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Comparative Study
. 2019 Jul;28(7):1931-1939.
doi: 10.1007/s11136-019-02144-6. Epub 2019 Feb 28.

The added value of the EQ-5D with a cognition dimension in injury patients with and without traumatic brain injury

A J L M Geraerds  1 , Gouke J Bonsel  2   3 , Mathieu F Janssen  4 , M A de Jongh  5 , Inge Spronk  2 , Suzanne Polinder  2 , Juanita A Haagsma  2
Affiliations
Comparative Study

The added value of the EQ-5D with a cognition dimension in injury patients with and without traumatic brain injury

A J L M Geraerds et al. Qual Life Res. 2019 Jul.

Abstract

Purpose: This study investigated the psychometric gain, if any, from the extension of the EQ-5D with a cognition bolt-on (EQ-5D + C) in a large cohort injury patients with and without traumatic brain injury (TBI).

Methods: Hospitalized adult injury patients filled out a survey 1 month after initial admission. The survey included the EQ-5D-3L, the cognition bolt-on item in EQ-5D format, and the visual analogue scale (EQ-VAS). We compared ceiling and other distributional effects between EQ-5D and EQ-5D + C and TBI and non-TBI group, and assessed convergent validity using the predictive association with EQ-VAS. Also, we assessed explanatory power using regression analysis, and classification efficiency using Shannon indices.

Results: In total, 715 TBI patients and 1978 non-TBI patients filled out the EQ-5D + C and EQ-VAS. Perfect health was reported by 7.9% (N = 214) on the EQ-5D, and 7.3% (N = 197) on the EQ-5D + C. Convergent validity was highest for EQ-5D + C in the TBI group (Spearman's rank correlation coefficient = - 0.736) and lowest for EQ-5D in the non-TBI group (Spearman's rank correlation coefficient = - 0.652). For both TBI and non-TBI groups, the explanatory power of EQ-5D + C was slightly higher than of EQ-5D (R2 = 0.56 vs. 0.53 for TBI; R2 = 0.47 vs. 0.45 for non-TBI). Absolute classification efficiency was higher for EQ-5D + C than for EQ-5D in both TBI groups, whereas relative classification efficiency was similar.

Conclusions: Psychometric performance in general of both the EQ-5D and EQ-5D + C was better in TBI patients. Adding a cognitive bolt-on slightly improved the psychometric performance of the EQ-5D-3L.

Keywords: Cognition; EQ-5D; HRQoL; TBI.

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Conflict of interest statement

All the authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Patient flow chart
Fig. 2
Fig. 2
Adjusted R2 per EQ-5D dimensions included for TBI and non-TBI patients for the EQ-VAS. M mobility, S self-care, U usual activities, P pain/discomfort, A anxiety/depression, C cognition
See this image and copyright information in PMC

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