Validation of the EuroQol questionnaire in cardiac rehabilitation

Objective: To analyse the psychometric properties of the EuroQol
questionnaire (EQ-5D) applied to patients with acute coronary
syndromes (ACS).Setting: Rehabilitation hospital.Patients and
design: 106 consecutive patients with ACS (51% myocardial
infarction, 42% coronary artery bypass grafting, 7% angina)
completed the EQ-5D, the 36 item short form health survey (SF-36),
and the MacNew questionnaire at admission, at discharge, and three
months after inpatient cardiac rehabilitation. Acceptance,
validity, reliability, and responsiveness of the EQ-5D were
tested.Results: The EQ-5D was highly accepted. The EQ-5D index
showed substantial ceiling effects after rehabilitation. As
expected the EQ-5D visual analogue scale (VAS) score (70.3 v 57.1)
and EQ-5D index (77.8 v 64.5) were significantly better for
patients with myocardial infarction than for patients who underwent
surgery (both p ⩽ 0.001). Significant correlations were found
between the EQ-5D VAS score, EQ-5D index, and domains of the SF-36
(r = 0.21 to r = 0.74). The correlation with the MacNew subscores
and with the global score ranged between 0.55 and 0.78. With
repeated measurement the EQ-5D showed reasonable reliability in
stable patients with intraclass correlation ranging between 0.91
and 0.54. EQ-5D was responsive in patients who indicated
improvement in health states between admission and discharge
(effect size 0.74--0.82).Conclusion: The psychometric properties of
the EQ-5D were satisfying. It is a reasonably valid, reliable, and
responsive instrument for patients with ACS. It may be useful in
clinical research and epidemiological studies to generate
preference based valuations of health related quality life.