Xuejing (Jennifer) Jin, Fatima Al Sayah, Arto Ohinmaa, Deborah A. Marshall, Christopher Smith, Jeffrey A. Johnson

Clinical Orthopaedics and Related Research (CORR) July 2019, 477:1632-1644.

The EQ-5D has been widely using in measuring health-related quality of life (HRQL) of patients following joint arthroplasty, especially in registry programs. Previous studies indicated that the ceiling effect of the three-level EQ-5D (EQ-5D-3L) limits its application in joint arthroplasty. The five-level EQ-5D (EQ-5D-5L) was developed by adding two response levels to each dimension to improve measurement properties of the instrument; however, in joint arthroplasty field, evidence that supports the EQ-5D-5L is superior to the 3L version is limited.

In this study, Jin and colleagues examined and compared the performance of the EQ-5D-3L and EQ-5D-5L among patients awaiting total hip (THA) or knee (TKA) arthroplasty using data from the Alberta Bone and Joint Health Data Repository, which recorded information on all patients receiving elective hip or knee replacements in Alberta since 2010.

The study showed that, compared to the 3L version, the EQ-5D-5L had better measurement properties in terms of response distribution, construct validity, and ability to discriminate between patients with different severity levels of health problems, especially in mobility (a key health aspect or outcome in these patients).

Jin concluded, “the EQ-5D-5L is more appropriate for measuring HRQL of patients awaiting THA and TKA than the EQ-5D-3L.” The findings “support the use of the EQ-5D-5L for more accurate measurement of HRQL in clinical research and routine application among these patients.”

You can read the full article here.

Following the publication, the Clinical Orthopaedics and Related Research journal published a commentary that summarized the importance and limitations of collecting patient-reported outcome measures (PROMs) in hip and knee replacement. The commentary endorsed the application of the EQ-5D in economic evaluations of hip and knee interventions, and highlighted the demand of minimally important difference (MID) in this field. Additionally, it recommended establishing public searchable databases, and exploring the use of pre-surgery PROMs to screen patients or predict prognosis.

You can read the full commentary here.

For any questions or comments, please do not hesitate to contact us at apersu@ualberta.ca.

Fatima Al Sayah, Arto Ohinmaa, Jeffrey A. Johnson

MDM Policy and Practice 2018 (in press)

Anxiety and depressive symptoms are highly prevalent in chronic disease patients, including those with type 2 diabetes. These symptoms, often undiagnosed and untreated, adversely impact diabetes management and outcomes.

In this study, Al Sayah and colleagues examined the performance of two of the most commonly used patient-reported outcome (PRO)measures of health-related quality of life (EQ-5D-5L and the SF-12 v.2) in screening for anxiety and depressive symptoms in type 2 diabetes patients in primary care setting in Alberta. The researchers opted to explore these measures given their increasing use in the healthcare system in routine outcome measurement.

The researchers found that the EQ-5D-5L and the SF-12 to be suitable tools for screening for anxiety and depressive symptoms in adults with type 2 diabetes. The anxiety/depression dimension of the EQ-5D and the MCS score of the SF-12 had the best performance in screening for these symptoms.

Al Sayah stated “These tools present a unique opportunity for a standardized approach for routine mental health screening in primary care settings within the context of routine outcome measurement initiatives, particularly for patients with chronic diseases”. And added “Users should consider all pros and cons of each measure while selecting a PRO measure that would also serve as a screener for mental health”.

You can read the full article here: https://journals.sagepub.com/doi/full/10.1177/2381468318799361

For any questions or comments, please do not hesitate to contact us at apersu@ualberta.ca