriasis. On the basis of the results from this trial, the EQ-5D should be considered as a general PRO measure in future clinical trials of patients with moderate to severe plaque psoriasis.