Analyzing the Pain/Discomfort and Anxiety/Depression Composite Domains and the Meaning of Discomfort in the EQ-5D: A Mixed-Methods Study

Dec 1, 2022, 00:00
10.1016/j.jval.2022.06.012
https://www.valueinhealthjournal.com/article/S1098-3015(22)02067-8/fulltext
Title : Analyzing the Pain/Discomfort and Anxiety/Depression Composite Domains and the Meaning of Discomfort in the EQ-5D: A Mixed-Methods Study
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(22)02067-8&doi=10.1016/j.jval.2022.06.012
First page : 2003
Section Title : PATIENT-REPORTED OUTCOMES
Open access? : Yes
Section Order : 2003

Objectives

The EQ-5D has 2 composite domains: pain/discomfort (PD) and anxiety/depression (AD). This study aims to explore how respondents use the composites to self-report health and what the meaning of discomfort is in the EQ-5D for the general public.

Methods

Both qualitative and quantitative data were collected in an online cross-sectional survey involving a nationally representative general population sample in Hungary (n = 1700). Respondents completed the 5-level version of EQ-5D, followed by the composites split into individual subdomains. Open-ended questions were asked to explore respondents’ interpretations and experiences of discomfort.

Results

Six different response behaviors were identified in the composites: “uniform” (21%-32%), “most severe” (30%-34%), “least severe” (16%-23%), “average” (2%-4%), “synergistic” (4%-5%), and “inconsistent” (13%-15%). Compared with the individual subdomains, many respondents under-reported their problems on both composites (PD 16%-22% and AD 6%-13%, P  .05).

Conclusions

We found empirical evidence of measurement error in the composite responses on the EQ-5D, including under- and inconsistent reporting, ordering effects, potential differential item functioning, and interdomain dependency. Our findings contribute new knowledge to the development of new and refinement of existing self-reported health status instruments, also beyond the EQ-5D.

Categories :
  • Health State Utilities
  • Oncology
  • Patient-Centered Research
  • Specific Diseases & Conditions
  • Study Approaches
  • Surveys & Expert Panels
Tags :
  • composite domains
  • content analysis
  • discomfort
  • EQ-5D-5L
  • measurement properties
  • mixed-methods research
  • self-reported health
Regions :
  • Eastern and Central Europe
ViH Article Tags :