Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2015

Open Access 01-12-2015 | Research

The responsiveness of the EQ-5D and time trade-off scores in schizophrenia, affective disorders, and alcohol addiction

Authors: Michael Sonntag, Hans-Helmut König, Alexander Konnopka

Published in: Health and Quality of Life Outcomes | Issue 1/2015

Login to get access

Abstract

Objective

To compare the responsiveness of the EQ-5D index (German and British tariff), the EQ-5D visual analogue scale (EQ VAS), and time trade-off (TTO) scores in schizophrenia, affective disorders, and alcohol addiction.

Methods

We used a sample of 502 patients and examined the measures at baseline and after 14 months. We used the generic “WHO Quality of Life BREF” (WHOQOL) and the disorder-specific “Global Severity Index” (GSI) as anchors for a relevant improvement in a patient’s health status. In a complete case analysis, we assessed the responsiveness, which is the ability to detect a change given a relevant change on the anchor. We computed the effect sizes (ESs) and standardised response means (SRMs).

Results

In patients with schizophrenia, the ESs and SRMs were large (ES/SRM > 0.8) for the British EQ-5D index (ESGSI: 0.93; SRMGSI: 0.89; SRMWHOQOL: 0.82). In patients with affective disorders, we found large ESs and SRMs for the EQ VAS (ESGSI: 1.79; ESWHOQOL: 0.90; SRMGSI: 1.52; SRMWHOQOL: 0.93) and a large ES for the British EQ-5D index (ESGSI: 0.88). In patients with alcohol addiction, the ESs and SRMs were large for the EQ VAS (ESGSI: 1.40; ESWHOQOL: 0.94; SRMGSI: 1.04; SRMWHOQOL: 0.83). The ESs and SRMs of the German EQ-5D index were consistently lower than those of the British EQ-5D index. Regarding TTO score, ESs and SRMs were generally less than 0.5.

Conclusions

No preference-based instrument was consistently more responsive than others across all mental disorders. While the EQ VAS was the most responsive instrument in patients with affective disorders or alcohol addiction, the British EQ-5D index was reasonably responsive in patients with schizophrenia.
Appendix
Available only for authorised users
Literature
1.
Brazier J, Deverill M, Green C, Harper R, Booth A. A review of the use of health status measures in economic evaluation. Health Technol Assess. 1999;3:i–iv. 1–164.PubMed
2.
Brazier J, Ratcliffe J, Salomon J, Tsuchiya A. Measuring and valuing health benefits for economic evaluation. Oxford: Oxford University Press; 2007.
3.
Sonntag M, König HH, Konnopka A. The estimation of utility weights in cost-utility analysis for mental disorders: a systematic review. Pharmacoeconomics. 2013;31:1131–54.CrossRefPubMed
4.
Streiner DL, Norman GR. Health measurement scales : a practical guide to their development and use. 4th edn. Oxford. New York: Oxford University Press; 2008.CrossRef
5.
Krahn M, Bremner KE, Tomlinson G, Ritvo P, Irvine J, Naglie G. Responsiveness of disease-specific and generic utility instruments in prostate cancer patients. Qual Life Res. 2007;16:509–22.CrossRefPubMed
6.
Salaffi F, Stancati A, Carotti M. Responsiveness of health status measures and utility-based methods in patients with rheumatoid arthritis. Clin Rheumatol. 2002;21:478–87.CrossRefPubMed
7.
Kaplan RM, Tally S, Hays RD, Feeny D, Ganiats TG, Palta M, et al. Five preference-based indexes in cataract and heart failure patients were not equally responsive to change. J Clin Epidemiol. 2011;64:497–506.PubMedCentralCrossRefPubMed
8.
Gregor JC, McDonald JW, Klar N, Wall R, Atkinson K, Lamba B, et al. An evaluation of utility measurement in Crohn’s disease. Inflamm Bowel Dis. 1997;3:265–76.PubMed
9.
Moock J, Kohlmann T. Comparing preference-based quality-of-life measures: results from rehabilitation patients with musculoskeletal, cardiovascular, or psychosomatic disorders. Qual Life Res. 2008;17:485–95.CrossRefPubMed
10.
Stavem K, Froland SS, Hellum KB. Comparison of preference-based utilities of the 15D, EQ-5D and SF-6D in patients with HIV/AIDS. Qual Life Res. 2005;14:971–80.CrossRefPubMed
11.
Gerhards SA, Huibers MJ, Theunissen KA, de Graaf LE, Widdershoven GA, Evers SM. The responsiveness of quality of life utilities to change in depression: a comparison of instruments (SF-6D, EQ-5D, and DFD). Value Health. 2011;14:732–9.CrossRefPubMed
12.
Lamers LM, Bouwmans CA, van Straten A, Donker MC, Hakkaart L. Comparison of EQ-5D and SF-6D utilities in mental health patients. Health Econ. 2006;15:1229–36.CrossRefPubMed
13.
McCrone P, Patel A, Knapp M, Schene A, Koeter M, Amaddeo F, et al. A comparison of SF-6D and EQ-5D utility scores in a study of patients with schizophrenia. J Ment Health Policy Econ. 2009;12:27–31.PubMed
14.
Mulhern B, Mukuria C, Barkham M, Knapp M, Byford S, Soeteman D, et al. Using generic preference-based measures in mental health: psychometric validity of the EQ-5D and SF-6D. Br J Psychiatry. 2014;205:236–43.CrossRefPubMed
15.
Roick C, Heinrich S, Deister A, Zeichner D, Birker T, Heider D, et al. [The regional psychiatry budget: costs and effects of a new multisector financing model for psychiatric care]. Psychiatr Prax. 2008;35:279–85.CrossRefPubMed
16.
Dimdi. [ICD-10-GM 2005 - International Statistical Classification of Diseases and Related Health Problems- German Modification 10. Revision, Version 2005]. Köln: Deutscher Ärzte-Verlag; 2005.
17.
Group EQ. EuroQol--a new facility for the measurement of health-related quality of life. The EuroQol Group Health Policy. 1990;16:199–208.CrossRef
18.
Dolan P, Gudex C, Kind P, Williams A. The time trade-off method: results from a general population study. Health Econ. 1996;5:141–54.CrossRefPubMed
19.
Greiner W, Claes C, Busschbach JJ, von der Schulenburg JM. Validating the EQ-5D with time trade off for the German population. Eur J Health Econ. 2005;6:124–30.CrossRefPubMed
20.
Brazier J, Green C, McCabe C, Stevens K. Use of visual analog scales in economic evaluation. Expert Rev Pharmacoecon Outcomes Res. 2003;3:293–302.CrossRefPubMed
21.
Brazier J, McCabe C. ‘Is there a case for using visual analogue scale valuations in CUA’ by Parkin and Devlin. A response: ‘yes there is a case, but what does it add to ordinal data?’. Health Econ. 2007;16:645–7. discussion 649–651.CrossRefPubMed
22.
Torrance GW, Feeny D, Furlong W. Visual analog scales: do they have a role in the measurement of preferences for health states? Med Decis Making. 2001;21:329–34.CrossRefPubMed
23.
Brazier J, Deverill M. A checklist for judging preference-based measures of health related quality of life: learning from psychometrics. Health Econ. 1999;8:41–51.CrossRefPubMed
24.
25.
Trompenaars FJ, Masthoff ED, Van Heck GL, Hodiamont PP, De Vries J. Content validity, construct validity, and reliability of the WHOQOL-Bref in a population of Dutch adult psychiatric outpatients. Qual Life Res. 2005;14:151–60.CrossRefPubMed
26.
Mas-Exposito L, Amador-Campos JA, Gomez-Benito J, Lalucat-Jo L, Research Group on Severe Mental D. The World Health Organization Quality of Life Scale Brief Version: a validation study in patients with schizophrenia. Qual Life Res. 2011;20:1079–89.CrossRefPubMed
27.
Herrman H, Hawthorne G, Thomas R. Quality of life assessment in people living with psychosis. Soc Psychiatry Psychiatr Epidemiol. 2002;37:510–8.CrossRefPubMed
28.
Derogatis L. SCL-90-R: administration, scoring and procedures manual. Minneapolis (MN): National Computer Systems; 1994.
29.
Norman GR, Sloan JA, Wyrwich KW. Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care. 2003;41:582–92.PubMed
30.
Sloan JA, Cella D, Hays RD. Clinical significance of patient-reported questionnaire data: another step toward consensus. J Clin Epidemiol. 2005;58:1217–9.CrossRefPubMed
31.
Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. L. Erlbaum Associates: Hillsdale, N.J; 1988.
32.
Husted JA, Cook RJ, Farewell VT, Gladman DD. Methods for assessing responsiveness: a critical review and recommendations. J Clin Epidemiol. 2000;53:459–68.CrossRefPubMed
33.
Revicki DA, Cella D, Hays RD, Sloan JA, Lenderking WR, Aaronson NK. Responsiveness and minimal important differences for patient reported outcomes. Health Qual Life Outcomes. 2006;4:70.PubMedCentralCrossRefPubMed
34.
Terwee CB, Dekker FW, Wiersinga WM, Prummel MF, Bossuyt PM. On assessing responsiveness of health-related quality of life instruments: guidelines for instrument evaluation. Qual Life Res. 2003;12:349–62.CrossRefPubMed
35.
Norman GR, Wyrwich KW, Patrick DL. The mathematical relationship among different forms of responsiveness coefficients. Qual Life Res. 2007;16:815–22.CrossRefPubMed
36.
Crosby RD, Kolotkin RL, Williams GR. Defining clinically meaningful change in health-related quality of life. J Clin Epidemiol. 2003;56:395–407.CrossRefPubMed
37.
Whynes DK, McCahon RA, Ravenscroft A, Hodgkinson V, Evley R, Hardman JG. Responsiveness of the EQ-5D health-related quality-of-life instrument in assessing low back pain. Value Health. 2013;16:124–32.CrossRefPubMed
38.
Konnopka A, Gunther OH, Angermeyer MC, Konig HH. [Discriminative ability, construct validity and sensitivity to change of the EQ-5D quality of life questionnaire in paranoid schizophrenia]. Psychiatr Prax. 2006;33:330–6.CrossRefPubMed
39.
Terwee CB, Roorda LD, Dekker J, Bierma-Zeinstra SM, Peat G, Jordan KP, et al. Mind the MIC: large variation among populations and methods. J Clin Epidemiol. 2010;63:524–34.CrossRefPubMed
40.
de Vet HC, Terwee CB. The minimal detectable change should not replace the minimal important difference. J Clin Epidemiol. 2010;63:804–5. author reply 806.CrossRefPubMed
41.
Mulhern B, Rowen D, Brazier J, Smith S, Romeo R, Tait R, et al. Development of DEMQOL-U and DEMQOL-PROXY-U: generation of preference-based indices from DEMQOL and DEMQOL-PROXY for use in economic evaluation. Health Technol Assess. 2013;17:v–xv. 1–140.CrossRefPubMed
42.
König HH, Bernert S, Angermeyer MC. [Health Status of the German population: results of a representative survey using the EuroQol questionnaire]. Gesundheitswesen. 2005;67:173–82.CrossRefPubMed
43.
Attema AE, Edelaar-Peeters Y, Versteegh MM, Stolk EA. Time trade-off: one methodology, different methods. Eur J Health Econ. 2013;14 Suppl 1:S53–64.CrossRefPubMed
Metadata
Title
The responsiveness of the EQ-5D and time trade-off scores in schizophrenia, affective disorders, and alcohol addiction
Authors
Michael Sonntag
Hans-Helmut König
Alexander Konnopka
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2015
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-015-0315-4

Other articles of this Issue 1/2015

Health and Quality of Life Outcomes 1/2015 Go to the issue

Research Article

Elicitation of health state utilities associated with varying severities of flares in Systemic Lupus Erythematosus

Research

Reliability and validity of the Portuguese version of the Generalized Anxiety Disorder (GAD-7) scale

Research Article

Health related quality of life in patients with actinic keratosis – an observational study of patients treated in dermatology specialist care in Denmark

Research

Early intervention influences positively quality of life as reported by prematurely born children at age nine and their parents; a randomized clinical trial

Research

Loss and psychosocial factors as determinants of quality of life in a cohort of earthquake survivors

Research

Utility estimation of hypothetical chronic obstructive pulmonary disease health states by the general population and health professionals