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Performance of two measures of general health-related quality of life, the EQ-5D and the RAND-36 among critically ill patients

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Abstract

Objective

To compare two health-related quality of life measures, the preference-based EQ-5D with five questions and the profile-based RAND-36 with 36 questions, in previous critically ill patients.

Design

Prospective observational study.

Setting

A ten-bed medical-surgical intensive care unit (ICU) in a tertiary care university hospital.

Patients

Of the 2,709 critically ill patients, treated during the years 1995–2000, the 1,099 patients of the 1,443 still alive who returned both mailed measures were included in the study.

Interventions

None.

Measurements and main results

The EQ-5D and the RAND-36 correlated well (P <.001). Ceiling effect was more obvious with the EQ-5D; the values of the RAND-36 varied usually from 0 to 100 in all the three levels of the corresponding EQ-5D question, and the weakest statistically significant differences were between the EQ levels 2 and 3. In particular, the RAND-36 proved to differentiate better the levels of mobility, self-care, and poor outcome.

Conclusions

The EQ-5D and the RAND-36 correlated well, but when more precisely stated information is needed, especially regarding mobility, self-care, or low quality of life levels of previous critically ill patients, the profile-based RAND-36 may discriminate better.

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References

  1. Angus DC, Carlet J (2003) Surviving intensive care: a report from the 2002 Brussels Roundtable. Intensive Care Med 29:368–377

    PubMed  Google Scholar 

  2. Black NA, Jenkinson C, Hayes JA, Young D, Vella K, Rowan KW, Daly K, Ridley S (2001) Review of outcome measures used in adult critical care. Crit Care Med 29:2119–2124

    Article  CAS  PubMed  Google Scholar 

  3. Bowling A (1997) Evaluating health services: multidisciplinary collaboration. In: Research methods in health care. Open University, Buckingham Philadelphia, pp 6–15

  4. Garrett A, Schmidt L, Macintosh A, Fitzpatric R (2002) Quality of life measurement: bibliographic study of patients assessed health outcome measure. BMJ 324:1417

    Article  PubMed  Google Scholar 

  5. Jones I (1997) Costing health services: health economics. In: Bowling A (ed) Research methods in health care. Open University, Buckingham Philadelphia, pp 79–97

  6. Kutsogiannis DJ, Noseworthy T (2001) Health-related quality of life; during and following critical care. In: Sibbald JW, Bion JF (eds) Evaluating critical care. Springer, Berlin Heidelberg New York, pp 86–103

  7. Kerridge RK, Glasziou PP, Hillman KM (1995) The use of “quality-adjusted life years” (QALYs) to evaluate treatment in intensive care. Anaesth Intens Care 23:322–331

    CAS  Google Scholar 

  8. Heyland DK, Guyatt G, Cook DJ, Meade M, Juniper E, Cronin L, Gafni A (1998) Frequency and methodological rigor of quality of life assessments in the critical care literature. Crit Care Med 26:591–598

    CAS  PubMed  Google Scholar 

  9. Patrick DL, Danis M, Southerland LI, Hong G (1988) Quality of life following intensive care. J Gen Intern Med 3:218–223

    CAS  PubMed  Google Scholar 

  10. Bergner M, Robbitt RA, Kressel S, Pollard WE, Gibson BS, Morris JR (1981) The sickness impact profile. Development and final version of health status measure. Med Care 19:787–805

    CAS  PubMed  Google Scholar 

  11. Hunt SM, McKenna SP, McEwen J, Williams J, Papp E (1981) The Nottingham health profile: subjective health status and medical consultations. Soc Sci Med 15:221–229

    CAS  Google Scholar 

  12. Ware MK, Snow KK, Kosinski M, Gandek B (1993) SF-36 Health survey: manual and interpretation guide. The Health Institute, New England Medical Centre, Boston

  13. Kind P, Rosser RM, Williams A (1982) Valuation of quality of life; some psychometric evidence. In: Jones-Lee MW (ed) The value of life and safety. Elsevier, Amsterdam

  14. Spitzer WO, Dobson AJ, Hall J, Chesterman E, Levi J, Shepherd R, Battista RN, Catchlove BR (1981) Measuring the quality of life of cancer patients: a concise Quality of Life Index for use by physicians. J Chronic Dis 34:585–597

    Article  CAS  PubMed  Google Scholar 

  15. Hays RD, Sherbourne CD, Mazel R (1993) The RAND 36-item HEALTH survey 1.0. Health Econ 2:217–277

    CAS  PubMed  Google Scholar 

  16. Brooks R (1996) EuroQol; the current state of Play. Health Policy 37:53–72

    Article  CAS  PubMed  Google Scholar 

  17. Bowling A (1997) The principles of research. In: Research methods in health care. Open University, Buckingham Philadelphia, pp 130–138

  18. Johnson JA, Ohinmaa A, Murti B, Sintonen H, Coons SJ (2000) Comparison of Finnish and U.S-based Visual Analog Scale Valuations of the EQ-5D measure. Med Decis Making 20:281–289

    CAS  PubMed  Google Scholar 

  19. Ohinmaa A, Sintonen H (1996) Quality of life of Finnish population measures by EuroQol. In: Badia X, Herdman M, Segura A (eds) EuroQol, Plenary Meeting. Barcelona 1995, 3–5 October. Discussion papers, Catalan Institute of Public Health, Barcelona, pp 161–172

  20. Aalto A, Aro S, Aro AR, Mähönen M (1999) RAND 36-item Survey 1.0. Finnish version. STAKES (National Research and Development Centre for Welfare and Health), Helsinki

  21. Coons SJ, Rao S, Keininger DL, Hays RD (2000) A comparative review of generic quality-of-life instruments. Pharmacoeconomics 17:13–35

    CAS  PubMed  Google Scholar 

  22. Ware JE, Kosinski M, Keller SD (1994) SF-36 Physical and mental health summary scales. A user’s manual. Health Assessment Lab, Boston MA

  23. Knaus WA, Wagner DP, Draper EA, Zimmerman JE (1985) APACHE II severity of disease classification system. Crit Care Med 13:818–829

    CAS  PubMed  Google Scholar 

  24. Myers C, Wilks D (1999) Comparison of Euroqol EQ-5D and SF-36 in patients with chronic fatigue syndrome. Qual Life Res 8:9–16

    Article  CAS  PubMed  Google Scholar 

  25. Brazier J, Jones N, Kind P (1993) Testing the validity of the Euroqol and comparing it with the SF-36 health survey questionnaire. Qual Life Res 2:169–180

    CAS  PubMed  Google Scholar 

  26. Bosch JL, Hunink MG (2000) Comparison of the Health Utilities index Mark 3 (HUI3) and the EuroQol EQ-5D in patients treated for intermittent claudication. Qual Life Res 9:591–601

    Article  CAS  PubMed  Google Scholar 

  27. McHorney CA, Taylor AR (1995) Individual patient monitoring in clinical practice: are available health status surveys adequate? Qual Life Res 4:293–307

    CAS  PubMed  Google Scholar 

  28. Badia X, Diaz-Prieto A, Gorriz MT, Herdman R, Torrado H, Farrero E, Cavanilles JM (2001) Using EuroQol-5D to measure changes in quality of life 12 months after discharge from an intensive care unit. Intensive Care Med 27:1901–1907

    Article  CAS  PubMed  Google Scholar 

  29. Jenkinson C, Stradling J, Petersen S (1998) How should we evaluate health status? A comparison of three methods in patients presenting with obstructive sleep apnea. Qual Life Res 7:95–100

    Article  CAS  PubMed  Google Scholar 

  30. Johnson JA, Coons SJ (1998) Comparison of the EQ-5D and SF-12 in adult US sample. Qual Life Res 7:155–166

    Article  CAS  PubMed  Google Scholar 

  31. Granja C, Teixeira-Pinto A, Costa-Pereira A (2002) Quality of life after intensive care - evaluation with EQ-5D questionnaire. Intensive Care Med 28:898–907

    Article  PubMed  Google Scholar 

  32. Kaarlola A, Pettilä V, Kekki P (2003) Quality of life six years after intensive care. Intensive Care Med 29:1294–1299

    Article  PubMed  Google Scholar 

  33. Bosch JL, van der Graaf J, Hunink MGM (1999) Health-related quality of life after angioplasty and stent placement in patients with iliac artery disease; results of the randomised controlled clinical trial. Circulation 99:3155–3160

    CAS  PubMed  Google Scholar 

  34. Herridge MS, Cheung AM, Tansey CM, Matte-Martyn A, Diaz-Granados N, Al-Saidi F, Cooper AB, Guest CB, Mazer CD, Mehta S, Stewart TE, Barr A, Cook D, Slutsky AS (2003) One-year outcome in survivors of the acute respiratory distress syndrome. N Engl J Med 348:683–693

    Article  PubMed  Google Scholar 

  35. Schelling G, Richter M, Roozendaal B, Rothenhäusler HB, Krauseneck T, Stoll C, Nollert G, Schmidt M, Kapfhammer HP (2003) Exposure to high stress in the intensive care unit may have negative effects on health-related quality-of-life outcome after cardiac surgery. Crit Care Med 31:1971–1980

    Article  PubMed  Google Scholar 

  36. Cornock MA (1998) Stress and the intensive care patient: perceptions of patients and nurses. J Adv Nurs 27:518–527

    Article  CAS  PubMed  Google Scholar 

  37. Scragg P, Jones A, Fauvel N (2001) Psychological problems following ICU treatment. Anaesthesia 56:9–14

    Article  CAS  PubMed  Google Scholar 

  38. Schelling G, Stoll C, Haller M, Briegel J, Manert W, Hummel T, Lenhart A, Heyduck M, Polasek J, Meier M, Preuss U, Bullinger M, Schuffel W, Peter K (1998) Health-related quality of life and posttraumatic stress disorder in survivors of the acute respiratory distress syndrome. Crit Care Med 26:651–659

    Article  CAS  PubMed  Google Scholar 

  39. Skogstad W (2000) Working in the world of bodies. A medical ward. In: Hinshelwood RD, Skogstad W (eds) Observing organisations. Anxiety, defence and culture in health care. Routledge, London, pp 101–121

  40. Bion WR (1961) Experiences in groups. Routledge, Bristol, pp 59–75

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Acknowledgement

We are very thankful to S. Sarna for statistical advice

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Correspondence to Anne Kaarlola.

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Appendices

Appendix 1

The EQ-5D questionnaire: http://www.euroqol.org

Appendix 2

The RAND-36 questionnaire: http://www.rand.org/health/surveys/sf36item/questionnaire.html

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Kaarlola, A., Pettilä, V. & Kekki, P. Performance of two measures of general health-related quality of life, the EQ-5D and the RAND-36 among critically ill patients. Intensive Care Med 30, 2245–2252 (2004). https://doi.org/10.1007/s00134-004-2471-6

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  • DOI: https://doi.org/10.1007/s00134-004-2471-6

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