Health Assessment Questionnaire (HAQ)을 이용한 EuroQol (EQ5D) 추정의 타당성 = Validity of Estimating EuroQol (EQ5D) from a Health Assessment Questionnaire (HAQ)

다국어 초록 (Multilingual Abstract)

Objective: Assessment of health-related quality of life in patients with rheumatoid arthritis (RA) has become important in health research. Health economists have used linear regression equations to mathematically transform changes in HAQ scores into EQ5D data, which can be used to calculate quality adjusted life years (QALYs). We aimed to examine whether a given approach is justified. Methods: A total of 223 patients with RA were recruited from the Hospital for Rheumatic Diseases at Hanyang University. They completed the HAQ and EQ5D and a correlation analysis was performed between the two instruments. We compared HAQ and EQ5D score changes for patients who completed the EQ5D and HAQ at first and second visits (n=159). Predicted EQ5D was estimated from the HAQ using the calculating method of Bansnack et al. The mean difference between the predicted EQ5D from the HAQ and observed health utility score at the first visit and change during the study were tested by the paired t-test. Results: In the cross-sectional study, EQ5D scores were moderately inversely correlated with HAQ (r=-0.716, p＜0.001). However, the predicted EQ5D from the HAQ was significantly different from the observed EQ5D (p=0.001; 95% confidence interval [CI] 0.020∼0.079). The change in EQ5D was also inversely correlated with the change in the HAQ (r=-0.615, p＜0.001), and change in the predicted EQ5D scores corresponded well with changes in observed health utility scores (p=0.155; 95% CI (-0.0873∼0.0140). Conclusion: Changes in predicted EQ5D corresponded with observer changes in EQ5D, suggesting that it may be better to use predicted EQ5D form HAQ to identify change in the quality of life.

참고문헌 (Reference)

1 Bansback N, "Using the health assessment questionnaire to estimate preferencebased single indices in patients with rheumatoid arthritis" 57 : 963-971, 2007

2 Bergner M, "The sickness impact Profile: development and final revision of a health status measure" 19 : 787-805, 1981

3 Fries JF, "The dimensions of health outcomes: the Health Assessment Questionnaire, disability and pain scales" 9 : 789-793, 1982

4 Ware JE, "SF-36 Health Survey Manual and Interpretation Guide"

5 Bae SC, "Psychometric evaluation of a Korean Health Assessment Questionnaire for clinical research" 25 : 1975-1979, 1998

6 Torrance GW, "Multiattribute utility function for a comprehensive health status classification system: Health Utilities Index Mark2" 34 : 702-722, 1996

7 Tanno M, "Modelling and cost-effectiveness analysis of etanercept in adults with rheumatoid arthritis in Japan: a preliminary analysis" 16 : 77-84, 2006

8 Brenna A, "Modeling the cost-effectiveness of etanercept in adults with rheumatoid arthritis in the UK" 43 : 62-72, 2004

9 Hurst NP, "Measuring health-related quality of life in rheumatoid arthritis: validity, responsiveness and reliability of EuroQol (EQ-5D)" 36 : 551-559, 1997

10 Meenan RF, "Measuring health status in arthritis. The arthritis impact measurement scales" 23 : 146-152, 1980

11 Fries JF, "Measurement of patient outcome in arthritis" 23 : 137-145, 1980

12 Scott DL, "Limited correlation between the Health Assessment Questionnaire (HAQ) and EuroQol in rheumatoid arthritis: questionable validity of deriving quality adjusted life years from HAQ" 66 : 1534-1537, 2007

13 Linde L, "Health-related quality of life: validity, reliability, and responsiveness of SF-36, EQ-15D, EQ-5D, RAQoL, and HAQ in patients with rheumatoid arthritis" 35 : 1528-1537, 2008

14 Kim CG, "Health-related quality of life in korean patients with rheumatoid arthritis" 9 : S60-S72, 2002

15 Harrison MJ, "Exploring the validity of estimating EQ-5D and SF-6D utility values from the health assessment questionnaire in patients with inflammatory arthritis" 8 : 21-, 2010

16 Sherrer YS, "Disability in rheumatoid arthritis: comparison of prognostic factors across three populations" 14 : 705-709, 1987

17 Kim MH, "Cross-cultural adaptation and validation of the Korean version of the EQ-5D in patients with rheumatic diseases" 14 : 1401-1406, 2005

18 Torrance GW, "A utility maximization model for evaluation of health care programs" 7 : 118-133, 1972

19 Kaplan RM, "A general health policy model: update and applications" 23 : 203-235, 1988