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Responsiveness of EQ-5D Youth version 5-level (EQ-5D-5L-Y) and 3-level (EQ-5D-3L-Y) in Patients With Idiopathic Scoliosis

Wong, Carlos King Ho PhD; Cheung, Prudence Wing Hang BDSc(Hon); Luo, Nan PhD; Lin, Jiaer BSc; Cheung, Jason Pui Yin MBBS, MMedSc, MS, PDipMDPath, FRCS, FHKAM, FHKCOS

doi: 10.1097/BRS.0000000000003116
HEALTH SERVICES RESEARCH
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Study Design. Prospective cohort study

Objective. The aim of this study was to evaluate the responsiveness of EQ-5D Youth version (EQ-5D-Y) 5-level and 3-level in patients with idiopathic scoliosis

Summary of Background Data. A new version of EQ-5D-Y increasing the number of response levels from 3 (3LY) to 5 (5LY) has been recently introduced. Although the validity and reliability of 5LY and 3LY for use in idiopathic scoliosis patients are compared, responsiveness of two questionnaires among children and adolescents is unknown.

Methods. A total of 129 children or adolescents attending the spine clinics of a tertiary hospital in Hong Kong, China, completed 3LY and 5LY. At 3-month follow-up, 110 (85.2%) patients completed two EQ-5D-Y questionnaires, and the single-item Global Rating on Change Scale determining “worsened,”, “unchanged,”, or “improved” global health. Among those indicating “unchanged” in global health from baseline to follow-up, agreement in responses to each 3LY and 5LY item was examined. Mean changes in EQ-5D-Y scores during the past 3 months in patients with “worsened,” “unchanged,” and “improved” health were calculated.

Results. Most patients (82.7%) reported no change in global health, whereas about 12.7% and 4.5% of them felt better and worse, respectively, compared to baseline. Among those reporting “unchanged health,” the “Looking after myself” item exhibited the largest proportion of agreement in responses (5LY: 96.36%; 3LY: 95.50%), followed by “Mobility” (5LY 90.91%; 3LY 90.99%), “Usual activities” (5LY 83.64%; 3LY 87.39%), “Pain/discomfort”(5LY 68.18%; 3LY 76.58%), and “Feeling worried/sad/unhappy” (5LY 66.36%; 3LY 72.07%). In the “improved” or “worsened” group, the 3-month follow-up 5LY and 3LY scores were higher or lower compared with baseline, respectively.

Conclusion. The 5LY is demonstrated as responsive as the 3LY for patients with idiopathic scoliosis.

Level of Evidence: 2

A new version of EQ-5D-Y increasing the number of response levels from 3 (3LY) to 5 (5LY) has been recently introduced. Although previous study demonstrated similar validity and reliability between 5LY and 3LY, present study showed that the 5LY is demonstrated as responsive as the 3LY for idiopathic scoliosis patients.

Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China

Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China

Saw Swee Hock School of Public Health, National University of Singapore, Singapore.

Address correspondence and reprint requests to Carlos King Ho Wong, PhD, Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Rm 1-01, 1/F, Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong SAR, China; E-mail: carlosho@hku.hk. Jason Pui Yin Cheung, MBBS, MMedSc, MS, PDipMDPath, FRCS, FHKAM, FHKCOS, Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Professorial Block, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China; E-mail: cheungjp@hku.hk

Received 28 January, 2019

Revised 2 April, 2019

Accepted 8 May, 2019

CKHW and PWHC contributed equally to this study.

The manuscript submitted does not contain information about medical device(s)/drug(s).

The General Research Fund (#17119518 and #17156416), Research Grant Council, Hong Kong SAR funds were received in support of this work.

No relevant financial activities outside the submitted work.

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