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BMC Health Serv Res. 2019 Jul 12;19(1):482. doi: 10.1186/s12913-019-4310-z.

Convergent validity of the EQ-5D-3L in a randomized-controlled trial of the Housing First model.

Kozloff N1,2,3,4, Pinto AD5,6,7,8, Stergiopoulos V9,5,10,11, Hwang SW5,11,8,12,13, O'Campo P5,8, Bayoumi AM5,11,12,13.

Author information

1
Centre for Addiction and Mental Health, 250 College Street, 7th floor, Toronto, ON, M5T 1R8, Canada. n.kozloff@mail.utoronto.ca.
2
Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B1W8, Canada. n.kozloff@mail.utoronto.ca.
3
Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON, M5T1R8, Canada. n.kozloff@mail.utoronto.ca.
4
Institute of Health Policy, Management, and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, ON, M5T 3M6, Canada. n.kozloff@mail.utoronto.ca.
5
Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B1W8, Canada.
6
Department of Family and Community Medicine, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.
7
Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, 500 University Avenue, 5th Floor, Toronto, ON, M5G 1V7, Canada.
8
Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, 6th Floor, Toronto, ON, M5T 3M7, Canada.
9
Centre for Addiction and Mental Health, 250 College Street, 7th floor, Toronto, ON, M5T 1R8, Canada.
10
Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON, M5T1R8, Canada.
11
Institute of Health Policy, Management, and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, ON, M5T 3M6, Canada.
12
Department of Medicine, University of Toronto, Suite RFE 3-805, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada.
13
Division of General Internal Medicine, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada.

Abstract

BACKGROUND:

Health utility assessments are important for economic evaluations but few instruments have been validated in homeless people with mental illness. We examined the convergent validity of the EuroQol-5 Dimension 3-level questionnaire (EQ-5D-3L) as a measure of quality of life in homeless adults with mental illness.

METHODS:

Data were from Toronto participants in At Home/Chez Soi, a 24-month randomized controlled trial of Housing First (immediate access to scattered site housing and mental health support services) compared to treatment as usual for homeless adults with a mental disorder (n = 575). Participants completed the EQ-5D-3L at 6 month intervals. We tested convergent validity, hypothesizing strong correlation (r > 0.6) with the Lehman Quality of Life Interview 20 (QOLI-20) index and moderate correlations (r > 0.3) with the Colorado Symptom Index (CSI), Recovery Assessment Scale (RAS), and number of comorbidities. We also examined correlations between EQ-5D-3L scores and the QOLI-20 over time using a linear mixed-effects model.

RESULTS:

The EQ-5D-3L was not strongly correlated with the QOLI-20 (r ranged from 0.31-0.52 at various time points). The EQ-5D-3L was moderately correlated with the CSI, RAS, and number of comorbidities. The Snijders/Bosker r2 for longitudinal validity between the EQ-5D-3L and QOLI-20 within subjects over time was 0.2094 (square-root r = 0.4576).

CONCLUSIONS:

The EQ-5D-3L did not demonstrate strong convergent validity in homeless people with mental illness but was moderately correlated with several instruments. Further research is warranted to determine the optimal method for measuring health utilities in this population.

TRIAL REGISTRATION:

International Standard Randomised Control Trial Registry ISRCTN42520374 assigned on August 18, 2009.

KEYWORDS:

EQ-5D; Psychiatry; QOL in special populations; Utility measurement; Vulnerable populations/access to care

PMID:
31300051
PMCID:
PMC6626335
DOI:
10.1186/s12913-019-4310-z
[Indexed for MEDLINE]
Free PMC Article

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