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Validity, reliability and responsiveness of the EQ-5D in German stroke patients undergoing rehabilitation

Abstract

Purpose  

To analyse the psychometric properties of the EQ-5D in German stroke survivors undergoing neurological rehabilitation.

Methods  

The EQ-5D, the Hospital Anxiety and Depression Scale (HADS) and the Stroke Impact Scale (SIS) were completed before (210 subjects)
and after (183 subjects) a patient education programme in seven rehabilitation clinics in Bavaria, Germany. A postal follow-up
was conducted after 6 months. Acceptance, validity, reliability and responsiveness of the EQ-5D were tested. The SIS subscales
were used as external anchors to classify the patients into change groups between the measurements.

Results  

The proportion of missing answers ranged from 4.7 to 8.6%. Between 16 and 19% reported no problems in any EQ-5D dimension.
At baseline, correlations between EQ-5D index and the SIS subscales ranged from 0.15 (communication) to 0.60 (mobility). Correlations
with the EQ VAS were slightly smaller. All scores were reliable in test–retest with intraclass correlations ranging from 0.67
to 0.81. EQ-5D index and EQ VAS were consistently responsive only to improvements in health, showing small- to medium effect
sizes (0.27–0.42).

Conclusions  

The EQ-5D has shown reasonable validity, reliability and, more limited, responsiveness in stroke patients with mild to moderate
limitations of functional status, allowing it to be used in clinical trials in rehabilitation.

  • Content Type Journal Article
  • Pages 1-12
  • DOI 10.1007/s11136-011-0024-3
  • Authors
    • Matthias Hunger, Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany
    • Carla Sabariego, Ludwig-Maximilians-University, Institute for Public Health and Health Care Research, Marchioninistraße 17, 81377 Munich, Germany
    • Björn Stollenwerk, Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany
    • Alarcos Cieza, Ludwig-Maximilians-University, Institute for Public Health and Health Care Research, Marchioninistraße 17, 81377 Munich, Germany
    • Reiner Leidl, Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany