title: Validity, reliability and responsiveness of the EQ-5D in German stroke patients undergoing rehabilitation.
abstract: OBJECTIVE
  To analyse the psychometric properties of the EQ-5D in German stroke survivors undergoing neurological rehabilitation.
  
  
  METHODS
  The EQ-5D, the Hospital Anxiety and Depression Scale (HADS) and the Stroke Impact Scale (SIS) were completed before (210 subjects) and after (183 subjects) a patient education programme in seven rehabilitation clinics in Bavaria, Germany. A postal follow-up was conducted after 6 months. Acceptance, validity, reliability and responsiveness of the EQ-5D were tested. The SIS subscales were used as external anchors to classify the patients into change groups between the measurements.
  
  
  RESULTS
  The proportion of missing answers ranged from 4.7 to 8.6%. Between 16 and 19% reported no problems in any EQ-5D dimension. At baseline, correlations between EQ-5D index and the SIS subscales ranged from 0.15 (communication) to 0.60 (mobility). Correlations with the EQ VAS were slightly smaller. All scores were reliable in test-retest with intraclass correlations ranging from 0.67 to 0.81. EQ-5D index and EQ VAS were consistently responsive only to improvements in health, showing small- to medium effect sizes (0.27-0.42).
  
  
  CONCLUSIONS
  The EQ-5D has shown reasonable validity, reliability and, more limited, responsiveness in stroke patients with mild to moderate limitations of functional status, allowing it to be used in clinical trials in rehabilitation.
authors.affiliation: Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany. matthias.hunger@helmholtz-muenchen.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Hunger
authors.forename: Carla
authors.initials: C
authors.lastname: Sabariego
authors.forename: Björn
authors.initials: B
authors.lastname: Stollenwerk
authors.forename: Alarcos
authors.initials: A
authors.lastname: Cieza
authors.forename: Reiner
authors.initials: R
authors.lastname: Leidl
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics / Q000295:instrumentation; D011788:Quality of Life; D015203:Reproducibility of Results; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires / Q000592:standards; D017741:Survivors / Q000523:psychology; D055815:Young Adult