Responsiveness of the EQ-5D in patients with proximal humeral fractures.
BACKGROUND
This study evaluated the internal and external responsiveness of the EuroQol EQ-5D (EuroQol Group, Rotterdam, The Netherlands) health status component, defined as the instrument's ability to capture clinically important changes in patients with a proximal humeral fracture within the context of a prospective study.


METHODS
To evaluate the internal responsiveness of the EQ-5D, the observed change and the standardized response mean (SRM) in relation to the change in the EQ-5D(index) score were calculated. To calculate external responsiveness, an external criterion (EC) was constructed by using the Disabilities of the Arm, Shoulder and Hand (DASH) score. Receiver operating characteristic (ROC) curves and logistic regression analysis were used in the evaluation.


RESULTS
The mean change score from prefracture status to the 4-month follow-up for the EQ-5D was -20.9 and the corresponding SRM was 0.90, indicating good internal responsiveness. The clearly improved or clearly deteriorated patients according to the EC (DASH) reported change scores of approximately 12 points in the EQ-5D, corresponding to moderately strong SRMs, which, together with the results of the ROC analyses and logistic regression, indicated a good external responsiveness.


CONCLUSIONS
The EQ-5D displayed good internal and external responsiveness in patients with proximal humeral fractures and can be recommended for use as a quality of life measure in patients with this particular injury.
Department of Clinical Science and Education, Section of Orthopaedics, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. per.olerud@sodersjukhuset.se
Per
P
Olerud
Jan
J
Tidermark
Sari
S
Ponzer
Leif
L
Ahrengart
Gunnar
G
Bergström
D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011446:Prospective Studies; D011594:Psychometrics / Q000379:methods*; D011788:Quality of Life; D012784:Shoulder Fractures / Q000523:psychology / Q000534:rehabilitation*; D011795:Surveys and Questionnaires