Assessment of health-related quality of life in individuals with depressive symptoms: validity and responsiveness of the EQ-5D-3L and the SF-6D

Maike Stolz (), Christian Albus, Manfred E. Beutel, Hans-Christian Deter, Kurt Fritzsche, Christoph Herrmann-Lingen, Matthias Michal, Katja Petrowski, Joram Ronel, Jobst-Hendrik Schultz, Wolfgang Söllner, Cora Weber, Martina Zwaan and Christian Krauth
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Maike Stolz: Hannover Medical School
Christian Albus: University of Cologne
Manfred E. Beutel: University Medical Center Mainz
Hans-Christian Deter: Charité Universitaetsmedizin Berlin
Kurt Fritzsche: Medical Center-University of Freiburg
Christoph Herrmann-Lingen: University of Göttingen Medical Center
Matthias Michal: University Medical Center Mainz
Katja Petrowski: Technical University of Dresden
Joram Ronel: Clinic Barmelweid
Jobst-Hendrik Schultz: Heidelberg University Hospital
Wolfgang Söllner: Paracelsus Medical University Nuremberg
Cora Weber: Oberhavel Clinic, Clinic Hennigsdorf
Martina Zwaan: Hannover Medical School
Christian Krauth: Hannover Medical School

The European Journal of Health Economics, 2023, vol. 24, issue 8, No 5, 1297-1307

Abstract: Abstract Background The EQ-5D and the SF-6D are examples of commonly used generic preference-based instruments for assessing health-related quality of life (HRQoL). However, their suitability for mental disorders has been repeatedly questioned. Objective To assess the responsiveness and convergent validity of the EQ-5D-3L and SF-6D in patients with depressive symptoms. Methods The data analyzed were from cardiac patients with depressive symptoms and were collected as part of the SPIRR-CAD (Stepwise Psychotherapy Intervention for Reducing Risk in Coronary Artery Disease) trial. The EQ-5D-3L and SF-6D were compared with the HADS (Hospital Anxiety and Depression Scale) and PHQ-9 (Patient Health Questionnaire) as disease-specific instruments. Convergent validity was assessed using Spearman’s rank correlation. Effect sizes were calculated and ROC analysis was performed to determine responsiveness. Results Data from 566 patients were analysed. The SF-6D correlated considerably better with the disease-specific instruments (|rs|= 0.63–0.68) than the EQ-5D-3L (|rs|= 0.51–0.56). The internal responsiveness of the SF-6D was in the upper range of a small effect (ES: − 0.44 and − 0.47), while no effect could be determined for the EQ-5D-3L. Neither the SF-6D nor the EQ-5D-3L showed acceptable external responsiveness for classifying patients’ depressive symptoms as improved or not improved. The ability to detect patients whose condition has deteriorated was only acceptable for the EQ-5D-3L. Conclusion Overall, both the convergent validity and responsiveness of the SF-6D are better than those of the EQ-5D-3L in patients with depressive symptoms. The SF-6D appears, therefore, more recommendable for use in studies to evaluate interventions for this population.

Keywords: EQ-5D-3L; SF-6D; Mental disorder; Validity; Responsiveness (search for similar items in EconPapers)
JEL-codes: I10 (search for similar items in EconPapers)
Date: 2023
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DOI: 10.1007/s10198-022-01543-w

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