Exploring the causal and effect nature of EQ-5D dimensions: an application of confirmatory tetrad analysis and confirmatory factor analysis

Health and Quality of Life Outcomes
Thor Gamst-KlaussenJan Abel Olsen

Abstract

The relationship between the various items in an HRQoL instrument is a key aspect of interpreting and understanding preference weights. The aims of this paper were i) to use theoretical models of HRQoL to develop a conceptual framework for causal and effect relationships among the five dimensions of the EQ-5D instrument, and ii) to empirically test this framework. A conceptual framework depicts the symptom dimensions [Pain/discomfort (PD) and Anxiety/depression (AD)] as causal indicators that drive a change in the effect indicators of activity/participation [Mobility (MO), Self-care (SC) and Usual activities (UA)], where MO has an intermediate position between PD and the other two effect dimensions (SC and UA). Confirmatory tetrad analysis (CTA) and confirmatory factor analysis (CFA) were used to test this framework using EQ-5D-5L data from 7933 respondents in six countries, classified as healthy (n = 1760) or in one of seven disease groups (n = 6173). CTA revealed the best fit for a model specifying SC and UA as effect indicators and PD, AD and MO as causal indicators. This was supported by CFA, revealing a satisfactory fit to the data: CFI = 0.992, TLI = 0.972, RMSEA = 0.075 (90% CI 0.062-0.088), and SRMR = 0.012. The EQ-5D a...Continue Reading

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Citations

Nov 5, 2019·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Jan Abel Olsen, RoseAnne Misajon
Apr 25, 2020·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Thor Gamst-Klaussen, Admassu N Lamu
Dec 8, 2020·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·You-Shan FengInes Buchholz
Jul 9, 2021·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·You-Shan FengThomas Kohlmann

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