The Use of Generic Patient-Reported Outcome Measures in Emergency Department Surveys: Discriminant Validity Evidence for the Veterans RAND 12-Item Health Survey and the EQ-5D

Jae-Yung Kwon; Lena Cuthbertson; Richard Sawatzky

doi:10.1016/j.jval.2022.07.016

The Use of Generic Patient-Reported Outcome Measures in Emergency Department Surveys: Discriminant Validity Evidence for the Veterans RAND 12-Item Health Survey and the EQ-5D

Value Health. 2022 Dec;25(12):1939-1946. doi: 10.1016/j.jval.2022.07.016. Epub 2022 Aug 30.

Authors

Jae-Yung Kwon¹, Lena Cuthbertson², Richard Sawatzky³

Affiliations

¹ School of Nursing, Trinity Western University, Langley, BC, Canada; School of Nursing, University of Victoria, Victoria, BC, Canada; Office of Patient-Centred Measurement, British Columbia Ministry of Health, Vancouver, BC, Canada; BC SUPPORT Unit, Patient-Centred Measurement Methods Cluster, Vancouver, BC, Canada. Electronic address: jykn1@uvic.ca.
² Office of Patient-Centred Measurement, British Columbia Ministry of Health, Vancouver, BC, Canada; BC SUPPORT Unit, Patient-Centred Measurement Methods Cluster, Vancouver, BC, Canada.
³ School of Nursing, Trinity Western University, Langley, BC, Canada; BC SUPPORT Unit, Patient-Centred Measurement Methods Cluster, Vancouver, BC, Canada; Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, BC, Canada; Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

PMID: 36055921
DOI: 10.1016/j.jval.2022.07.016

Abstract

Objectives: This study aimed to compare discriminant validity evidence of 2 generic patient-reported outcome measures (PROMs), the Veterans RAND 12-Item Health Survey (VR-12) and level 5 of EQ-5D (EQ-5D-5L), for use in emergency departments (EDs).

Methods: Data were obtained via a cross-sectional survey of 5876 patients in British Columbia (Canada) who completed a questionnaire after visiting an ED in 2018. We compared the extent to which the VR-12 and the EQ-5D-5L distinguished among groups of ED patients with different levels of comorbidity burden and self-reported physical and mental or emotional health status. Multivariable logistic regression was used to evaluate the ability of the 2 PROMs to identify patients presenting with a mental health (MH) condition.

Results: All the measures produced small effect sizes (ESs) for discriminating comorbidity levels (R² range: 0.00 [VR-12 mental component summary {MCS}] to 0.10 [VR-12 physical component summary score]). The EQ-5D visual analog scale offered the largest ES for discriminating self-reported physical health (R² = 0.48), whereas the MCS, the VR-12 MH domain, and the EQ-5D-5L anxiety/depression dimension had the largest ESs for discriminating self-reported mental or emotional health (R² = 0.42, 0.40, and 0.38, respectively). The MCS produced a medium ES (R² = 0.42) along with the VR-12 utility score (R² = 0.27) compared with the EQ-5D-5L index (R² = 0.19). Having a MH condition was predominantly identified by the MCS (Pratt index = 0.56).

Conclusions: The VR-12 PROM provides a more comprehensive measurement of MH than the EQ-5D-5L, which is important to inform healthcare service needs for patients who present in EDs with MH challenges.

Keywords: EQ-5D; Veterans RAND 12-Item Health Survey; comorbidity; discriminant validity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

British Columbia
Cross-Sectional Studies
Emergency Service, Hospital
Health Status
Health Surveys
Humans
Patient Reported Outcome Measures
Psychometrics / methods
Quality of Life* / psychology
Reproducibility of Results
Surveys and Questionnaires
Veterans*