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Evaluating health related quality of life in older people at risk of osteoporotic fracture: a head-to-head comparison of the EQ-5D-5L and AQoL-6D


Si, L and Tu, L and Xie, Y and Chen, G and Hiligsmann, M and Yang, M and Zhang, Y and Zhang, X and Jiang, Y and Wei, Q and Gu, J and Palmer, AJ, Evaluating health related quality of life in older people at risk of osteoporotic fracture: a head-to-head comparison of the EQ-5D-5L and AQoL-6D, Social Indicators Research pp. 1-16. ISSN 0303-8300 (2020) [Refereed Article]

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Copyright 2020 Springer Nature B.V.

DOI: doi:10.1007/s11205-020-02414-8


We aimed to conduct a head-to-head comparison of the five-level version of the EuroQol five-dimensional questionnaire (EQ-5D-5L) and the Assessment of Quality of Life-6D (AQoL-6D) in measuring health-related quality of life (HRQoL) of older people at risk of osteoporotic fracture. Participants (n = 291) were recruited from the Third Affiliated Hospital of Sun Yat-Sen University. Study participants were asked to complete the EQ- 5D-5L and the AQoL-6D and the results were converted to health-state utilities (HSUs) using population-specific scoring algorithms. The agreement among HSUs was evaluated using the intraclass correlation coefficient and illustrated using BlandľAltman plots. The minimally important difference (MID) for the EQ-5D and AQoL was set at 0.074 and 0.06. Information on socio-demographic background, socio-economic status and clinical risk factors in FRAX« was collected. Nonparametric statistics were used to explore the known group validity measured by fracture risk. Mean (median) EQ-5D-5L and AQoL-6D HSUs were 0.73(0.83) and 0.74(0.79) for the study population. The EQ-5D-5L and the AQoL-6D HSUs strongly agreed and the HSU difference reached the MID level in both instruments. While a decreasing trend of AQoL-6D utilities was observed with worsening bone mineral density, EQ-5D-5L HSUs were similar in individuals with normal and osteopenic bone mineral densities. The AQoL-6D was also effective for measuring difference in independent living, relationships, mental health, coping and pain. Both instruments showed good known-group validity. The EQ-5D-5L and AQoL-6D are all valid measures for older people at risk of osteoporotic fracture.

Item Details

Item Type:Refereed Article
Keywords:health-related quality-of-life, EQ-5D, assessment of quality of life, Chinese, osteoporosis
Research Division:Economics
Research Group:Applied economics
Research Field:Health economics
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Evaluation of health outcomes
UTAS Author:Palmer, AJ (Professor Andrew Palmer)
ID Code:141655
Year Published:2020
Deposited By:Menzies Institute for Medical Research
Deposited On:2020-11-06
Last Modified:2021-04-14

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