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]
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.
health-related quality-of-life, EQ-5D, assessment of quality of life, Chinese, osteoporosis