This preprint is under consideration at Health and Quality of Life Outcomes. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
Research
AM Garratt
Norwegian Institute of Public Health
Corresponding Author
ORCiD: https://orcid.org/0000-0002-1000-4780
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The EuroQol EQ-5D is the most widely researched and applied patient-reported outcome measure worldwide. The original EQ-5D-3L and more recent EQ-5D-5L include three and five response categories respectively. Evidence from healthy and sick populations shows that the additional two response categories improve measurement properties but there has not been a concurrent comparison of the two versions in patients with low back pain (LBP).
Methods: LBP patients taking part in a multicenter randomized controlled trial of lumbar total disc replacement and conservative treatment completed the EQ-5D-3L and 5L in an eight-year follow-up questionnaire. The 3L and 5L were assessed for aspects of data quality including missing data, floor and ceiling effects, response consistency, and based on a priori hypotheses, associations with the Oswestry Disability Index (ODI), Pain-Visual Analogue Scales and Hopkins Symptom Checklist (HSCL-25).
Results: At the eight-year follow-up, 151 (87%) patients were available and 146 completed both the 3L and 5L. Levels of missing data were the same for the two versions. Compared to the EQ-5D-5L, the 3L had significantly higher floor (pain discomfort) and ceiling effects (mobility, self-care, pain/discomfort, anxiety/depression). For these patients the EQ-5D-5L described 73 health states compared to 28 for the 3L. Shannon’s indices also showed the 5L outperformed the 3L in tests of classification efficiency. Correlations with the ODI, Pain-VAS and HSCL-25 were largely as hypothesized, the 5L having slightly higher correlations than the 3L. In a multivariate regression analysis, ODI, Pain-VAS and HSCL-25 scores explained 13% more variation in EQ-5D-5L scores compared to 3L scores.
Conclusion: The EQ-5D assesses important aspect of health in LBP patients and the 5L improves upon the 3L in this respect. The EQ-5D-5L is recommended in preference to the 3L version, however, further testing in other back pain populations together with additional measurement properties, including responsiveness to change, is recommended.
Trial Registration: retrospectively registered: https://clinicaltrials.gov/ct2/show/NCT01704677.
Keywords
EQ-5D-3L, EQ-5D-5L, low back pain, patient reported outcome measures, PROMs, quality of life, validity, psychometrics
Loading...
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 25 Jan, 2021
No community comments so far
Editorial decision: Major Revision
On 15 Mar, 2021
Review #3 received
Received 06 Mar, 2021
Review #2 received
Received 06 Mar, 2021
Reviewer #3 agreed
On 14 Feb, 2021
Review #1 received
Received 14 Feb, 2021
Reviewer #2 agreed
On 10 Feb, 2021
Reviewers invited
Invitations sent on 26 Jan, 2021
Reviewer #1 agreed
On 26 Jan, 2021
Editor assigned
On 19 Jan, 2021
Submission checks complete
On 19 Jan, 2021
Editor invited
On 19 Jan, 2021
First submitted
On 18 Jan, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Economics & Outcomes Research
Learn more about our company.
A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
This preprint is under consideration at Health and Quality of Life Outcomes. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
AM Garratt
Norwegian Institute of Public Health
Corresponding Author
ORCiD: https://orcid.org/0000-0002-1000-4780
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 25 Jan, 2021
No community comments so far
Editorial decision: Major Revision
On 15 Mar, 2021
Review #3 received
Received 06 Mar, 2021
Review #2 received
Received 06 Mar, 2021
Reviewer #3 agreed
On 14 Feb, 2021
Review #1 received
Received 14 Feb, 2021
Reviewer #2 agreed
On 10 Feb, 2021
Reviewers invited
Invitations sent on 26 Jan, 2021
Reviewer #1 agreed
On 26 Jan, 2021
Editor assigned
On 19 Jan, 2021
Submission checks complete
On 19 Jan, 2021
Editor invited
On 19 Jan, 2021
First submitted
On 18 Jan, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Economics & Outcomes Research
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The EuroQol EQ-5D is the most widely researched and applied patient-reported outcome measure worldwide. The original EQ-5D-3L and more recent EQ-5D-5L include three and five response categories respectively. Evidence from healthy and sick populations shows that the additional two response categories improve measurement properties but there has not been a concurrent comparison of the two versions in patients with low back pain (LBP).
Methods: LBP patients taking part in a multicenter randomized controlled trial of lumbar total disc replacement and conservative treatment completed the EQ-5D-3L and 5L in an eight-year follow-up questionnaire. The 3L and 5L were assessed for aspects of data quality including missing data, floor and ceiling effects, response consistency, and based on a priori hypotheses, associations with the Oswestry Disability Index (ODI), Pain-Visual Analogue Scales and Hopkins Symptom Checklist (HSCL-25).
Results: At the eight-year follow-up, 151 (87%) patients were available and 146 completed both the 3L and 5L. Levels of missing data were the same for the two versions. Compared to the EQ-5D-5L, the 3L had significantly higher floor (pain discomfort) and ceiling effects (mobility, self-care, pain/discomfort, anxiety/depression). For these patients the EQ-5D-5L described 73 health states compared to 28 for the 3L. Shannon’s indices also showed the 5L outperformed the 3L in tests of classification efficiency. Correlations with the ODI, Pain-VAS and HSCL-25 were largely as hypothesized, the 5L having slightly higher correlations than the 3L. In a multivariate regression analysis, ODI, Pain-VAS and HSCL-25 scores explained 13% more variation in EQ-5D-5L scores compared to 3L scores.
Conclusion: The EQ-5D assesses important aspect of health in LBP patients and the 5L improves upon the 3L in this respect. The EQ-5D-5L is recommended in preference to the 3L version, however, further testing in other back pain populations together with additional measurement properties, including responsiveness to change, is recommended.
Trial Registration: retrospectively registered: https://clinicaltrials.gov/ct2/show/NCT01704677.
Loading...