EQ-5D versus SF-12 in coronary patients: are they interchangeable?

Value Health. 2014 Jan-Feb;17(1):84-9. doi: 10.1016/j.jval.2013.10.010.

Abstract

Objectives: The aim of this study was to compare EuroQol five-dimensional (EQ-5D) utility scores and six-dimensional health state classification (SF-6D) utility scores (derived from the 12-Item Short-Form Health Survey [SF-12]) by using a large European sample of patients with stable coronary heart disease. Special attention was given to country-specific results.

Methods: Data from the EURopean Action on Secondary and Primary Prevention by Intervention to Reduce Events III (EUROASPIRE III) survey were used. Patients hospitalized for a coronary artery bypass graft, percutaneous coronary intervention, acute myocardial infarction, or myocardial ischemia were interviewed and examined at least 6 months after their acute event. Health-related quality of life was assessed by using the EQ-5D and the SF-12. SF-12 outcomes were converted to SF-6D utility values, allowing comparison between both measures.

Results: Both EQ-5D and SF-6D results were available for 7472 patients with coronary heart disease from 20 European countries. The measures were significantly correlated (intraclass correlation coefficient = 0.536); however, large differences between the two measures remain. A total of 28.8% of the patients reported a ceiling effect on the EQ-5D instrument, whereas only 4.2% of the patients reported full health based on the SF-6D. Especially the mental component does not seem to be completely captured by the EQ-5D instrument. Furthermore, patients with worse EQ-5D outcomes were more likely to have better SF-6D results, whereas patients with better EQ-5D outcomes were more likely to have worse SF-6D results.

Conclusions: Both measures are not interchangeable. Whereas the main disadvantage of the EQ-5D questionnaire is its ceiling effect, the potential advantages of SF-12 might disappear when converting the outcomes into an SF-6D utility, because of the small differences between patients.

Keywords: EQ-5D; SF-12; coronary heart disease; health-related quality of life; utility.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Algorithms
  • Coronary Disease / epidemiology
  • Coronary Disease / prevention & control*
  • Coronary Disease / therapy*
  • Cross-Sectional Studies
  • Europe / epidemiology
  • Female
  • Health Status*
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Primary Prevention
  • Quality of Life*
  • Secondary Prevention
  • Surveys and Questionnaires*