Top

Published in:

Open Access 01-07-2019

Health-related quality of life in injury patients: the added value of extending the EQ-5D-3L with a cognitive dimension

Authors: Robbin H. Ophuis, Mathieu F. Janssen, Gouke J. Bonsel, Martien J. Panneman, Suzanne Polinder, Juanita A. Haagsma

Published in: Quality of Life Research | Issue 7/2019

Abstract

Introduction

The EQ-5D is frequently used to understand the development of health-related quality of life (HRQL) following injury. However, the lack of a cognition dimension is generally felt as disadvantageous as many injuries involve cognitive effects. We aimed to assess the added value of a cognitive dimension in a cohort of injury patients.

Methods

We analyzed EQ-5D-3L extended with cognition (EQ-5D + C) dimension responses of 5346 adult injury patients. We studied dimension dependency, assessed the additional effect of the cognitive dimension on the EQ-VAS, and, using the EQ-VAS as a dependent variable, determined the impact of EQ-5D and EQ-5D + C attributes in multivariate regression analyses.

Results

Extreme cognitive problems combined with no problems on other dimensions are uncommon, whereas severe problems on other dimensions frequently occur without cognitive problems. The EQ-VAS significantly decreased when cognitive problems emerged. Univariate regression analyses indicated that all EQ-5D + C dimensions were significantly associated with the EQ-VAS. Exploratory analyses showed that using any set of five of the six EQ-5D + C dimensions resulted in almost identical explained variance, and adding the remaining 6th dimension resulted in a similar additional impact.

Conclusions

The addition of the cognition dimension increased the explanatory power of the EQ-5D-3L. Although the increase in explanatory power was relatively small after the cognition dimension was added, the decrease of HRQoL (measured with the EQ-VAS) resulting from cognitive problems was comparable to the decreases resulting from other EQ-5D dimensions.

Gabbe, B. J., Simpson, P. M., Cameron, P. A., Ponsford, J., Lyons, R. A., Collie, A., Fitzgerald, M., Judson, R., Teague, W. J., Braaf, S., Nunn, A., Ameratunga, S., & Harrison, J. E. (2017). Long-term health status and trajectories of seriously injured patients: A population-based longitudinal study. PLoS Medicine, 14(7), e1002322.

Cameron, P. A., Gabbe, B. J., & McNeil, J. J. (2006). The importance of quality of survival as an outcome measure for an integrated trauma system. Injury, 37(12), 1178–1184.CrossRefPubMed

Gabbe, B. J., Simpson, P. M., Harrison, J. E., Lyons, R. A., Ameratunga, S., Ponsford, J., Fitzgerald, M., Judson, R., Collie, A., & Cameron, P. A. (2016). Return to work and functional outcomes after major trauma: Who recovers, when, and how well? Annals of Surgery, 263(4), 623–632.CrossRefPubMed

Brooks, R. (1996). EuroQol: The current state of play. Health Policy, 37(1), 53–72.CrossRef

EuroQol (1990) A new facility for the measurement of health-related quality of life. Health Policy, 16(3), 199–208.CrossRef

Krabbe, P. F., Stouthard, M. E., Essink-Bot, M. L., & Bonsel, G. J. (1999). The effect of adding a cognitive dimension to the EuroQol multiattribute health-status classification system. Journal of Clinical Epidemiology, 52(4), 293–301.CrossRefPubMed

Jelsma, J., & Maart, S. (2015). Should additional domains be added to the EQ-5D health-related quality of life instrument for community-based studies? An analytical descriptive study. Population Health Metrics, 13, 13.CrossRefPubMedPubMedCentral

Gudex, C. (1991). Are we lacking a dimension of energy in the EuroQol instrument. Paper presented at the EuroQol conference proceedings, Lund.

Yang, Y., Brazier, J., & Tsuchiya, A. (2014). Effect of adding a sleep dimension to the EQ-5D descriptive system: A “bolt-on” experiment. Medical Decision Making, 34(1), 42–53.CrossRefPubMed

10.

Finch, A. P., Brazier, J. E., & Mukuria, C. (2018). What is the evidence for the performance of generic preference-based measures? A systematic overview of reviews. European Journal of Health Economics, 19(4), 557–570.CrossRefPubMed

11.

Finch, A. P., Brazier, J. E., Mukuria, C., & Bjorner, J. B. (2017). An exploratory study on using principal-component analysis and confirmatory factor analysis to identify bolt-on dimensions: The EQ-5D case study. Value Health, 20(10), 1362–1375.CrossRefPubMed

12.

Bryant, R. A., O’Donnell, M. L., Creamer, M., McFarlane, A. C., Clark, C. R., & Silove, D. (2010). The psychiatric sequelae of traumatic injury. American Journal of Psychiatry, 167(3), 312–320.CrossRef

13.

McInnes, K., Friesen, C. L., MacKenzie, D. E., Westwood, D. A., & Boe, S. G. (2017). Mild Traumatic Brain Injury (mTBI) and chronic cognitive impairment: A scoping review. PLoS ONE, 12(4), e0174847.

14.

Qureshi, S. U., Long, M. E., Bradshaw, M. R., Pyne, J. M., Magruder, K. M., Kimbrell, T., Hudson, T. J., Jawaid, A., Schulz, P. E., & Kunik, M. E. (2011). Does PTSD impair cognition beyond the effect of trauma? Journal of Neuropsychiatry and Clinical Neurosciences, 23(1), 16–28.CrossRefPubMed

15.

Polinder, S., van Beeck, E. F., Essink-Bot, M. L., Toet, H., Looman, C. W., Mulder, S., & Meerding, W. J. (2007). Functional outcome at 2.5, 5, 9, and 24 months after injury in the Netherlands. Journal of Trauma, 62(1), 133–141.CrossRefPubMed

16.

van Beeck, E. F., Panneman, M. J. M., Polinder, S., & Blatter, B. (2017). Injuries resulting from accidents and violence in the Netherlands; results of an Emergency Department register. Nederlands Tijdschrift voor Geneeskunde, 161:D1534.PubMed

17.

Haagsma, J. A., van Beeck, E. F., Toet, H., & Polinder, S. (2013). Posttraumatic stress disorder following injury: Trajectories and impact on health-related quality of life. Journal of Depression and Anxiety, S4, 002.

18.

Dolan, P. (1997). Modeling valuations for EuroQol health states. Medical Care, 35(11), 1095–1108.CrossRefPubMed

19.

Versteegh, M. M., Vermeulen, K. M., Evers, S. M. A. A., Prenger, R., & Stolk, E. A. (2016). Dutch tariff for the five-level version of EQ-5D. Value Health, 19(4), 343–352.CrossRef

20.

Lamers, L. M., McDonnell, J., Stalmeier, P. F., Krabbe, P. F., & Busschbach, J. J. (2006). The Dutch tariff: results and arguments for an effective design for national EQ-5D valuation studies. Health Economics, 15(10), 1121–1132.CrossRefPubMed

21.

Meerding, W. J., Looman, C. W., Essink-Bot, M. L., Toet, H., Mulder, S., & van Beeck, E. F. (2004). Distribution and determinants of health and work status in a comprehensive population of injury patients. Journal of Trauma, 56(1), 150–161.CrossRefPubMed

22.

Wolfs, C. A., Dirksen, C. D., Kessels, A., Willems, D. C., Verhey, F. R., & Severens, J. L. (2007). Performance of the EQ-5D and the EQ-5D + C in elderly patients with cognitive impairments. Health and Quality of Life Outcomes, 5, 33.CrossRefPubMedPubMedCentral

23.

Swinburn, P., Lloyd, A., Boye, K. S., Edson-Heredia, E., Bowman, L., & Janssen, B. (2013). Development of a disease-specific version of the EQ-5D-5L for use in patients suffering from psoriasis: lessons learned from a feasibility study in the UK. Value Health, 16(8), 1156–1162.CrossRefPubMed

24.

Whynes, D. K. (2013). Does the correspondence between EQ-5D health state description and VAS score vary by medical condition? Health and Quality of Life Outcomes, 11, 155.CrossRefPubMedPubMedCentral

25.

Perneger, T. V., & Courvoisier, D. S. (2011). Exploration of health dimensions to be included in multi-attribute health-utility assessment. International Journal for Quality in Health Care, 23(1), 52–59.CrossRefPubMed

26.

Carroll, L. J., Cassidy, J. D., Cancelliere, C., Cote, P., Hincapie, C. A., Kristman, V. L., Holm, L. W., Borg, J., Nygren-de Boussard, C., & Hartvigsen, J. (2014). Systematic review of the prognosis after mild traumatic brain injury in adults: Cognitive, psychiatric, and mortality outcomes: Results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. Archives of Physical Medicine and Rehabilitation, 95(3 Suppl), 152–173.CrossRef

27.

Janssen, M. F., Pickard, A. S., Golicki, D., Gudex, C., Niewada, M., Scalone, L., Swinburn, P., & Busschbach, J. (2013). Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups: A multi-country study. Quality of Life Research, 22(7), 1717–1727.CrossRefPubMed

Title: Health-related quality of life in injury patients: the added value of extending the EQ-5D-3L with a cognitive dimension
Authors: Robbin H. Ophuis
Mathieu F. Janssen
Gouke J. Bonsel
Martien J. Panneman
Suzanne Polinder
Juanita A. Haagsma
Publication date: 01-07-2019
Publisher: Springer International Publishing
Published in: Quality of Life Research / Issue 7/2019
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-019-02156-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Health-related quality of life in injury patients: the added value of extending the EQ-5D-3L with a cognitive dimension

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 7/2019

Do 8- to 18-year-old children/adolescents with chronic physical health conditions have worse health-related quality of life than their healthy peers? a meta-analysis of studies using the KIDSCREEN questionnaires

Obesity phenotype and patient-reported outcomes in moderate and severe chronic kidney disease: a cross-sectional study from the CKD-REIN cohort study

Relationship between paid leave, financial burden, and patient-reported outcomes among employed patients who have undergone bone marrow transplantation

Racial/ethnic disparities in health-related quality of life and health status across pre-, early-, and mid-adolescence: a prospective cohort study

Effect of neighborhood and individual social capital in early childhood on oral health-related quality of life: a 7-year cohort study

Predicting quality of life during and post detention in incarcerated juveniles