Responsiveness of the EuroQol (EQ-5D) and the Nottingham Health Profile (NHP) in elderly patients with femoral neck fractures

Abstract

Introduction: The objective of this study was to evaluate the internal and external responsiveness of the EuroQol (EQ-5D) and the Nottingham Health Profile (NHP) and to evaluate the overlap of change scores from the two instruments.

Methods: Sixty patients with femoral neck fractures treated with internal fixation at a university hospital participated. Internal responsiveness was assessed using a paired t-test and the standardised response mean (SRM) for patients with displaced fractures hypothesised to deteriorate between baseline and the 6-month follow-up. In the analyses of external responsiveness, receiver operator characteristics (ROC) and logistic regression were employed to assess the correspondence between the chosen external criterion (EC) defining fracture displacement, i.e. displaced vs. undisplaced fractures, and the change scores from the EQ-5D and the NHP. The overlap in change scores for the overall scores and comparable subdimensions of the two instruments was evaluated by correlational analyses.

Results: The SRM were large and the change in HRQoL over time was statistically significant for both instruments in patients with displaced fractures. A correspondence was found between the EC and change scores for both questionnaires. The correlation coefficients between the change scores for the overall scores and comparable subdimensions of the two instruments ranged from relatively small to moderate.

Conclusions: The results yielded support for the internal and external responsiveness of the EQ-5D and the NHP and indicated an advantage for the EQ-5D. The empirical overlap between change scores from the two instruments was limited.