Responsiveness and minimal clinically important difference of the EQ-5D-5L in cervical intraepithelial neoplasia: a longitudinal study

• Published in: Health and quality of life outcomes 2020-10, Vol.18 (1), p.324-11, Article 324
• Main Authors: Hu, Xin, Jing, Mingxia, Zhang, Mei, Yang, Ping, Yan, Xiaolong
• Format: Article
• Language: English
• Subjects: Adult; Care and treatment; Cervical cancer; Cervix dysplasia; China; CIN; Correlation analysis; EQ-5D-5L; Female; Gynecology; Health aspects; Humans; Longitudinal Studies; Mathematical analysis; MCID; MDC; Medical research; Methods; Middle Aged; Minimal Clinically Important Difference; Patients; Postoperative Period; Quality of Life; Questionnaires; Rank tests; Reproducibility of Results; Responsiveness; Surgery; Surveys and Questionnaires - standards; Uterine Cervical Dysplasia - psychology; Uterine Cervical Dysplasia - surgery; Uterine Cervical Neoplasms - psychology; Uterine Cervical Neoplasms - surgery; Visual Analog Scale
• ISSN: 1477-7525; 1477-7525
• DOI: 10.1186/s12955-020-01578-8

With the widespread clinical application of the five-level version of the EuroQol five-dimensional questionnaire (EQ-5D-5L), whether the questionnaire scores are responsive to changes in patients' health and how much changes in questionnaire scores represent patients' real health changes require consideration. Consequently, we assessed responsiveness and estimated the minimal clinically important difference (MCID) of the EQ-5D-5L in surgically treated patients with cervical intraepithelial neoplasia (CIN) to determine the relationship between MCID and minimal detectable change (MDC). We conducted a longitudinal, observational study. Participants were patients with CIN from the gynecology inpatient department of a grade-A tertiary hospital in Shihezi, Xinjiang, China. Participants completed the EQ-5D-5L and the Global Rating of Change Questionnaire (GRCQ) at baseline and one month post-surgery. The Wilcoxon signed-rank test was used to compare EQ-5D-5L scores pre- and post-treatment. We calculated the effect size (ES) and the standardized response mean (SRM) to quantitatively assess responsiveness. Distribution-based, anchor-based, and instrument-defined methods were used to estimate MCID. MCID to MDC ratios at individual- and group-levels were also calculated. Fifty patients with CIN completed the follow-up investigation (mean age 44.76 ± 8.72 years; mean follow-up time 32.28 ± 1.43 days). The index value and EQ visual analogue scale (EQ VAS) of the EQ-5D-5L improved by 0.025 and 6.92 (all p