Assessment of psychometric properties, feasibility and usefulness of the EQ- 5D-5L in Ethiopian stroke patients
No Thumbnail Available
Date
2023
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Ababa University
Abstract
Background: Stroke ranks as the second-leading global fatality and affects the quality of life for
survivors. Despite limited knowledge about the impact of acute stroke on health-related quality
of life in Ethiopia, longitudinal studies on stroke patients offer some insight internationally.
Objective: To assess the Psychometric properties, feasibility and usefulness of EQ-5D-5L
among Ethiopian stroke patients.
Methods: A sequential mixed-method study design was conducted among 200 patient-proxy
dyads at 6 public hospitals of Addis Ababa, Ethiopia from November 2021-November 2022.
STATA version 15 was used for the quantitative analysis.The internal consistency was assessed
using Cronbach‘s alpha (α). Chi-square test was used for the problem/no problem report
comparison among patients and proxies across different interview periods. Mean difference
between patient and proxy in the EQ-5D index and EQ VAS was reported using paired t-test. In
addition, patient/proxy response agreement, convergent validity, and known group validity were
assessed. Qualitative data was analyzed thematically using MaxQDA version 20.
Results: EQ-5D-5L demonstrated good internal consistency with a Cronbach‘s α of 0.86, 0.92
and 0.93 at baseline, Visit 2 and visit 3 respectively. In visits two and three compared to the
baseline report, a better agreement was observed between patient and caregivers. There was a
moderate to strong association between the mRS score and the EQ VAS and EQ-5D index.
Significant differences in mean utility were noted among patients with different stroke disability
levels, as measured by mRS. Patients, proxies, and data collectors found it easier to answer EQ-
5D-5L questions during follow-up visits compared to baseline. Two major themes were
identified with respect to discrepancies in patient and proxy ratings, which attributed to
reflections on the feasibility of questions and concerns on perceived disease impact.
Conclusion: The EQ-5D-5L is a reliable and valid tool for assessing HRQoL in stroke patients.
The findings also showed that proxy assessments acquired 3 and 6 months after stroke are more
reliable than those obtained in the acute setting.
Description
Keywords
EQ-5D-5L, Ethiopia, Feasibility, Psychometric property, Stroke