Psychometric assessment of EQ-5D-5L and ReQoL measures in patients with anxiety and depression : construct validity and responsiveness

Abstract

Purpose

Generic health measures have been questioned for quantifying mental-health-related outcomes. In patients with anxiety and/or depression, our aim is to assess the psychometric properties of the preference-based EQ-5D-5L (generic health) and ReQoL-UI (recovery-focussed quality of life) for economic evaluation against the PHQ-9 (depression) and GAD-7 (anxiety). EQ-5D-5L anxiety/depression item and ReQoL-10 are also assessed.

Methods

A 2:1 (intervention: control) randomised controlled trial collected measures at baseline and 8 weeks post baseline; in the intervention arm, data were also collected 3, 6, 9, and 12-months post baseline. EQ-5D-5L preference-based scores were obtained from the value set for England (VSE) and ‘cross-walked’ EQ-5D-3L United Kingdom (UK) value set scores. ReQoL-UI preference-based scores were obtained from its UK value set as applied to seven ReQoL-10 items. EQ-5D-5L and ReQoL measures’ construct validity and responsiveness were assessed compared against PHQ-9 and GAD-7 scores and group cut-offs.

Results

361 people were randomised to intervention (241) or control (120). ReQoL-UI/-10 had better construct validity with depression severity than the EQ-5D-5L (VSE/cross-walk scores), which had relatively better construct validity with anxiety severity than the ReQoL-UI/-10. Across all intervention-arm time-points relative to baseline, responsiveness was generally better for EQ-5D-5L (VSE in particular) than ReQoL-UI, but worse than ReQoL-10.

Conclusion

There is insufficient evidence to recommend the ReQoL-UI over EQ-5D-5L for economic evaluations to capture anxiety severity. However, there may be rationale for recommending the ReQoL-UI over the EQ-5D-5L to capture depression severity given its better construct validity, albeit poorer responsiveness, and if recovery-focussed quality of life relative to condition-specific symptomology is the construct of interest.

Metadata

Item Type:	Article
Authors/Creators:	Franklin, M. https://orcid.org/0000-0002-2774-9439 Enrique, A. Palacios, J. Richards, D.
Copyright, Publisher and Additional Information:	© 2021 The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Keywords:	EQ-5D-5L; ReQoL-10; ReQoL-UI; Anxiety; Depression; Psychometrics; Economic evaluation
Dates:	Published: September 2021 Published (online): 9 April 2021 Accepted: 23 March 2021
Institution:	The University of Sheffield
Academic Units:	The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research
Funding Information:	Funder Grant number Silvercloud Health N/A Department of Health and Social Care NIHR200166
Depositing User:	Symplectic Sheffield
Date Deposited:	15 Apr 2021 11:40
Last Modified:	18 Feb 2022 12:10
Status:	Published
Publisher:	Springer Nature
Refereed:	Yes
Identification Number:	10.1007/s11136-021-02833-1
Open Archives Initiative ID (OAI ID):	oai:eprints.whiterose.ac.uk:172995

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Psychometric assessment of EQ-5D-5L and ReQoL measures in patients with anxiety and depression : construct validity and responsiveness

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