Do We Need to Assess Quality-of-Life with Both the St George’s Respiratory Questionnaire and the EuroQol 5-Dimension Questionnaire in a Clinical Study with an Economic Component: Insights from the REVOLENS Study in Severe Emphysema
Received 22 July 2019
Accepted for publication 31 October 2019
Published 14 January 2020 Volume 2020:15 Pages 135—142
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Richard Russell
Julie Bulsei, 1 Jeanne Pfister, 1 Sylvie Leroy, 2 Jeanne Marie Perotin, 3 Coralie Barbe, 4 Charles-Hugo Marquette, 2 Gaëtan Deslee, 3 Isabelle Durand-Zaleski 1
On behalf of the REVOLENS study group
1AP-HP URC Eco IdF, Unité de recherche clinique en économie de la santé d’Ile de France, Paris, France; 2Service de Pneumologie, CHU de Nice, FHU OncoAge, Université Côte d’Azur, Nice, France; 3Service de Pneumologie, INSERM U1250, Hôpital Universitaire, Reims, France; 4Unité d’Aide Méthodologique, Pôle Recherche et Santé Publique, Hôpital Universitaire de Reims, Reims, France
Correspondence: Julie Bulsei
Urc Eco Ile-de-France (AP-HP), Hôtel Dieu, 1, place du Parvis Notre-Dame, Paris 75004, France
Tel +33 1 40 27 57 52
Introduction: The use of two quality-of-life questionnaires in a single clinical trial with an economic component can be challenging due to the associated workload in terms of data collection and an increased risk of missing data. The aim of our study was to determine whether the questionnaire chosen to measure health status, the St. George’s Respiratory Questionnaire (SGRQ), could be administered on its own without adding the EuroQol five dimensions questionnaire (EQ-5D) for economic evaluation in emphysema studies.
Materials and Methods: Data were prospectively collected during the REVOLENS trial assessing endobronchial coil treatment in severe emphysema. To quantify the association between the two questionnaires, correlations between the EQ-5D and the SGRQ were first tested and the concordance was then studied in order to know whether the two questionnaires were interchangeable. Finally, the Starkie et al algorithm predicting EQ-5D utility values from the SGRQ was used on REVOLENS’s individual patient data. The Student’s t-test, correlation and concordance between EQ-5D individual value (from the REVOLENS study) and predicted value (from the Starkie et al algorithm) were studied to test this algorithm.
Results: Results showed a strong correlation but no concordance between the EQ-5D and the SGRQ, demonstrating that the two questionnaires are not interchangeable. Moreover, the algorithm predicting EQ-5D utilities from the SGRQ did not provide utility values comparable to those observed in the REVOLENS study. Indeed, our study demonstrated a strong correlation between predicted and individual EQ-5D values but no concordance.
Conclusion: The use of both the EQ-5D and the SGRQ in a clinical study with an economic component is justified. Based on our results, the SGRQ should not be used to obtain a utility score to calculate the incremental cost-effectiveness ratio and conclude on the efficiency of an intervention in emphysema patients.
Keywords: quality-of-life, St. George’s Respiratory Questionnaire, EuroQol five dimensions questionnaire, correlation, concordance
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