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The validity of EQ‐5D US preference weights in liver transplant candidates and recipients
Author(s) -
Russell Robert T.,
Feurer Irene D.,
Wisawatapnimit Panarut,
Pinson C. Wright
Publication year - 2009
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.21648
Subject(s) - medicine , eq 5d , quality of life (healthcare) , anxiety , construct validity , population , health care , demography , gerontology , psychometrics , clinical psychology , health related quality of life , psychiatry , disease , environmental health , sociology , economics , economic growth , nursing
Abstract Health utility instruments assess patients' valuation of specific health states, which can be converted to quality‐adjusted life years for cost‐utility analysis. Data from the EQ‐5D, a generic health‐related quality of life questionnaire from EuroQoL, can be reported as 5 health status scores or as a single health preference weight (HPW). US population–based HPWs were published by Shaw and colleagues in 2005 (Med Care 2005;43:203‐220). Our aim was to test the validity of US EQ‐5D HPWs and health status scores in liver transplant patients. EQ‐5D scores were converted to HPWs with Shaw et al.'s model. Data were stratified by measurement period: pretransplant period, early posttransplant period (≤12 months), intermediate posttransplant period (13‐36 months), and late posttransplant period (>36 months). EQ‐5D scores were compared to specific, hypothesized Short Form 36 Health Survey, Center for Epidemiologic Studies Depression Scale, and Beck Anxiety Inventory scores that were identified a priori on the basis of construct similarity. Criterion‐related and construct validity were tested with nonparametric methods. Two hundred eighty‐five adults participated (113 in the pretransplant period, 60 in the early posttransplant period, 47 in the intermediate posttransplant period, and 65 in the late posttransplant period), and follow‐up averaged 36 ± 36 months. Eighty‐one percent of the hypothesized relationships between EQ‐5D and gold‐standard scales were strong ( r ≥ |0.5|, P < 0.001), and the remainder were moderate ( r > |0.3|, P < 0.001). Differences between pretransplant and posttransplant EQ‐5D HPWs were statistically significant. In conclusion, EQ‐5D dimensions and the health utility index generated from Shaw's US population preference weights demonstrated criterion‐related and construct validity in liver transplant patients. It is a valid instrument for cost‐utility analysis in this setting. Liver Transpl 15:88–95, 2009. © 2008 AASLD.