EQ-5D 之效度分析 - nhis.nhri.org.tw

1 1 EQ-5D -2009 1 1 2 3 3 1. 2. 3. (1) WHO (According to the WHO definition,quality of life refers to individuals perceptions of their position in life in the context of the culture and value systems in which they live, and in relation to their goals, expectations, standards, and concerns)(2-3) (4) (5) (Health-related quality of life, HRQOL) (6,7)

2 Sf-36(short form 36) (utility-based) 36 8 (8) SF-36 2 (6) SF-36 SF-36 1996 (9-10) EQ-5D (preference-based) (11) 5 (self-classifier) 0-100 SF-36 EQ-5D (12) (13-17) 53 15 EQ-5D (18-19) EQ-5D 2001 2005 SF-36 2009 EQ-5D SF-36 EQ-5D EQ-5D SF-36 EQ-5D 3 2009 30528 25636 ( ) 12 12-64 65 12-64 19201 ( SF-36 ) ( EQ-5D )

3 12-64 4 12-64 4 EQ-5D 4752 EQ-5D 24 EQ-5D 19 EQ_VAS SF-36 EQ-5D EQ-5D / / / / 243 (time trade-off TTO) EQ-5D (EQ-index) (20) (21-22) EQ-VAS 20 (visual analog scale) 0 100 0 100 SF-36 (Physical Functioning PF 10 ) (Role 4 limitation due to Physical problems RP 4 ) (Bodily Pain BP 2 ) (General Health GH 5 ) (Vitality VT 4 ) (Social Functioning SF 2 ) (Role limitation due to Emotional problems RE 3 ) (Mental Health MH 5 ) 8 36 0 100 36 (Physical Component Scale PCS) (Mental Component Scale MCS) 1989 (23) EQ-5D (24)

4 (25) (26-27) CDC (28) (29) EQ-5D (30-31) 5 (7,32) (concurrent validity) (discriminant validity) (convergent validity) (construct validity) (33) EQ-5D (34) 1. (concurrent validity) (1) EQ-5D ( / / ) SF-36 ( ) (19, 33, 35, 38) (2) EQ-5D ( / ) SF-36 PF RP BP RE MH (35) (3) EQ-5D ( / ) SF-36 RE MH (35) (4) EQ-5D SF-36 RP (35) (5) EQ-VAS (35-37) (6) EQ-VAS (35) 2.

5 (discriminant validity) (1) SF-36 GH (SF-36 ) EQ-index EQ-VAS (17, 19, 21, 35, 36, 37, 40) 6 (2) (35) (2) EQ-5D SF-36 (19) 3. (convergent validity) (1) EQ-5D SF-36 EQ-5D SF-36 (19, 39) Pearson s EQ-index EQ-VAS SF-36 EQ-index SF-36 t-test Scheff s test chi-square test SAS 4752 12-64 ( ) 25-64 7 100 6 10% EQ-5D SF-36 SF-36 PF RP BP RE MH PF RP RE MH BP MH RE RP BP RE MH EQ-5D 7 SF-36 RE MH EQ-5D RP SF-36 PF RP EQ-VAS EQ-VAS 18-24 25-39 40-64 12-17 40-64 25-39 ( )

6 EQ-index EQ-VAS EQ-index EQ-VAS EQ-index EQ-index EQ-VAS EQ-index EQ-VAS ( ) EQ-5D EQ-index EQ-VAS SF-36 EQ-5D / SF-36 ( ) EQ-5D SF-36 SF-36 ( ) EQ-5D 243 EQ-5D 39 / 90% ( ) SF-36 EQ-5D EQ-5D EQ-VAS 8 EQ-index EQ-VAS EQ-5D SF-36 EQ-5D EQ-VAS SF-36 GH VT MH EQ-5D (40) (ceiling effect) (32,41)

7 3436 ( ) EQ-5D ( ) (42) (37) (43) (44) EQ-5D EQ-5D EQ-5D 9 Table1. Characteristics of 4752 respondents age 12-64 years. n % Age, mean (SD, n=4752) ( ) 12-17 years old 553 18-24 years old 646 25-39 years old 1463 40-64 years old 2084 Gender Male 2276 Female 2476 Marital Status Single 1944 Married 2431 Divorced or separated 227 Widowed 145 Education Level Primary or below 608 Secondary 2461 Colledge or above 1682 Employment status Current employed 3059 Unemployed 1692 Family income per month less than 30K 882 30-50K 967 50-70K 870 70-100K 668 greater than 100K 669 10 Table1.

8 Characteristics of 4752 respondents age 12-64 years (cont.) n % Medical Services Use Emergency in past 1 yearr 521 Hospitalization in past 1 year 220 Dentistry clinic visit in past 1 year 2434 Outpatient visit in past 1 month 1670 Chronic condition 1316 Hypertension 463 Diabete 185 Stroke 34 Asthma 193 Kidney disease 155 Any Heart disease 137 Gout 134 Stomach or duodenal ulcer 194 COPD 39 Liver disease(non-cancer) 216 Cancer 28 Arthritis 110 Mental disorder 84 11 Table 2. Test of concurrent validity of EQ-5D . Mean of the SF-36 scales and domains Variable n PF RP BP GH VT SF RE MH PCS MCS Mobility No problem 4708 With problem 44 difference Self-Care No problem 4736 With problem 15 difference Usual Activity No problem 4695 With problem 56 difference Pain/Discomfort No problem 4108 With problem 629 difference

9 Anxiety/Depression No problem 4334 With problem 411 difference 1 p< , others were < 12 Table 3. Test of concurrent EQ-VAS. Correlation with EQ-VAS n Mean SD P. Pearson Spearman Gender Male 2269 Female 2464 Age < a a 12-17 years 553 18-24 years 646 b 25-39 years 1462 b 40-64 years 2066 b,c a p< b p< of comparing to 12-17 years. c p< of comparing to 25-39 years 13 Table 4. Test of discriminant validity. Mean of EQ_index Mean of EQ-VAS N EQ-index_JP4 EQ-index_UK4 N EQ-VAS Emergency1 No 4210 4212 Yes 517 519 p < < < Hospitalization1 No 4512 4516 Yes 216 216 p < < < Dentistry clinic visit1 No 2288 2284 Yes 2420 2428 p Outpatient visit2 No 3072 3069 Yes 1657 1664 p < < < Chronic condition3 Without 3423 3426 With 1306 1307 p < < < General Health today Excellent 165 167 Very good 1297 1300 Good 1472 1474 Fair 1613 1612 Poor 157 154 p 1 in past 1 year 2 in past 1 month 3 self-reported chronic conditions including having hypertension, diabetes.

10 Stroke, asthma, kidney disease, any heart disease, gout, stomach or duodenal ulcer