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Validity, reliability and responsiveness of the EQ-5D in German stroke patients undergoing rehabilitation

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Abstract

Purpose

To analyse the psychometric properties of the EQ-5D in German stroke survivors undergoing neurological rehabilitation.

Methods

The EQ-5D, the Hospital Anxiety and Depression Scale (HADS) and the Stroke Impact Scale (SIS) were completed before (210 subjects) and after (183 subjects) a patient education programme in seven rehabilitation clinics in Bavaria, Germany. A postal follow-up was conducted after 6 months. Acceptance, validity, reliability and responsiveness of the EQ-5D were tested. The SIS subscales were used as external anchors to classify the patients into change groups between the measurements.

Results

The proportion of missing answers ranged from 4.7 to 8.6%. Between 16 and 19% reported no problems in any EQ-5D dimension. At baseline, correlations between EQ-5D index and the SIS subscales ranged from 0.15 (communication) to 0.60 (mobility). Correlations with the EQ VAS were slightly smaller. All scores were reliable in test–retest with intraclass correlations ranging from 0.67 to 0.81. EQ-5D index and EQ VAS were consistently responsive only to improvements in health, showing small- to medium effect sizes (0.27–0.42).

Conclusions

The EQ-5D has shown reasonable validity, reliability and, more limited, responsiveness in stroke patients with mild to moderate limitations of functional status, allowing it to be used in clinical trials in rehabilitation.

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Acknowledgments

The RCT evaluating the ICF-based patient education was supported by the German Federal Ministry of Education and Research (BMBF). We acknowledge with thanks for time and information provided by the study participants.

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Authors and Affiliations

  1. Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany

    Matthias Hunger, Björn Stollenwerk & Reiner Leidl

  2. Ludwig-Maximilians-University, Institute for Public Health and Health Care Research, Marchioninistraße 17, 81377, Munich, Germany

    Carla Sabariego & Alarcos Cieza

  3. Ludwig-Maximilians-University, Munich Center of Health Sciences, Ludwigstr. 28 RG, 80539, Munich, Germany

    Reiner Leidl

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  1. Matthias Hunger
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  2. Carla Sabariego
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  4. Alarcos Cieza
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  5. Reiner Leidl
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Correspondence to Matthias Hunger.

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Hunger, M., Sabariego, C., Stollenwerk, B. et al. Validity, reliability and responsiveness of the EQ-5D in German stroke patients undergoing rehabilitation. Qual Life Res 21, 1205–1216 (2012). https://doi.org/10.1007/s11136-011-0024-3

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