Psychometric properties of the EQ-5D-5L in diabetes mellitus patients in Spain
Abstract Background The EQ-5D-5L five-dimensional instrument, is one of the most widely used generic preference-based questionnaires to measure health-related quality of life and to estimate utility indices for use in economic evaluation. This study aimed to assess the psychometric properties of the...
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SpringerOpen
2025-05-01
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| Series: | Journal of Patient-Reported Outcomes |
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| Online Access: | https://doi.org/10.1186/s41687-025-00874-5 |
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| author | Amaia Bilbao-González Marta González-Sáenz de Tejada Montse Ferrer Yolanda Ramallo-Fariña Miguel Paja-Fano Carlos García-Forero Daniela Mestre Iñigo Gorostiza-Hormaetxe |
| author_facet | Amaia Bilbao-González Marta González-Sáenz de Tejada Montse Ferrer Yolanda Ramallo-Fariña Miguel Paja-Fano Carlos García-Forero Daniela Mestre Iñigo Gorostiza-Hormaetxe |
| author_sort | Amaia Bilbao-González |
| collection | DOAJ |
| description | Abstract Background The EQ-5D-5L five-dimensional instrument, is one of the most widely used generic preference-based questionnaires to measure health-related quality of life and to estimate utility indices for use in economic evaluation. This study aimed to assess the psychometric properties of the Spanish EQ-5D-5L questionnaire in patients with Diabetes Mellitus (DM) assessing reliability, validity, and item-level properties such as item functioning. Methodology We included 133 patients with DM who completed the EQ-5D-5L, the Audit on Diabetes-Dependent Quality of Life (ADDQoL), the Hospital Anxiety and Depression Scale (HADS), one question about general health and sociodemographic, and clinical data. The reliability was assessed by Cronbach’s alpha, and the item functioning by the item response theory (IRT). Convergent validity was tested using the Spearman correlation coefficient between EQ-5D-5L, ADDQoL, HADS and the general health question. We examined known-groups validity by comparing the EQ-5D-5L scores between subgroups defined by age, gender, BMI, regular physical activity, disease duration, glycemic control by glycosylated blood hemoglobin (HbA1c) (%), type of DM, general health and anxiety and depression level using t-test, ANOVA, Wilcoxon or Kruskal-Wallis tests. Results The reliability was supported with a Cronbach’s alpha of 0.78. The IRT results supported the unidimensionality and showed adequate item functioning, except for the anxiety/depression dimension. The item with highest discriminatory power was usual activities dimension, followed by self-care and mobility dimensions. The EQ-5D-5L showed adequate convergent validity, with high correlation with the ADDQoL, HADS and general health. Older age, women, obese, no regular physical activity, ≥ 10 years of disease duration, poor glycemic control, poorer general health and higher anxiety and depression level linked with lower EQ-5D-5L scores. Conclusions These findings support the adequate psychometric properties of the EQ-5D-5L in patients with DM, supporting its use for clinicians and researchers as an outcome measure and for use in economic evaluation studies. |
| format | Article |
| id | doaj-art-e41ad74b965c4460a2ec3da4a5ee2d09 |
| institution | DOAJ |
| issn | 2509-8020 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Patient-Reported Outcomes |
| spelling | doaj-art-e41ad74b965c4460a2ec3da4a5ee2d092025-08-20T03:22:07ZengSpringerOpenJournal of Patient-Reported Outcomes2509-80202025-05-019111310.1186/s41687-025-00874-5Psychometric properties of the EQ-5D-5L in diabetes mellitus patients in SpainAmaia Bilbao-González0Marta González-Sáenz de Tejada1Montse Ferrer2Yolanda Ramallo-Fariña3Miguel Paja-Fano4Carlos García-Forero5Daniela Mestre6Iñigo Gorostiza-Hormaetxe7Osakidetza Basque Health Service, Research and Innovation Unit, Basurto University HospitalNetwork for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS)Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute)Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS)Osakidetza Basque Health Service, Department of Endocrinology, Basurto University HospitalSchool of Medicine, Universitat Internacional de CatalunyaOsakidetza Basque Health Service, Research and Innovation Unit, Basurto University HospitalOsakidetza Basque Health Service, Research and Innovation Unit, Basurto University HospitalAbstract Background The EQ-5D-5L five-dimensional instrument, is one of the most widely used generic preference-based questionnaires to measure health-related quality of life and to estimate utility indices for use in economic evaluation. This study aimed to assess the psychometric properties of the Spanish EQ-5D-5L questionnaire in patients with Diabetes Mellitus (DM) assessing reliability, validity, and item-level properties such as item functioning. Methodology We included 133 patients with DM who completed the EQ-5D-5L, the Audit on Diabetes-Dependent Quality of Life (ADDQoL), the Hospital Anxiety and Depression Scale (HADS), one question about general health and sociodemographic, and clinical data. The reliability was assessed by Cronbach’s alpha, and the item functioning by the item response theory (IRT). Convergent validity was tested using the Spearman correlation coefficient between EQ-5D-5L, ADDQoL, HADS and the general health question. We examined known-groups validity by comparing the EQ-5D-5L scores between subgroups defined by age, gender, BMI, regular physical activity, disease duration, glycemic control by glycosylated blood hemoglobin (HbA1c) (%), type of DM, general health and anxiety and depression level using t-test, ANOVA, Wilcoxon or Kruskal-Wallis tests. Results The reliability was supported with a Cronbach’s alpha of 0.78. The IRT results supported the unidimensionality and showed adequate item functioning, except for the anxiety/depression dimension. The item with highest discriminatory power was usual activities dimension, followed by self-care and mobility dimensions. The EQ-5D-5L showed adequate convergent validity, with high correlation with the ADDQoL, HADS and general health. Older age, women, obese, no regular physical activity, ≥ 10 years of disease duration, poor glycemic control, poorer general health and higher anxiety and depression level linked with lower EQ-5D-5L scores. Conclusions These findings support the adequate psychometric properties of the EQ-5D-5L in patients with DM, supporting its use for clinicians and researchers as an outcome measure and for use in economic evaluation studies.https://doi.org/10.1186/s41687-025-00874-5Diabetes mellitusEQ-5D-5LUtility indexPsychometric propertiesItem response theory |
| spellingShingle | Amaia Bilbao-González Marta González-Sáenz de Tejada Montse Ferrer Yolanda Ramallo-Fariña Miguel Paja-Fano Carlos García-Forero Daniela Mestre Iñigo Gorostiza-Hormaetxe Psychometric properties of the EQ-5D-5L in diabetes mellitus patients in Spain Journal of Patient-Reported Outcomes Diabetes mellitus EQ-5D-5L Utility index Psychometric properties Item response theory |
| title | Psychometric properties of the EQ-5D-5L in diabetes mellitus patients in Spain |
| title_full | Psychometric properties of the EQ-5D-5L in diabetes mellitus patients in Spain |
| title_fullStr | Psychometric properties of the EQ-5D-5L in diabetes mellitus patients in Spain |
| title_full_unstemmed | Psychometric properties of the EQ-5D-5L in diabetes mellitus patients in Spain |
| title_short | Psychometric properties of the EQ-5D-5L in diabetes mellitus patients in Spain |
| title_sort | psychometric properties of the eq 5d 5l in diabetes mellitus patients in spain |
| topic | Diabetes mellitus EQ-5D-5L Utility index Psychometric properties Item response theory |
| url | https://doi.org/10.1186/s41687-025-00874-5 |
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