Good responsiveness with EuroQol 5-Dimension questionnaire and Short Form (36) Health Survey in 20-69 years old patients with a femoral neck fracture: A 2-year prospective follow-up study in 182 patients.
BACKGROUND
EQ-5D and SF-36 are two questionnaires used to measure health related quality of life (HRQoL). The responsiveness of these instruments has previously been evaluated in elderly populations with hip fracture but not in a younger population. The purpose was to evaluate the responsiveness of SF-36 and EQ-5D in a younger population with femoral neck fracture.


METHODS
182 patients aged 20-69 were consecutively included. HRQoL was measured by EQ-5D and SF-36 at 4, 12 and 24 months. Pain and function were measured by Harris Hip Score (HHS) on the same occasions. The responsiveness of EQ-5D and SF-36 was evaluated by calculation of two effect sizes; standardized effect size (SES) and standardized response mean (SRM), and by analysing how changes in score correlated to changes in function and subjective state of health. External responsiveness was also evaluated by calculating receiver operating characteristic curve and area under the curve.


RESULTS
SES was large at four months for both EQ-5D and SF-36 (1.09 and 0.83 respectively) and moderate at the 12- and 24-month follow-ups. The correlation between changes (4-24 months) in HHS and changes in HRQoL were 0.44 for EQ-5D and 0.37 for SF-36. EQ-5D and SF-36 were both more sensitive than HHS in their ability to predict subjective improvements after a hip fracture.


CONCLUSIONS
The effect sizes and the ability to follow and predict the external standard indicates that both EQ-5D and SF-36 have good internal and external responsiveness in this younger population with femoral neck fracture. The generic HRQoL questionnaires were superior to a hip-specific instrument in predicting the patients' subjective feelings of an improved state of health. EQ-5D is simple to administer and shows similar responsiveness as SF-36 and may be sufficient to use as an outcome measure in clinical trials.
Karolinska Institutet, Department of Clinical Science Intervention and Technology (CLINTEC), Department of Orthopaedics, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
Niklas
N
Honkavaara
Karolinska Institutet, Department of Clinical Science Intervention and Technology (CLINTEC), Department of Orthopaedics, Karolinska University Hospital, Huddinge, Stockholm, Sweden. Electronic address: amer.al-ani@ptj.se.
Amer N
AN
Al-Ani
Karolinska Institutet, Department of Clinical Science Intervention and Technology (CLINTEC), Department of Orthopaedics, Norrtälje Hospital TioHundra AB.
Pierre
P
Campenfeldt
Karolinska Institutet, Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Department of Orthopaedics Karolinska University Hospital Solna, Stockholm, Sweden.
Wilhelmina
W
Ekström
Department of Orthopaedics, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
Margareta
M
Hedström
D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D005265:Femoral Neck Fractures / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology*; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
EQ-5D and Sf-36; Femoral neck fracture; Health related quality of life; Middle-aged; Responsiveness; Young