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Qual Life Res. 2019 Mar 18. doi: 10.1007/s11136-019-02156-2. [Epub ahead of print]

Health-related quality of life in injury patients: the added value of extending the EQ-5D-3L with a cognitive dimension.

Author information

1
Department of Public Health, Erasmus MC University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
2
Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
3
Division Mother and Child, Utrecht University Medical Center, Utrecht, The Netherlands.
4
Consumer Safety Institute, Amsterdam, The Netherlands.
5
Department of Public Health, Erasmus MC University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands. j.haagsma@erasmusmc.nl.

Abstract

INTRODUCTION:

The EQ-5D is frequently used to understand the development of health-related quality of life (HRQL) following injury. However, the lack of a cognition dimension is generally felt as disadvantageous as many injuries involve cognitive effects. We aimed to assess the added value of a cognitive dimension in a cohort of injury patients.

METHODS:

We analyzed EQ-5D-3L extended with cognition (EQ-5D + C) dimension responses of 5346 adult injury patients. We studied dimension dependency, assessed the additional effect of the cognitive dimension on the EQ-VAS, and, using the EQ-VAS as a dependent variable, determined the impact of EQ-5D and EQ-5D + C attributes in multivariate regression analyses.

RESULTS:

Extreme cognitive problems combined with no problems on other dimensions are uncommon, whereas severe problems on other dimensions frequently occur without cognitive problems. The EQ-VAS significantly decreased when cognitive problems emerged. Univariate regression analyses indicated that all EQ-5D + C dimensions were significantly associated with the EQ-VAS. Exploratory analyses showed that using any set of five of the six EQ-5D + C dimensions resulted in almost identical explained variance, and adding the remaining 6th dimension resulted in a similar additional impact.

CONCLUSIONS:

The addition of the cognition dimension increased the explanatory power of the EQ-5D-3L. Although the increase in explanatory power was relatively small after the cognition dimension was added, the decrease of HRQoL (measured with the EQ-VAS) resulting from cognitive problems was comparable to the decreases resulting from other EQ-5D dimensions.

KEYWORDS:

Cognition; EQ-5D; Health-related quality of life; Injury; Trauma

PMID:
30887386
DOI:
10.1007/s11136-019-02156-2

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