Interchangeability of the EQ-5D and the SF-6D in Long-Lasting Low Back Pain |
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Authors: | Rikke Søgaard MSc MPH PhD Finn Bjarke Christensen MD PhD DMSc Tina Senholt Videbæk MD Cody Bünger MD DMSc Terkel Christiansen MSc |
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Institution: | CAST (Centre for Applied Health Services Research and Technology Assessment), Institute for Public Health, University of Southern Denmark, Odense, Denmark;;Orthopaedic Division, Aalborg Hospital, Aarhus University Hospital, Aarhus, Denmark;;Spine Unit, Aarhus Hospital, Aarhus University Hospital, Aarhus, Denmark;;Health Economics Unit, Institute for Public Health, University of Southern Denmark, Odense, Denmark |
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Abstract: | Objectives: The objective of this study was to investigate the interchangeability of the EuroQol 5D (EQ-5D) and the Short Form 6D (SF-6D) in individuals with long-lasting low back pain to guide the optimal choice of instrument and to inform decision-makers about any between-measure discrepancy, which require careful interpretation of the results of cost-utility evaluations. Methods: A cross-sectional study was conducted across 275 individuals who had spinal surgery on indication of chronic low back pain. EQ-5D and SF-6D were mailed to respondents for self-completion. Statistical analysis of between-measure agreement (using English weights) was based on Bland and Altman's limits of agreement and a series of linear regressions. Results: A moderate mean difference of 0.085 (SD 0.241) was found, but because it masked more severe bidirectional variation, the expected variation between observations of EQ-5D and SF-6D in future studies was estimated at 0.546. The EQ-5D's N3 term alone explained a factor of 0.79 of the variation in between-measure differences, while the explanatory value of adding variables of age, sex, diagnosis, previous surgery, and occupational status was basically zero. A final model including only dummy variables for the N3 term and five identified framing effects explained a factor of 0.86 of the variation in between-measure differences. Conclusions: Although the EQ-5D and the SF-6D are both psychometrically valid for generic outcome assessment in long-lasting low back pain, it appears that they cannot generally be used interchangeably for measurement of preference values. Sensitivity analysis examining the impact of between-measure discrepancy thus remains a necessary condition for the interpretation of the results of cost-utility evaluations. |
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Keywords: | EQ-5D health-related quality of life low back pain SF-6D |
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