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Rehab Measures: Euro-QOL

Link to instrument

Instrument available at EuroQol.org (other languages available below) 

Title of Assessment

Euro-QOL 

Acronym

EQ-5D

Instrument Reviewer(s)

Initially reviewed by Sue Saliga, PT, PHSc, CEEAA and the TBI EDGE task force of the Neurology Section of the APTA in 10/2012

Summary Date

11/27/2012 

Purpose

EQ-5D™ is a standardized instrument for use as a measure of health for clinical and economic appraisal.

Description

  • Applicable to a wide range of health conditions and treatments, the EQ-5D health questionnaire provides a simple descriptive profile and a single index value for health status.
  • Measures the dimensions of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.
  • Each dimension is described by three possible levels of problems (no, mild to moderate, and severe).
  • Respondent’s answer to different hypothetical choices are translated into a preference-based score, yielding an index score based on a scale from 0.000 (death) to 1.000 (perfect health).

Area of Assessment

 

Body Part

 

ICF Domain

Body Structure; Body Function; Participation 

Domain

 

Assessment Type

 

Length of Test

05 Minutes or Less 

Time to Administer

A few minutes

Number of Items

6 items 

Equipment Required

Paper and pencil

Training Required

No formal training, information available on line

Type of training required

No Training 

Cost

Not Free 

Actual Cost

Fee involved for licensing

Age Range

 

Administration Mode

 

Diagnosis

Arthritis; Chronic Obstructive Pulmonary Disease; Concussion; Pain; Stroke 

Populations Tested

  • Rheumatoid Arthritis
  • Eye pathology
  • COPD
  • Irritable Bowel Syndrome
  • Chronic low back pain
  • Stroke

Standard Error of Measurement (SEM)

Not Established

Minimal Detectable Change (MDC)

Not Established

Minimally Clinically Important Difference (MCID)

Not Established

Cut-Off Scores

Not Established

Normative Data

Not Established

Test-retest Reliability

Traumatic Brain Injury: (Van Agt et al., n=208; mean age=49.3 (18.3); gender=43.3% female; Dutch population)

  • Generalizability Theory was used for test-retest reliability assessment; results interpreted as there are some respondents who value some health states very differently the first or the second time, hence, good test retest reliability

Interrater/Intrarater Reliability

Not Established

Internal Consistency

Not Established

Criterion Validity (Predictive/Concurrent)

Not Established

Construct Validity (Convergent/Discriminant)

General Population (British sample): (Brazier et al., n=1453; visited general practitioner in previous 2 weeks, attended outpatient in previous 3 months, inpatient in previous year, chronic physical health problem)

  • The Spearman Rank correlation coefficients of the total score and the UK SF-36 dimensions were found to be in the range 0.48-0.60 (p < 0.01)

Traumatic Brain Injury: (Klose et al.; n=104; mean age=41; gender=male n=78)

  • Decreased scores on the EuroQoL Visual Analog Scale (VAS) in patients with posttraumatic hypopituitarism 12mo after injury

 Traumatic Brain Injury: (Bell et al, 2005; n=171; telephone intervention n=85 and standard follow up n=86; mean age = 36 (15)

  • significantly increased EuroQoL scores as an effect of a scheduled telephone intervention in patients with moderate to severe TBI

Content Validity

Not Established

Face Validity

Not Established

Floor/Ceiling Effects

General population (British sample): (Brazier et al, 1993; n=1463; age range=16-74; male gender=655)

  • Ceiling effects were larger for the EuroQOL dimensions than for the SF-36 dimensions

Domains
% at ceiling
% at floor
Mobility
97.0
0.1
Self-Care
99.1
0.1
Main Activity
96.5
3.5
Family/leisure
95.2
4.8
Pain/discomfort
64.1
1.9
Anxiety/depression
81.1
29.9
Total Score
54.6
0

Responsiveness

Traumatic Brain Injury (moderate and severe): (Bell et al, 2005; n =171; telephone intervention n=85 and standard follow up n=86; mean age =36 (15)

  • Small treatment effect: 0.10

Professional Association Recommendations

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (VEDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

 

For detailed information about how recommendations were made, please visit:  http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

 

Abbreviations:

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

 

Recommendations for use based on acuity level of the patient:

 

Acute

(CVA < 2 months post)

(SCI < 1 month post)

(Vestibular < 6 months post)

Subacute

(CVA 2 to 6 months)

(SCI 3 to 6 months)

Chronic

(> 6 months)

StrokEDGE

NR

R

R

 

Recommendations based on level of care in which the assessment is taken:

 

Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility

Outpatient

Rehabilitation

Home Health

StrokEDGE

NR

R

R

R

R

TBI EDGE

NR

LS

NR

LS

LS

 

Recommendations for use based on ambulatory status after brain injury:

 

Completely Independent

Mildly dependant

Moderately Dependant

Severely Dependant

TBI EDGE

N/A

N/A

N/A

N/A

 

Recommendations for entry-level physical therapy education and use in research:

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

StrokEDGE

No

Yes

Yes

Not reported

TBI EDGE

No

Yes

Yes

Not reported

Considerations

  • Translations available in over 150 languages
  • Recommended by the Core Data Elements Workgroup as a supplemental measure in TBI research (Wilde et al, 2010)
  •  In TBI, the instrument has been used in some outcome studies with good success

EuroQOL translations:

Other languages available at http://www.euroqol.org/eq-5d-products/eq-5d-3l.html

These translations, and links to them, are subject to the Terms and Conditions of Use of the Rehab Measures Database. RIC is not responsible for and does not endorse the content, products or services of any third-party website, and does not make any representations regarding its quality, content or accuracy. If you would like to contribute a language translation to the RMD, please contact us at rehabmeasures@ric.org.

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Bibliography

Bell, K. R., Temkin, N. R., et al. (2005). "The effect of a scheduled telephone intervention on outcome after moderate to severe traumatic brain injury: a randomized trial." Arch Phys Med Rehabil 86(5): 851-856. Find it on PubMed

Brazier, J., Jones, N., et al. (1993). "Testing the validity of the Euroqol and comparing it with the SF-36 health survey questionnaire." Qual Life Res 2(3): 169-180. Find it on PubMed

Klose, M., Watt, T., et al. (2007). "Posttraumatic hypopituitarism is associated with an unfavorable body composition and lipid profile, and decreased quality of life 12 months after injury." J Clin Endocrinol Metab 92(10): 3861-3868. Find it on PubMed

van Agt, H. M., Essink-Bot, M. L., et al. (1994). "Test-retest reliability of health state valuations collected with the EuroQol questionnaire." Soc Sci Med 39(11): 1537-1544. Find it on PubMed

Wilde, E. A., Whiteneck, G. G., et al. (2010). "Recommendations for the use of common outcome measures in traumatic brain injury research." Arch Phys Med Rehabil 91(11): 1650-1660 e1617. Find it on PubMed

Year published

 

Instrument in PDF Format

Yes 
Approval Status Approved 
 
Attachments
Created at 11/28/2012 10:53 PM  by Jason Raad 
Last modified at 9/3/2014 10:53 AM  by Jason Raad