Elsevier

Respiratory Medicine

Volume 102, Issue 4, April 2008, Pages 519-536
Respiratory Medicine

Use of a preference-based measure of health (EQ-5D) in COPD and asthma

https://doi.org/10.1016/j.rmed.2007.11.016Get rights and content
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Summary

Background

EQ-5D is a generic preference-based measure of health that can help to understand the impact of asthma and chronic obstructive pulmonary disease (COPD). The purpose of this paper was to synthesize literature on the validity and reliability of EQ-5D use in studies of asthma and COPD, and estimate EQ-5D utility scores associated with stage of disease.

Methods

A structured search was conducted in EMBASE and MEDLINE (1988–2007) using keywords relevant to respiratory disease and EQ-5D. Original research studies in asthma or COPD that reported EQ-5D results and/or psychometric properties were included.

Results

Studies that reported psychometric properties supported the construct validity, test–retest reliability, and responsiveness of EQ-5D in asthma (seven studies) and COPD (nine studies), although some evidence of ceiling effects were observed in asthma studies. In asthma studies that reported summary scores (n=11), EQ-5D index-based scores ranged from 0.42 (SD 0.30) to 0.93 (SD not reported). In COPD studies (n=8), scores ranged from 0.52 (SD 0.16) to 0.84 (SD 0.15). While few asthma studies reported scores by severity level, sufficient studies in COPD were available to calculate pooled mean utility scores according to GOLD stage: stage I=0.74 (0.62–0.87), stage II=0.74 (0.66–0.83), stage III=0.69 (0.60–0.78) and stage IV=0.61 (0.44–0.77) (most severe).

Conclusions

Evidence generally supported the validity and reliability of EQ-5D in asthma and COPD. Utility scores associated with COPD stage may be useful for modeling health outcomes in economic evaluations of treatments for COPD.

Keywords

Asthma
COPD
Health outcomes
Quality of life
EQ-5D

Abbreviations

COPD
chronic obstructive pulmonary disease
HRQL
health related quality of life
GOLD
the global initiative for chronic obstructive lung disease
SD
standard deviation
VAS
visual analog scale
DALYs
disability adjusted life years
FEV1
forced expiratory volume 1 s
AQLQ
Asthma Quality of Life Questionnaire
SF-36
Short Form-36
QALY
quality adjusted life years
GINA
the global initiative for asthma
UK
United Kingdom
SE
standard error
NASQ
Newcastle Asthma Symptoms Questionnaire

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