COMPARISON OF THE MEASUREMENT PROPERTIES OF EQ-5D-5L AND SF-6DV2 IN KOREAN PATIENTS WITH LUMBAR SPINAL STENOSIS
Author(s)
Eun Young Bae, PhD1, Hea-Lim Kim, PhD2.
1Professor, Gyeongsang National University, Jinju, Gyeongnam province, Korea, Republic of, 2Seoul National University, Seoul, Korea, Republic of.
1Professor, Gyeongsang National University, Jinju, Gyeongnam province, Korea, Republic of, 2Seoul National University, Seoul, Korea, Republic of.
OBJECTIVES: To compare the measurement properties of the EQ-5D-5L and SF-6Dv2 in Korean patients with lumbar spinal stenosis (LSS).
METHODS: A cross-sectional survey was conducted from January 2024 to August 2025 at three Korean medicine hospitals, enrolling 300 patients with LSS. Health-related quality of life was assessed using the Korean versions of the EQ-5D-5L, SF-6Dv2, and Oswestry Disability Index (ODI). Three patients with incomplete responses were excluded, leaving 297 patients for analysis. Agreement between the two instruments was assessed using the intraclass correlation coefficient (ICC) and Bland-Altman plots. Convergent validity was evaluated using Spearman's rank correlation. Known-group validity was assessed by comparing utility scores between patients with above- and below-median ODI scores using the Mann-Whitney U test. Sensitivity was compared using relative efficiency (RE), with the EQ-5D-5L F-statistic as the reference (RE = 1).
RESULTS: The mean (SD) utility scores were 0.678 (0.167) for the EQ-5D-5L and 0.350 (0.474) for the SF-6Dv2. The ICC was 0.354, indicating poor-to-moderate absolute agreement. The mean difference between the two instruments was 0.328 (95% limits of agreement: −0.367 to 1.022), and the Bland-Altman plot revealed that the EQ-5D-5L consistently generated higher utility scores. Nevertheless, Spearman's correlation was 0.803 (p less than 0.001), indicating strong convergent validity. Both instruments demonstrated known-group validity, with significantly higher utility scores in the lower-disability group (both p < 0.001). The RE was 0.893, suggesting marginally greater sensitivity of the SF-6Dv2 in discriminating between disability subgroups.
CONCLUSIONS: Both instruments demonstrated good convergent and known-group validity in Korean patients with LSS. However, despite their strong correlation, poor absolute agreement and wide limits of agreement indicate they are not interchangeable. As the EQ-5D-5L generated substantially higher utility scores than the SF-6Dv2, instrument choice may meaningfully influence QALY estimates and cost-utility analyses for LSS interventions in Korea.
METHODS: A cross-sectional survey was conducted from January 2024 to August 2025 at three Korean medicine hospitals, enrolling 300 patients with LSS. Health-related quality of life was assessed using the Korean versions of the EQ-5D-5L, SF-6Dv2, and Oswestry Disability Index (ODI). Three patients with incomplete responses were excluded, leaving 297 patients for analysis. Agreement between the two instruments was assessed using the intraclass correlation coefficient (ICC) and Bland-Altman plots. Convergent validity was evaluated using Spearman's rank correlation. Known-group validity was assessed by comparing utility scores between patients with above- and below-median ODI scores using the Mann-Whitney U test. Sensitivity was compared using relative efficiency (RE), with the EQ-5D-5L F-statistic as the reference (RE = 1).
RESULTS: The mean (SD) utility scores were 0.678 (0.167) for the EQ-5D-5L and 0.350 (0.474) for the SF-6Dv2. The ICC was 0.354, indicating poor-to-moderate absolute agreement. The mean difference between the two instruments was 0.328 (95% limits of agreement: −0.367 to 1.022), and the Bland-Altman plot revealed that the EQ-5D-5L consistently generated higher utility scores. Nevertheless, Spearman's correlation was 0.803 (p less than 0.001), indicating strong convergent validity. Both instruments demonstrated known-group validity, with significantly higher utility scores in the lower-disability group (both p < 0.001). The RE was 0.893, suggesting marginally greater sensitivity of the SF-6Dv2 in discriminating between disability subgroups.
CONCLUSIONS: Both instruments demonstrated good convergent and known-group validity in Korean patients with LSS. However, despite their strong correlation, poor absolute agreement and wide limits of agreement indicate they are not interchangeable. As the EQ-5D-5L generated substantially higher utility scores than the SF-6Dv2, instrument choice may meaningfully influence QALY estimates and cost-utility analyses for LSS interventions in Korea.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
PCR121
Topic
Economic Evaluation, Patient-Centered Research, Real World Data & Information Systems
Topic Subcategory
Health State Utilities, Instrument Development, Validation, & Translation, Patient-reported Outcomes & Quality of Life Outcomes
Disease
Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), No Additional Disease & Conditions/Specialized Treatment Areas