Comparison of the EuroQol and short form 6D in Singapore multiethnic asian knee osteoarthritis patients scheduled for total knee replacement

Objective To compare the EuroQol (EQ‐5D) and Short Form 6D (SF‐6D) among multiethnic Asian patients with knee osteoarthritis (OA) scheduled for total knee replacement in Singapore. Methods Patients were asked to complete questionnaires including the EQ‐5D, Short Form 36, Western Ontario and McMaster...

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Bibliographic Details
Published in:Arthritis and rheumatism 2007-08, Vol.57 (6), p.1043-1049
Main Authors: Xie, Feng, Li, Shu‐chuen, Luo, Nan, Lo, Ngai‐nung, Yeo, Seng‐jin, Yang, Kuang‐ying, Fong, Kok‐yong, Thumboo, Julian
Format: Article
Language:English
Subjects:
Aged
Algorithms
Arthroplasty, Replacement, Knee
Biological and medical sciences
Disability Evaluation
Diseases of the osteoarticular system
EQ‐5D
Female
Health Status Indicators
Health‐related quality of life
Humans
Knee Joint - pathology
Male
Medical sciences
Middle Aged
Miscellaneous. Osteoarticular involvement in other diseases
Orthopedic surgery
Osteoarthritis
Osteoarthritis, Knee - complications
Osteoarthritis, Knee - ethnology
Osteoarthritis, Knee - physiopathology
Osteoarthritis, Knee - surgery
Quality of Life
Quality-Adjusted Life Years
SF‐6D
Singapore
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surveys and Questionnaires
Utility
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Summary:Objective To compare the EuroQol (EQ‐5D) and Short Form 6D (SF‐6D) among multiethnic Asian patients with knee osteoarthritis (OA) scheduled for total knee replacement in Singapore. Methods Patients were asked to complete questionnaires including the EQ‐5D, Short Form 36, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Lequesne knee index. EQ‐5D and SF‐6D utility scores were calculated using the scoring algorithms developed from the UK general population. Agreement between the 2 instruments was assessed by comparing their score distributions, means, medians, intraclass correlation coefficients (ICCs), and a Bland‐Altman plot. Correlations of the EQ‐5D and SF‐6D with WOMAC and Lequesne knee index scores were also examined. Results A consecutive sample of 258 knee OA patients (127 English‐speaking and 131 Chinese‐speaking) participated. The mean ± SD EQ‐5D utility score was 0.49 ± 0.31 (range −0.25–1.00) and the mean SF‐6D utility score was 0.63 ± 0.12 (range 0.32–0.89). In a hypothetical example, this 0.14‐point difference in mean utility scores yielded a difference of $10,000/quality‐adjusted life year (QALY) in cost‐effectiveness ratios. The score distribution was bimodal for the EQ‐5D and normal for the SF‐6D. This poor agreement was also demonstrated by the Bland‐Altman plot and the low ICC (range 0.18–0.54). Correlations of the WOMAC and Lequesne index with the EQ‐5D were higher than with the SF‐6D. Conclusion Using different preference‐based health‐related quality of life instruments may yield different utility scores, which could have a great impact on QALY estimates. This highlights the importance of selecting appropriate instruments for economic evaluation. Additional research is needed to determine which instrument (the EQ‐5D or the SF‐6D) should be used in OA patients.
ISSN:0004-3591
0893-7524
1529-0131
1529-0123
DOI:10.1002/art.22883