Reliability, Validity and Responsiveness of the EQ-5D-5L in Assessing and Valuing Health Status in Adolescents and Young Adults with Posttraumatic Stress Disorder : a Randomized Controlled Trail

Kurzfassung/Abstract

To validate the EQ-5D-5L health-related quality of life (HrQoL) questionnaire inadolescents and young adults with posttraumatic stress disorder (PTSD) after sexualand/or physical abuse. We used data from a randomized controlled trial of 87participants with PTSD aged 14–21 years. The discriminative ability was evaluatedby comparing participants scores on thedescriptive system of the EQ-5D-5L withgeneral population scores. Furthermore, the discriminative ability between sub-groups of participants with different disease severity levels was estimated. Corre-lations between the EQ-5D index and clinical parameters were used to measureconstruct validity. Test-retest reliability was measured by intraclass correlationcoefficients (ICC) between baseline, posttreatment and 3-month follow-up scoresof participants with stable symptoms. Finally, the responsiveness of the EQ-5D wascalculated by mean differences, effect sizes and receiver operating characteristic(ROC) analyses for participants with improved symptoms. Participants reportedsignificantly more problems on the dimensions“mobility”,“usual activities”,“pain/discomfort”and“anxiety/depression”than the general population. The EQ-5D-5L was able to discriminate between different disease severity levels. The EQ-5D index and clinical scales were significantly correlated with absolute values ofcorrelation coefficients varying between 0.21 and 0.59. Furthermore, ICCs between 0.65 and 0.91 indicated good test-retest reliability for the EQ-5D index. The ICCs for the EQ-VAS between baseline and 3-month follow-up, and posttreatment and 3-month follow-up were statistically significant with 0.71 and 0.87, respectively,whereas the ICC between baseline and posttreatment was 0.08 and not statistically significant. Effect sizes to measure the responsiveness ranged between −0.008 and 0.40 for the EQ-5D index and −0.32 and 0.40 for the EQ-VAS. Furthermore, the area under the curve in ROC analyses was between 0.40 and 0.64 for the EQ-5Dindex and 0.60 and 0.70 for the EQ-VAS. Discriminative ability, test-retest reli-ability and construct validity of the EQ-5D-5L were good, whereas the responsive-ness was rather weak. Nevertheless, the EQ-5D-5L can be used to measure HrQoLin adolescents and young adults with PTSD. German Clinical Trials Registeridentifier: DRKS00004787; dateof registration: 18th March 2013;https://www.drks.de