ArticleJournal of patient-reported outcomes2022
Adding a fatigue item to the EQ-5D-5L improves its psychometric performance in the general population.
Article in Journal of patient-reported outcomes, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Psychometric validation of a cognition and social participation bolt-on for the EQ-5D-5L in SARS-CoV-2 infected German healthcare workers.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Article
- Testing culturally relevant EQ-5D-5L bolt-ons for the Chinese general population: first quantitative phase of a mixed methods study.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Article
- Identifying and developing EQ-5D-5L bolt-on items for Chinese chronic obstructive pulmonary disease patients.Health and quality of life outcomes · 2025Article
- Measuring inequality in quality of life: Why the EQ-5D may underestimate it.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025Article
- Identifying and developing culturally relevant EQ-5D-5L bolt-on items for Chinese population: qualitative phase of a mixed-methods study.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025Article
- Concurrent Validity Between EQ-5D and HRQ-6D Measures in Patients with Different Primary Diagnoses.Journal of clinical medicine · 2024Article
- Healthcare consumer acceptability of routine use of the EQ-5D-5L in clinical care: a cross-sectional survey.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024Article
- Population Norms for the EQ-5D-5L, PROPr and SF-6D in Hungary.PharmacoEconomics · 2024Article
- Developing and testing culturally relevant bolt-on items for EQ-5D-5L in Chinese populations: a mixed-methods study protocol.BMJ open · 2024Review
- Long-term health outcomes of Q-fever fatigue syndrome patients.Epidemiology and infection · 2023Article
- Extending the EQ-5D: the case for a complementary set of 4 psycho-social dimensions.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2023Article
- Health-related quality of life in patients with multiple system atrophy using the EQ-5D-5L.Brain and behavior · 2022Article
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Authors and funding
5 authors.
Funding
Abstract
backgroundFatigue is a common and often disturbing sequela of serious chronic health conditions. In the widely applied HRQL instrument, the EQ-5D, this aspect is not included directly, for its assumed lack of additional information. We investigated the validity of this assumption by determining the gain-if any-of an additional fatigue item to the EQ-5D-5L in a general population sample.
methodsA Dutch general population sample (including diseased people) completed a web-based survey including the EQ-5D-5L and the Rivermead Post-Concussion Symptoms Questionnaire (RPQ). The RPQ fatigue item was used to create the EQ-5D-5L + Fatigue. We head-to-head compared the psychometric performance contrasting the EQ-5D-5L and EQ-5D-5L + Fatigue: distribution (e.g. ceiling), informativity cf. Shannon's indices, convergent validity, domain dependency, and explanatory power. Results were compared between subgroups with and without ≥ 1 chronic health condition.
resultsThe study population consisted of 3027 persons of whom 52% had a chronic health condition. The mean EQ-5D-5L utility score was 0.83 and 48% experienced some degree of fatigue. Adding the fatigue item to the EQ-5D-5L decreased the ceiling effect, increased absolute informativity (H' = 6.44 vs. H' = 4.90) and relative informativity (J' = 0.46 vs. J' = 0.42). The extra fatigue item slightly increased convergent validity (Spearman's rank correlation coefficient = - 0.61 vs. - 0.62). Domain dependency analysis showed that all EQ-5D-5L domains are dominant over the fatigue item. Explanatory power of the EQ-5D-5L + Fatigue was higher compared to the EQ-5D-5L (R
conclusionsAdding a fatigue item to the EQ-5D-5L improved all psychometric performance criteria of the enriched instrument in the general population. Effects are substantially larger in the subgroup with chronic health conditions, indicating that adding a fatigue item to the EQ-5D-5L is especially relevant in evaluating the HRQL of diseased people.
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