The Comparison of EQ-5D-5L Versus Disease/Treatment-Specific Measures in Pulmonary Embolism and Deep Vein Thrombosis

EQ-5D-5L has been developed from its parental measure, EQ-5D-3L, moving from 3 to 5 levels, aiming to improve sensitivity, discriminative power and limit ceiling effects. The use of 5L has grown rapidly in recent years. However, the use of EQ-5D-5L in pulmonary embolism (PE) and deep vein thrombosis (DVT) populations have not been validated. Furthermore, there is a lack of performance comparisons for EQ-5D-5L against disease-specific quality of life measures. The aim of this study was therefore to compare the measurement properties of EQ-5D-5L against PEmb-QoL and VEINS-QOL/Sym (disease-specific), and PACT-Q2 (treatment-specific) in both PE and DVT populations. PREFER in VTE,a non-interventional disease registry, was conducted between 2013 and 2014 in primary and secondary care across seven European countries. Consecutive patients with acute PE/DVT were documented and followed up over 12 months. Patients who completed all above-mentioned questionnaires at baseline were included in the study sample. The psychometric properties examined included acceptability (missing, ceiling and floor effects), validity (convergent, discriminant, and known-groups validity), and responsiveness. Known group validity and responsiveness were assessed using both effect size (Cohen’s d) and relative efficiency (F-statistic). A total of 1,054 and 1,537 complete cases for PE and DVT were identified. A ceiling effect in EQ-5D-5L was observed (14% and 10% in PE and DVT, respectively), while a higher proportion of missings was observed in PACT-Q2 (19% and 18%). EQ-5D-5L was low to moderately correlated with other measures (r<0.5). Low correlations (r<0.2) between each QOL measure against age and gender were observed, supporting the discrimination validity. EQ-5D-5L was associated with larger effect size/relative efficiency in most of known group comparisons in both groups. Similar results were observed for responsiveness. The results suggest that EQ-5D-5L is similar to PEmb-QoL, VENS-QOL/Sym and PACT-Q2 in terms of acceptability, validity and responsiveness in both PE and DVT populations.