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Health-related quality of life assessment by the EuroQol-5D can provide cost-utility data in the field of low-back surgery.

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Abstract

There is limited data on the cost-utility of low-back surgical procedures. The EuroQol-5D (EQ-5D) is a generic health-related quality of life (HRQL) instrument, which was designed for cost-utility analyses and for comparisons of therapeutic effects across different diseases. Disease-specific (HRQL) instruments cannot be used for such purposes. However, there is little evidence of the usefulness of the EQ-5D in the field of low-back surgery, and it might be too general to assess specific conditions. We therefore tested its validity and responsiveness against a widely used disease-specific HRQL instrument [the Oswestry disability index (ODI)], in a prospective study on 326 patients operated for degenerative disorders in the lumbar spine. The reliability of the EQ-5D was also evaluated. Follow-up time was 12 months. Cross-sectional construct validity of the EQ-5D and ODI in the assessments of pain, functional status, health state and employment status were equal. The ODI performed better only in the assessment of walking capability. Only small differences in responsiveness were found. The reliability of the EQ-5D was solid. Our results indicate that the EQ-5D is useful for estimating health state values and for monitoring outcome of patients undergoing low-back surgery. Hence, this instrument would provide valid data for cost–utility analyses.

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References

  1. Badia X, Monserrat S, Roset M, Herdman M (1999) Feasibility, validity and test-retest reliability of scaling methods for health states: the visual analogue scale and the time trade-off. Qual Life Res 8:303–310

    Google Scholar 

  2. Baker DJ, Pynsent PB, Fairbank CT (1990) The Oswestry Disability Index revisited: its reliability, repeatability and validity, and a comparison with the St Thomas’s Disability Index. In: Roland M, Jenner JR (eds) Back Pain. New approaches to rehabilitation and education. Manchester University Press, Manchester, pp. 174–186

    Google Scholar 

  3. Beurskens AJ, Vet HC, Koke AJ (1996) Responsiveness of functional status in low back pain: a comparison of different instruments. Pain 65:71–76

    Google Scholar 

  4. Brazier J, Deverill M, Green C, Harper R, Booth A (1999) A review of the use of health status measures in economic evaluation. Health Technol Assess 3:1–164

    Google Scholar 

  5. Brooks R (1996) EuroQol: the current state of play. Health Policy 37:53–72

    Google Scholar 

  6. Carmines EG, Zeller RA (1979) Reliability and validity assessment. Quantitiative applications in the social sciences. Sage University, Beverly Hills, paper 17, pp 1–71

  7. Coons SJ, Rao S, Keininger DL, Hays RD (2000) A comparative review of generic quality-of-life instruments. Pharmacoeconomics 17:13–35

    Google Scholar 

  8. Cronbach LJ (1951) Co-efficient alpha and the internal structure of tests. Psychometrika 16:297–334

    Google Scholar 

  9. Deyo RA, Centor RM (1986) Assessing the responsiveness of functional scales to clinical change: an analogy to diagnostic test performance. J Chronic Dis 39:897–906

    Google Scholar 

  10. Dionne CE, Von Korff M, Koepsell TD, Deyo RA, Barlow WE, Checkoway H (1999) A comparison of pain, functional limitations, and work status indices as outcome measures in back pain research. Spine 24:2339–2345

    Google Scholar 

  11. Dolan P (1996) Modelling valuations for health states: the effect of duration. Health Policy 38:189–203

    Google Scholar 

  12. Dolan P (1997) Modelling valuations for EuroQol health states. Med Care 35:1095–1108

    Google Scholar 

  13. Dolan P, Gudex C, Kind P, Williams A (1996) The time trade-off method: results from a general population study. Health Econ 5:141–154

    Google Scholar 

  14. Fairbank JC, Couper J, Davies JB, O’Brien JP (1980) The Oswestry low back pain disability questionnaire. Physiotherapy 66:271–273

    Google Scholar 

  15. Garratt AM, Klaber MJ, Farrin AJ (2001) Responsiveness of generic and specific measures of health outcome in low back pain. Spine 26:71–77

    Google Scholar 

  16. Hagg O, Fritzell P, Romberg K, Nordwall A (2001) The general function score: a useful tool for measurement of physical disability. Validity and reliability. Eur Spine J 10:203–210

    Google Scholar 

  17. Katz JN, Larson MG, Phillips CB, Fossel AH, Liang MH (1992) Comparative measurement sensitivity of short and longer health status instruments. Med Care 30:917–925

    Google Scholar 

  18. Kazis LE, Anderson JJ, Meenan RF (1989) Effect sizes for interpreting changes in health status. Med Care 27:S178–S189

    Google Scholar 

  19. Malter AD, Weinstein J (1996) Cost-effectiveness of lumbar discectomy. Spine 21:69S–74S

    Google Scholar 

  20. Nord E (1991) EuroQol: health-related quality of life measurement. Valuations of health states by the general public in Norway. Health Policy 18:25–36

    Google Scholar 

  21. Patrick DL, Deyo RA (1989) Generic and disease-specific measures in assessing health status and quality of life. Med Care 27:S217–S232

    Google Scholar 

  22. Patrick DL, Deyo RA, Atlas SJ, Singer DE, Chapin A, Keller RB (1995) Assessing health-related quality of life in patients with sciatica. Spine 20:1899–1908

    Google Scholar 

  23. Rabin R, de Charro F (2001) EQ-5D: a measure of health status from the EuroQol Group. Ann Med 33:337–343

    Google Scholar 

  24. Stromqvist B, Jonsson B, Fritzell P, Hagg O, Larsson BE, Lind B (2001) The Swedish National Register for lumbar spine surgery: Swedish society for spinal surgery. Acta Orthop Scand 72:99–106

    Google Scholar 

  25. Suarez-Almazor ME, Kendall C, Johnson JA, Skeith K, Vincent D (2000) Use of health status measures in patients with low back pain in clinical settings. Comparison of specific, generic and preference-based instruments. Rheumatology (Oxford) 39:783–790

    Google Scholar 

  26. Terwee CB, Dekker FW, Wiersinga WM, Prummel MF, Bossuyt PM (2003) On assessing responsiveness of health-related quality of life instruments: guidelines for instrument evaluation. Qual Life Res 12:349–362

    Google Scholar 

  27. The EuroQol Group (1990) EuroQol–a new facility for the measurement of health-related quality of life. The EuroQol Group. Health Policy 16:199–208

    Google Scholar 

  28. Weber H (1983) Lumbar disc herniation. A controlled, prospective study with ten years of observation. Spine 8:131–140

    Google Scholar 

  29. Wood-Dauphinee SL (2001) Assessment of back-related quality of life: the continuing challenge. Spine 26:857–861

    Google Scholar 

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Acknowledgements

The authors thank the nurses, Mrs Susanne Nyvoll and Mrs Unn Manskow, for their efforts in data collection and registration.

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Correspondence to Tore K. Solberg.

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Solberg, T.K., Olsen, JA., Ingebrigtsen, T. et al. Health-related quality of life assessment by the EuroQol-5D can provide cost-utility data in the field of low-back surgery.. Eur Spine J 14, 1000–1007 (2005). https://doi.org/10.1007/s00586-005-0898-2

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