The Added Value of the Cognition, Dining, Gastrointestinal Problems, Sleep, and Tiredness Bolt-Ons for the EQ-5D-5L in Patients With Coeliac Disease

Speaker(s)

Angyal M1, Janssen MF2, Lakatos PL3, Brodszky V4, Rencz F5
1Semmelweis University of Budapest, Budapest, Pest, Hungary, 2The EuroQol Group, Rotterdam, Netherlands, 3Semmelweis University 1st Department of Medicine, Budapest, Hungary and McGill University Health Centre, Division of Gastroenterology, Montreal, QC, Canada, 4Corvinus University of Budapest, Department of Health Policy, Budapest, PE, Hungary, 5Corvinus University of Budapest, Budapest, Pest, Hungary

Presentation Documents

OBJECTIVES: The EQ-5D has been found to potentially overestimate health-related quality of life (HRQoL) among patients with coeliac disease (CD). This study aims to examine the benefits of adding bolt-ons to the EQ-5D-5L by assessing their psychometric properties in CD patients.

METHODS: In 2020–2021, a cross-sectional online survey was conducted amongst 312 CD patients (age range: 18 to 80 years) in Hungary. Patients completed the EQ-5D-5L and five bolt-ons [cognition (CO), dining (DI), gastrointestinal problems (GI), sleep (SL), and tiredness (TI)], Gastrointestinal Symptom Rating Scale (GSRS) and the Satisfaction with Life Scale (SWLS). Reduction in ceiling, improvement in known-group validity based on self-perceived health, GSRS and symptoms, and multivariate linear regressions on EQ VAS and SWLS scores were used to determine the added value of bolt-ons. Spearman’s correlations were used to examine convergent validity of the GI bolt-on with GSRS total score and divergent validity between the five core dimensions and bolt-ons.

RESULTS: The ceiling of the EQ-5D-5L was 39%. Adding the TI, SL, GI, DI and CO individual bolt-ons reduced the ceiling to 17%, 23%, 24%, 26% and 37%, respectively. The GI bolt-on significantly improved the discriminatory power for all known-groups with relative efficiencies ranging between 1.30 (95%CI 1.14-1.49) and 1.84 (95%CI 1.56-2.23). The GI bolt-on was strongly correlated with GSRS total score (rs=0.71). Very weak to moderate correlations were found between the bolt-ons and the five core dimensions (range of rs=0.02 to 0.51). GI and CO improved the explained variance in EQ VAS from 0.41 to 0.44, and DI, SL and GI in SWLS from 0.19 to 0.21.

CONCLUSIONS: Relevant bolt-ons enhance the validity of EQ-5D-5L in patients with CD. The GI bolt-on demonstrated strong psychometric performance in multiple tests, suggesting its value in capturing important aspects of HRQoL potentially missed by the core five dimensions.

Code

PCR225

Topic

Patient-Centered Research

Topic Subcategory

Patient-reported Outcomes & Quality of Life Outcomes

Disease

Gastrointestinal Disorders