title: Measuring preference-based quality of life using the EuroQol EQ-5D in patients with cerebral aneurysms.
abstract: OBJECTIVE
  Cerebral aneurysms can adversely affect quality of life (QOL) via mass effect, subarachnoid hemorrhage, anxiety, or treatment sequelae. The EuroQol EQ-5D is a popular generic 5-item multiple-choice survey questionnaire that measures preference-based QOL on a 0 to 1 scale. We assessed the validity and reliability of the EQ-5D in patients with cerebral aneurysms.
  
  
  METHODS
  We collected data from 178 neurosurgery clinic patients with cerebral aneurysms. Patients were assigned Glasgow Outcome Scale, Rankin scale, Barthel index, and Physical Performance Test scores, and completed the Short-Form 12, Hospital Anxiety and Depression scale, and the EQ-5D. We assessed the construct validity of the EQ-5D by comparing the EQ-5D and the other scales using rank-order methods and multivariate linear regression. Reliability was assessed with Cronbach's alpha.
  
  
  RESULTS
  Patients had a mean age of 54.7 years (standard deviation, 12.6 years), 131 (74%) were women, and 98 (55%) had survived a subarachnoid hemorrhage. The mean EQ-5D score was 0.80 (standard deviation, 0.19). Construct validity of the EQ-5D was confirmed by statistically significant associations between EQ-5D and Glasgow Outcome Scale, Rankin scale, Barthel index, Physical Performance Test, Short-Form 12 Physical Component Summary, and Hospital Anxiety and Depression scores (for all, P < or = 0.05). Multivariate regression showed that the EQ-5D scores were independently associated with the Barthel index, Short-Form 12 Physical Component Summary, and Hospital Anxiety and Depression scale anxiety and depression subscales (pseudo R = 0.40). Reliability was demonstrated by Cronbach's alpha of 0.70.
  
  
  CONCLUSIONS
  The EQ-5D is a valid and reliable instrument for measuring QOL in patients with cerebral aneurysms. The EQ-5D provides a single QOL value incorporating functional status, physical functioning, and mental health.
authors.affiliation: Section of Neurosurgery, VA Connecticut Healthcare System, West Haven, Connecticut 06516, USA. Joseph.KingJr@va.gov
authors.forename: Joseph T
authors.initials: JT
authors.lastname: King
authors.forename: Joel
authors.initials: J
authors.lastname: Tsevat
authors.forename: Mark S
authors.initials: MS
authors.lastname: Roberts
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D023261:Glasgow Outcome Scale; D006304:Health Status; D006801:Humans; D002532:Intracranial Aneurysm / Q000523:psychology* / Q000601:surgery; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics / Q000379:methods*; D011788:Quality of Life; D012044:Regression Analysis; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires