The EQ Health and Wellbeing (EQ-HWB) tools have been developed to measure and value outcomes of both health and social care interventions, including those of carers, in a manner suitable for use in economic evaluation. The aim of this article is to add to the body of psychometric evidence for the performance of EQ-HWB, and its shorter version EQ-HWB-9, by assessing construct validity and reliability.
A sample of patients (n = 767) across 6 broadly defined health conditions and a sample of the general population (n = 302) completed the EQ-HWB measures alongside other measures. Convergent validity was assessed using Spearman and Pearson correlations. Known-group validity was investigated by using several self-reported variables and disease specific questions for the patient sample. Test-retest reliability was assessed by intraclass correlation coefficients and the kappa statistic.
Convergent validity between EQ-HWB items and related items from EQ-5D-5L, SWEMWBS, and ICECAP-A was highest in the patient sample. At the scale level, the highest correlations of EQ-HWB summative score and other measures were observed with both PHQ-8 and GAD-7 followed by EQ-5D-5L and ICECAP-A. The EQ-HWB measures showed ability to detect differences in the defined known groups. Comparing across measures, the EQ-HWB measures had the highest standardized effect sizes for groups defined by emotional problems. The EQ-HWB measures were found to be reliable with test-retest reliability being >0.8 for both groups.
The results show that the EQ-HWB measures have promising psychometric properties across both the patient and general populations.
What is it about? The study focuses on the EQ Health and Wellbeing (EQ-HWB) tools, which have been developed to measure health, social care, and carer-related quality of life. This topic is crucial because it informs decisions about spending money on health and social care in a more holistic way. There was a gap in the evidence supporting the use of the EQ-HWB tools. This paper fills the gap by assessing how accurately the EQ-HWB and EQ-HWB-9 measure health and wellbeing. The study contributes significantly by confirming these tools' strong accuracy in measuring quality of life across different populations.
How was the research conducted? The study uses psychometric assessment, which is a way to evaluate the reliability and validity of measurement tools with diverse participants. Researchers collected data on the EQ-HWB from 767 patients with mental and physical health conditions like anxiety, depression, diabetes, arthritis, asthma, and chronic obstructive pulmonary disease, and 302 individuals from the general population in the United Kingdom. The sample allowed for comprehensive assessment of the measures across different health and social care needs.
What were the results? The main finding is that EQ-HWB measures demonstrated strong reliability and validity, especially in capturing mental health outcomes when compared to other measures. Additional important findings include the tools' ability to distinguish effectively between different groups, for example those with emotional problems.
Why are the results important? For health technology assessment agencies, these results highlight the EQ-HWB tools' potential to enhance evaluations by including social and carer-related outcomes. In practical terms, these findings could lead to more comprehensive assessments in everyday clinical practices. Patients, social care users, and informal carers may benefit from these tools as they provide a broader understanding of quality of life which may impact health and social care policy developments.
What are the strengths and weaknesses of this study? A key strength of this study is its robust psychometric evaluation, which demonstrates the EQ-HWB tools' reliability and validity. However, a limitation is the need for further evidence on the tools' performance as standalone measures, as this study embedded EQ-HWB-9 within the longer EQ-HWB. Future research could expand knowledge by exploring the tools' application in specific health and social care interventions and diverse populations, potentially validating their use in wider healthcare settings.
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