The EQ‐5D: A new tool for studying clinical outcomes in chronic rhinosinusitis

Aaron Kyle Remenschneider · Laura D'Amico · Stacey Tutt Gray · Eric H. Holbrook · Richard E Gliklich · Ralph B. Metson

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Health Systems, Economic Evaluations, Quality of Life Sinusitis and nasal conditions Nasal Surgery and Airway Studies

Abstract

OBJECTIVES/HYPOTHESIS: To describe the role and applicability of the EuroQol 5-Dimension, 5-Level (EQ-5D-5L) questionnaire for the assessment of general health-related quality of life in patients with chronic rhinosinusitis. STUDY DESIGN: Prospective cohort study. METHODS: The EQ-5D-5L was administered to 462 patients with refractory chronic rhinosinusitis before and 3 months after sinus surgery. Preoperative and postoperative scores across each of five health dimensions were analyzed and the results compared to those obtained from two widely used chronic rhinosinusitis outcomes instruments: the Chronic Sinusitis Survey (CSS) and SinoNasal Outcomes Test-22 (SNOT-22). RESULTS: Three hundred and fifty patients completed the five questions and visual analog scale (VAS) of the EQ-5D at baseline and at 3 months for a response rate of 75.8%. There were no incomplete questionnaires. The frequency of patients reporting problems in the EQ-5D domains of pain/discomfort, anxiety/depression, and usual activities decreased following sinus surgery (74.3% vs. 34.4%, 48.6% vs. 31.4%, and 30.6% vs. 19.4%, respectively; all P < 0.001). The domains of mobility and self-care did not demonstrate statistically significant change. EQ-5D VAS (standard deviation) improved from 73.4 (16.9) before surgery to 82.0 (14.4) after surgery (P < 0.001). Preoperative VAS correlated with SNOT-22 scores (Pearson coefficient of 0.50; P < 0.01). Postoperative change in VAS and SNOT-22 scores demonstrated moderate correlation (Pearson coefficient of 0.36, P < 0.01). CONCLUSION: The EQ-5D is a general health measure with sensitivity to clinical change in rhinosinusitis that support its use for monitoring patient outcomes. The limited response burden and ability to directly calculate health utility make it an attractive tool for rhinosinusitis outcomes research.

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References

1992The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection.1992The MOS 36-ltem Short-Form Health Survey (SF-36)1990EuroQol - a new facility for the measurement of health-related quality of life 2011Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)1996EuroQol: the current state of play 2012Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups: a multi-country study 2005US Valuation of the EQ-5D Health States 2007Estimation of minimally important differences in EQ-5D utility and VAS scores in cancer

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2014EQ ‐5 D ‐derived health utility values in patients undergoing surgery for chronic rhinosinusitis 2019Responsiveness and minimal clinically important difference for the EQ-5D in chronic rhinosinusitis 2024Estimating the minimally important difference for the EQ-5D-5L and EORTC QLQ-C30 in cancer 2017An equity analysis of health examination service utilization by women from underdeveloped areas in western China

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