Background
Methods
Study design
Patient recruitment
Measures
Patient Health Questionnaire 15 (PHQ-15)
Patient Health Questionnaire 9 (PHQ-9)
Whiteley Index 7 (WI-7)
Short Form 36 (SF-36)
Psychometric analyses
Statistical methods
Results
Sociodemographic characteristics
Age in years | |
---|---|
mean (SD) | 49.06 (12.51) |
median | 49 |
Gender | |
male | 25.2% |
female | 74.8% |
Martial statusa
| |
unmarried | 20.0% |
married | 65.6% |
separated/ divorced | 10.3% |
widowed | 4.1% |
Living arrangementb
| |
living alone | 22.3% |
living with spouse/ partner | 70.0% |
living withe parents/ relatives | 4.9% |
other | 2.8% |
Educationc
| |
no school graduation | 1.4% |
secondary school graduation | 73.1% |
technical college/ university entrance qualification | 13.3% |
college/ university degree | 11.9% |
other (e.g. school for mentally handicapped children) | 0.3% |
Descriptive statistics of the EQ-5D
EQ-5D health state (regarding five items in the following order: `mobility´, `self-care´, `usual activities´, `pain/ discomfort´,`anxiety/ depression´ | n (%) |
---|---|
11122*
| 57 (19.5%) |
11222 | 42 (14.2%) |
11121 | 41 (13.9%) |
21222 | 25 (8.5%) |
11111 | 20 (6.8%) |
11112 | 16 (5.4%) |
21221 | 13 (4.4%) |
11221 | 9 (3.1%) |
21232 | 8 (2.7%) |
11223 | 7 (2.4%) |
Measures | Range: worst - best | n | Score | ||
---|---|---|---|---|---|
Mean (SD) | Median (range) | ||||
Health-related quality of life | EQ VAS | (0 – 100) | 287 | 58.56 (19.99) | 60 (0–100) |
EQ-5D index UK | (−0.594 – 1.00) | 293 | 0.62 (0.27) | 0.73 (−0.18 – 1.00) | |
EQ-5D index D | (−0.2 – 1.00) | 293 | 0.77 (0.24) | 0.89 (0.11 – 1.00) | |
SF-36 | |||||
Physical component score (PCS) | (2–76) | 294 | 42.78 (9.11) | 42.96 (13.99-65.40) | |
Mental component score (MCS) | (1–81) | 294 | 40.86 (10.61) | 40.61 (14.15-64.66) | |
Physical functioning (PF) | (0–100) | 294 | 70.86 (24.10) | 75 (0–100) | |
Role physical (RP) | (0–100) | 294 | 68.62 (26.36) | 75 (0–100) | |
Bodily pain (BP) | (0–100) | 294 | 48.50 (25.54) | 41 (0–100) | |
General health (GH) | (0–100) | 294 | 49.75 (18.54) | 50 (5–100) | |
Vitality (VT) | (0–100) | 294 | 39.75 (20.33) | 40 (0–100) | |
Social functioning (SF) | (0–100) | 294 | 61.97 (28.08) | 62.50 (0–100) | |
Role emotional (RE) | (0–100) | 294 | 67.58 (27.22) | 66.67 (0–100) | |
Mental health (MH) | (0–100) | 294 | 54.71 (19.68) | 56 (8–100) | |
Symptoms | PHQ-15 Sum score | (30–1) | 294 | 12.66 (4.81) | 12 (2–26) |
PHQ-9 Sum score | (27–0) | 294 | 9.33 (5.35) | 9 (0–27) | |
Illness worries | WI-7 Sum score | (28–0) | 294 | 10.91 (6.54) | 10 (0–28) |
Scores of reference instruments
Discriminative ability
Number of patients with problems in EQ-5D item: | EQ VAS Score | EQ-5D Index UK | EQ-5D Index D | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Somatic symptom severity
(PHQ-15)
|
Mobility (%)
a
|
Self-care (%)
a
|
Usual Activity (%)
a
|
Pain/ Discomfort (%)
a
|
Anxiety/ Depression (%)
a
|
Mean (SD)
|
Median
|
Mean (SD)
|
Median
|
Mean (SD)
|
Median
|
● Minimal/ Low | 14 (16.6%) | 0 (0.00%) | 22 (26.2%) | 65 (77.4%) | 44 (52.4%) | 68.59 (18.75) | 70 | 0.75 (0.16) | 0.727 | 0.87 (0.14) | 0.888 |
(0–9) | |||||||||||
(n=84 / 29%) | |||||||||||
● Medium | 32 (29.1%) | 2 (1.80%) | 54 (51.8%) | 96 (87.3%) | 72 (65.5%) | 58.8 (18.54) | 60 | 0.65 (0.24) | 0.691 | 0.80 (0.2) | 0.888 |
(10–14) | |||||||||||
(n=110 / 37%) | |||||||||||
● High | 38 (38.0%) | 7 (7.00%) | 63 (63.0%) | 94 (94.0%) | 79 (79.0%) | 50.01 (18.72) | 50 | 0.49 (0.32) | 0.689 | 0.66 (0.3) | 0.838 |
(15–30) | |||||||||||
(n=100 / 34%) | |||||||||||
p-value | 0.006b
| 0.009b
| < 0.001b
| 0.004b
| 0.001b
| < 0.001c
| < 0.001c
| < 0.001c
|
Convergent validity
Other measures | Mean score of other measures by response level of EQ-5D item | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
EQ-5D item | Mobility | Self Care | Usual Activity | Pain/ Discomfort | Anxiety/ Depression | |||||||||||
Problems: | No | Yes |
d
a
| No | Yes |
d
a
| No | Yes |
d
a
| No | Yes |
d
a
| No | Yes |
d
a
| |
Symptoms | PHQ-15 | |||||||||||||||
● Sum score | 11.99 | 14.4 | −0.51**
| 12.54 | 17.00 |
−1.13
*
| 11.3 | 14.23 | −0.64**
| 9.56 | 13.15 | −0.78**
| 11.17 | 13.44 | −0.20**
| |
PHQ-9 | ||||||||||||||||
● Sum score | 8.68 | 10.95 | −0.43**
| 9.21 | 12.89 | −0.61 | 7.57 | 11.29 | −0.73**
| 7.18 | 9.65 | −0.49 | 6.37 | 10.83 |
−0.94
**
| |
Illness worries | WI-7 | |||||||||||||||
● Sum score | 9.93 | 13.27 | −0.52**
| 10.68 | 17.44 |
−1.14
| 8.83 | 13.08 | −0.69**
| 7.92 | 11.34 | −0.55*
| 8.34 | 12.17 | −0.64**
| |
Health-related quality of life | SF-36 | |||||||||||||||
● Physical component score | 45.76 | 34.18 |
1.61
**
| 42.85 | 29.89 |
1.92
**
| 46.44 | 38.13 |
1.04
**
| 52.15 | 40.96 |
1.50
**
| 43.05 | 42.14 | 0.10 | |
● Mental component score | 41.20 | 40.56 | 0.06 | 41.14 | 37.37 | 0.32 | 44.81 | 36.72 |
0.81
**
| 43.81 | 40.59 | 0.30 | 49.00 | 36.97 |
1.32
**
| |
Physical functioning | 80.14 | 46.84 |
1.70
**
| 71.71 | 36.36 |
1.69
**
| 81.22 | 59.25 |
1.03
**
| 90.58 | 67.57 |
1.23
**
| 75.02 | 68.39 | 0.28 | |
Role physical | 71.79 | 56.55 | 0.55**
| 68.51 | 33.33 |
1.23
**
| 77.60 | 55.94 |
0.86
**
| 84.62 | 64.80 |
0.87
**
| 75.76 | 63.21 | 0.49**
| |
Bodily pain | 54.66 | 29.52 |
1.24
**
| 48.32 | 20.78 |
1.46
**
| 57.53 | 36.53 |
0.94
**
| 76.92 | 42.98 |
1.45
**
| 52.38 | 44.99 | 0.30 | |
General health perceptions | 53.06 | 41.10 | 0.72**
| 50.06 | 36.33 | 0.77 | 56.85 | 41.83 |
0.90
**
| 63.92 | 47.45 |
0.95
**
| 55.71 | 46.56 | 0.51**
| |
Vitality | 43.14 | 30.40 | 0.67**
| 39.97 | 24.63 | 0.75 | 48.94 | 28.85 |
1.17
**
| 53.12 | 37.42 | 0.78**
| 50-57 | 33.88 |
0.90
**
| |
Social functioning | 65.95 | 52.23 | 0.50**
| 62.50 | 47.22 | 0.53 | 75.57 | 47.93 |
1.17
**
| 74.68 | 60.10 | 0.53*
| 78.41 | 53.72 |
0.97
**
| |
Role emotional | 69.84 | 61.51 | 0.29 | 68.19 | 44.44 | 0.73 | 76.19 | 57.55 | 0.70**
| 79.49 | 65.62 | 0.53*
| 83.84 | 59.15 |
1.01
**
| |
Mental health | 56.50 | 50.94 | 0.27 | 55.27 | 43.56 | 0.55 | 61.82 | 47.22 | 0.79**
| 62.77 | 53.71 | 0.48 | 68.29 | 48.12 |
1.17
**
|
Other measures | Correlation EQ VAS score | Correlation EQ-5D index UK | Correlation EQ-5D index D | |
---|---|---|---|---|
Symptoms | PHQ-15 | |||
● Sum score | −0.468 | −0.448**
| −0.392**
| |
PHQ-9 | ||||
● Sum score | −0.489 | −0.474**
| −0.345**
| |
Illness worries | WI-7 | |||
● Sum score | −0.471 | −0.431**
| −0.331**
| |
Health-related quality of life | SF-36 | |||
● Physical component score |
0.589
|
0.574
**
|
0.636
**
| |
● Mental component score | 0.470 | 0.441**
| 0.221**
| |
Physical functioning |
0.538
|
0.567
**
|
0.600
**
| |
Role physical | 0.423 | 0.467**
| 0.386**
| |
Bodily pain |
0.599
|
0.579
**
|
0.595
**
| |
General health perceptions |
0.633
|
0.509
**
| 0.464**
| |
Vitality |
0.586
|
0.555
**
| 0.412**
| |
Social functioning |
0.564
|
0.530
**
| 0.381**
| |
Role emotional | 0.382 | 0.436**
| 0.254**
| |
Mental health |
0.517
| 0.477**
| 0.308**
|
Responsiveness
Statistics | Score | Change of health state anchored by SF-36 transition question | |||
---|---|---|---|---|---|
Worse (n=64) | Same (n=72) | Better (n=91) | |||
t0 – t2 | Mean difference (SD) | EQ VAS | −3.386 (19.714) | −3.284 (17.420) |
10.744** (16.755) |
EQ-5D index UK | −0.065 (0.285) | 0.029 (0.249) |
0.076** (0.199) | ||
EQ-5D index D | −0.069 (0.266) | 0.018 (0.229) |
0.046* (0.181) | ||
Effect size | EQ VAS | −0.17 | −0.14 | 0.62 | |
EQ-5D index UK | −0.18 | 0.11 | 0.39 | ||
EQ-5D index D | −0.22 | 0.08 | 0.26 | ||
Standardised response mean | EQ VAS | −0.16 | −0.15 | 0.65 | |
EQ-5D index UK | −0.20 | 0.12 | 0.38 | ||
EQ-5D index D | −0.23 | 0.07 | 0.25 |