Validation of the EuroQol questionnaire in cardiac rehabilitation

• Published in: Heart (British Cardiac Society) Vol. 92; no. 1; pp. 62 - 67
• Main Authors: Schweikert, B, Hahmann, H, Leidl, R
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01-01-2006; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: 36 item short form health survey; ACS; Acute coronary syndromes; Adult; Aged; Anxiety; Biological and medical sciences; cardiac rehabilitation; Cardiology. Vascular system; Cardiovascular disease; Cardiovascular Medicine; Coronary Disease - rehabilitation; EQ-5D; EuroQol questionnaire; Feasibility Studies; Female; Graph representations; health related quality of life; Hospitals; HRQoL; Humans; Male; Medical sciences; Middle Aged; Mortality; myocardial infarction; New York Heart Association; NYHA; Patient Satisfaction; Patients; Population; Preferences; Psychometrics; Quality of life; Quantitative psychology; Rehabilitation; Reproducibility of Results; SF-36; Studies; Surveys and Questionnaires - standards; Validity; Valuation; VAS; visual analogue scale; Heart; Validation; Questionnaire; Rehabilitation(human); Circulatory system; Cardiology; Phlebology
• ISSN: 1355-6037; 1468-201X
• DOI: 10.1136/hrt.2004.052787

Objective: To analyse the psychometric properties of the EuroQol questionnaire (EQ-5D) applied to patients with acute coronary syndromes (ACS). Setting: Rehabilitation hospital. Patients and design: 106 consecutive patients with ACS (51% myocardial infarction, 42% coronary artery bypass grafting, 7% angina) completed the EQ-5D, the 36 item short form health survey (SF-36), and the MacNew questionnaire at admission, at discharge, and three months after inpatient cardiac rehabilitation. Acceptance, validity, reliability, and responsiveness of the EQ-5D were tested. Results: The EQ-5D was highly accepted. The EQ-5D index showed substantial ceiling effects after rehabilitation. As expected the EQ-5D visual analogue scale (VAS) score (70.3 v 57.1) and EQ-5D index (77.8 v 64.5) were significantly better for patients with myocardial infarction than for patients who underwent surgery (both p ⩽ 0.001). Significant correlations were found between the EQ-5D VAS score, EQ-5D index, and domains of the SF-36 (r  =  0.21 to r  =  0.74). The correlation with the MacNew subscores and with the global score ranged between 0.55 and 0.78. With repeated measurement the EQ-5D showed reasonable reliability in stable patients with intraclass correlation ranging between 0.91 and 0.54. EQ-5D was responsive in patients who indicated improvement in health states between admission and discharge (effect size 0.74–0.82). Conclusion: The psychometric properties of the EQ-5D were satisfying. It is a reasonably valid, reliable, and responsive instrument for patients with ACS. It may be useful in clinical research and epidemiological studies to generate preference based valuations of health related quality life.