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First Author: M.Ang SINGAPORE
Co Author(s): T. Wong E. Lamoureux N. Luo
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To assess the construct validity and responsiveness of the EuroQOL-5D (EQ-5D) instrument in patients undergoing cataract surgery in Singapore.
Tertiary eye referral center, Singapore National Eye Center, Singapore.
In this prospective study, English- or Chinese-speaking patients (n=216) completed the EQ-5D and the VF-14 questionnaires before, and 3 months after they underwent cataract surgery. The impact of cataracts on patients was assessed using two standard gamble (SG) questions before surgery. Construct validity of the EQ-5D index and visual analog scale (VAS) was assessed by examining their correlation with the VF-14 and SG scores. Responsiveness of the EQ-5D was compared to that of the VF-14 in terms of the magnitude of score change associated with cataract surgery.
There were no significant differences in baseline characteristics between Chinese (n=156) and English (n=60) speaking patients. The EQ-5D index was correlated with VF-14 and SG scores in both Chinese-speaking patients (Spearmans rho: 0.24 to 0.27, p<0.05) and English-speaking patients (Spearmans rho: 0.22 to 0.41, p<0.01). In contrast, no correlation was found between the EQ-VAS, VF-14 or SG scores. The EQ-5D index and VF-14 score of patients improved after cataract surgery in both Chinese-speaking patients (mean difference 0.05ḟ0.19, P = 0.0018, effect size: 0.68) and English-speaking patients (mean difference 0.06ḟ0.12, P = 0.0002, effect size: 0.54). EQ-VAS worsened in Chinese-speaking patients (mean difference -3.61 ḟ15.64, P = 0.008, effect size: -0.28) and remained the same in English-speaking patients (mean difference 1.68 ḟ13.41, P = 0.3349, effect size: 0.12) after cataract surgery.
This is the first study, to our knowledge, that found that the EQ-5D index was a valid health utility measure for Asian patients with cataract in Singapore, which is responsive to the treatment benefits of cataract surgery. Therefore, the EQ-5D may be used to measure quality-adjusted life years for cost-utility analysis of interventions or programs for cataract.