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Validity and measurement equivalence of EQ-5D-5L questionnaire among heart failure patients in Malaysia: a cohort study
Wai Chee Kuan 
,
Kok Han Chee ,
Sazzli Kasim ,
Ka Keat Lim ,
Juman Al-Dujaili ,
Kenneth Kwing-Chin Lee ,
Siew Li Teoh
,
Kok Han Chee ,
Sazzli Kasim ,
Ka Keat Lim ,
Juman Al-Dujaili ,
Kenneth Kwing-Chin Lee ,
Siew Li Teoh
Journal of Medical Economics, Volume: 27, Issue: 1, Pages: 607 - 617
Swansea University Author:
Juman Al-Dujaili
-
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DOI (Published version): 10.1080/13696998.2024.2337563
Abstract
AimThis study aimed to examine the validity of EQ-5D-5L among HFrEF patients in Malaysia, and to explore the measurement equivalence of three main language versions.MethodsWe surveyed HFrEF patients from two hospitals in Malaysia, using Malay, English or Chinese versions of EQ-5D-5L. EQ-5D-5L dimens...
| Published in: | Journal of Medical Economics |
|---|---|
| ISSN: | 1369-6998 1941-837X |
| Published: |
Informa UK Limited
2024
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| Online Access: |
Check full text
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa69432 |
| first_indexed |
2025-05-07T16:01:51Z |
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2025-06-20T04:58:18Z |
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<?xml version="1.0"?><rfc1807><datestamp>2025-06-19T13:41:24.2743671</datestamp><bib-version>v2</bib-version><id>69432</id><entry>2025-05-07</entry><title>Validity and measurement equivalence of EQ-5D-5L questionnaire among heart failure patients in Malaysia: a cohort study</title><swanseaauthors><author><sid>47d192c8bb46dd4c0cc72bbfea4210ec</sid><ORCID>0000-0002-7515-5344</ORCID><firstname>Juman</firstname><surname>Al-Dujaili</surname><name>Juman Al-Dujaili</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2025-05-07</date><deptcode>MEDS</deptcode><abstract>AimThis study aimed to examine the validity of EQ-5D-5L among HFrEF patients in Malaysia, and to explore the measurement equivalence of three main language versions.MethodsWe surveyed HFrEF patients from two hospitals in Malaysia, using Malay, English or Chinese versions of EQ-5D-5L. EQ-5D-5L dimensional scores were converted to utility scores using the Malaysian value set. A confirmatory factor analysis longitudinal model was constructed. The utility and visual analog scale (VAS) scores were evaluated for validity (convergent, known-group, responsiveness), and measurement equivalence of the three language versions.Results200 HFrEF patients (mean age = 61 years), predominantly male (74%) of Malay ethnicity (55%), completed the admission and discharge EQ-5D-5L questionnaire in Malay (49%), English (26%) or Chinese (25%) languages. 173 patients (86.5%) were followed up at 1-month post-discharge (1MPD). The standardized factor loadings and average variance extracted were ≥ 0.5 while composite reliability was ≥ 0.7, suggesting convergent validity. Patients with older age and higher New York Heart Association (NYHA) class reported significantly lower utility and VAS scores. The change in utility and VAS scores between admission and discharge was large, while the change between discharge and 1MPD was minimal. The minimal clinically important difference for utility and VAS scores was ±0.19 and ±11.01, respectively. Malay and English questionnaire were equivalent while the equivalence of Malay and Chinese questionnaire was inconclusive.LimitationThis study only sampled HFrEF patients from two teaching hospitals, thus limiting the generalizability of results to the entire heart failure population.ConclusionEQ-5D-5L is a valid questionnaire to measure health-related quality of life and estimate utility values among HFrEF patients in Malaysia. The Malay and English versions of EQ-5D-5L appear equivalent for clinical and economic assessments.</abstract><type>Journal Article</type><journal>Journal of Medical Economics</journal><volume>27</volume><journalNumber>1</journalNumber><paginationStart>607</paginationStart><paginationEnd>617</paginationEnd><publisher>Informa UK Limited</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>1369-6998</issnPrint><issnElectronic>1941-837X</issnElectronic><keywords>Heart failure; health-relatedquality of life; validity;responsiveness; measure-ment equivalence; EQ-5D</keywords><publishedDay>31</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2024</publishedYear><publishedDate>2024-12-31</publishedDate><doi>10.1080/13696998.2024.2337563</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>None</funders><projectreference/><lastEdited>2025-06-19T13:41:24.2743671</lastEdited><Created>2025-05-07T10:25:36.3670557</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Pharmacy</level></path><authors><author><firstname>Wai Chee</firstname><surname>Kuan</surname><orcid>0000-0002-6243-1194</orcid><order>1</order></author><author><firstname>Kok Han</firstname><surname>Chee</surname><orcid>0000-0002-4485-0504</orcid><order>2</order></author><author><firstname>Sazzli</firstname><surname>Kasim</surname><orcid>0000-0003-4585-7713</orcid><order>3</order></author><author><firstname>Ka Keat</firstname><surname>Lim</surname><orcid>0000-0002-2340-4097</orcid><order>4</order></author><author><firstname>Juman</firstname><surname>Al-Dujaili</surname><orcid>0000-0002-7515-5344</orcid><order>5</order></author><author><firstname>Kenneth Kwing-Chin</firstname><surname>Lee</surname><orcid>0000-0002-2583-0030</orcid><order>6</order></author><author><firstname>Siew Li</firstname><surname>Teoh</surname><orcid>0000-0003-4163-7895</orcid><order>7</order></author></authors><documents><document><filename>69432__34524__66cf84999e304586ac146254e7ad2f02.pdf</filename><originalFilename>69432.VoR.pdf</originalFilename><uploaded>2025-06-19T13:33:01.0330868</uploaded><type>Output</type><contentLength>1969017</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© 2024 The Author(s). 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| spelling |
2025-06-19T13:41:24.2743671 v2 69432 2025-05-07 Validity and measurement equivalence of EQ-5D-5L questionnaire among heart failure patients in Malaysia: a cohort study 47d192c8bb46dd4c0cc72bbfea4210ec 0000-0002-7515-5344 Juman Al-Dujaili Juman Al-Dujaili true false 2025-05-07 MEDS AimThis study aimed to examine the validity of EQ-5D-5L among HFrEF patients in Malaysia, and to explore the measurement equivalence of three main language versions.MethodsWe surveyed HFrEF patients from two hospitals in Malaysia, using Malay, English or Chinese versions of EQ-5D-5L. EQ-5D-5L dimensional scores were converted to utility scores using the Malaysian value set. A confirmatory factor analysis longitudinal model was constructed. The utility and visual analog scale (VAS) scores were evaluated for validity (convergent, known-group, responsiveness), and measurement equivalence of the three language versions.Results200 HFrEF patients (mean age = 61 years), predominantly male (74%) of Malay ethnicity (55%), completed the admission and discharge EQ-5D-5L questionnaire in Malay (49%), English (26%) or Chinese (25%) languages. 173 patients (86.5%) were followed up at 1-month post-discharge (1MPD). The standardized factor loadings and average variance extracted were ≥ 0.5 while composite reliability was ≥ 0.7, suggesting convergent validity. Patients with older age and higher New York Heart Association (NYHA) class reported significantly lower utility and VAS scores. The change in utility and VAS scores between admission and discharge was large, while the change between discharge and 1MPD was minimal. The minimal clinically important difference for utility and VAS scores was ±0.19 and ±11.01, respectively. Malay and English questionnaire were equivalent while the equivalence of Malay and Chinese questionnaire was inconclusive.LimitationThis study only sampled HFrEF patients from two teaching hospitals, thus limiting the generalizability of results to the entire heart failure population.ConclusionEQ-5D-5L is a valid questionnaire to measure health-related quality of life and estimate utility values among HFrEF patients in Malaysia. The Malay and English versions of EQ-5D-5L appear equivalent for clinical and economic assessments. Journal Article Journal of Medical Economics 27 1 607 617 Informa UK Limited 1369-6998 1941-837X Heart failure; health-relatedquality of life; validity;responsiveness; measure-ment equivalence; EQ-5D 31 12 2024 2024-12-31 10.1080/13696998.2024.2337563 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee None 2025-06-19T13:41:24.2743671 2025-05-07T10:25:36.3670557 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Pharmacy Wai Chee Kuan 0000-0002-6243-1194 1 Kok Han Chee 0000-0002-4485-0504 2 Sazzli Kasim 0000-0003-4585-7713 3 Ka Keat Lim 0000-0002-2340-4097 4 Juman Al-Dujaili 0000-0002-7515-5344 5 Kenneth Kwing-Chin Lee 0000-0002-2583-0030 6 Siew Li Teoh 0000-0003-4163-7895 7 69432__34524__66cf84999e304586ac146254e7ad2f02.pdf 69432.VoR.pdf 2025-06-19T13:33:01.0330868 Output 1969017 application/pdf Version of Record true © 2024 The Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License. true eng http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| title |
Validity and measurement equivalence of EQ-5D-5L questionnaire among heart failure patients in Malaysia: a cohort study |
| spellingShingle |
Validity and measurement equivalence of EQ-5D-5L questionnaire among heart failure patients in Malaysia: a cohort study Juman Al-Dujaili |
| title_short |
Validity and measurement equivalence of EQ-5D-5L questionnaire among heart failure patients in Malaysia: a cohort study |
| title_full |
Validity and measurement equivalence of EQ-5D-5L questionnaire among heart failure patients in Malaysia: a cohort study |
| title_fullStr |
Validity and measurement equivalence of EQ-5D-5L questionnaire among heart failure patients in Malaysia: a cohort study |
| title_full_unstemmed |
Validity and measurement equivalence of EQ-5D-5L questionnaire among heart failure patients in Malaysia: a cohort study |
| title_sort |
Validity and measurement equivalence of EQ-5D-5L questionnaire among heart failure patients in Malaysia: a cohort study |
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47d192c8bb46dd4c0cc72bbfea4210ec_***_Juman Al-Dujaili |
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Juman Al-Dujaili |
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Wai Chee Kuan Kok Han Chee Sazzli Kasim Ka Keat Lim Juman Al-Dujaili Kenneth Kwing-Chin Lee Siew Li Teoh |
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Journal of Medical Economics |
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1369-6998 1941-837X |
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10.1080/13696998.2024.2337563 |
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Informa UK Limited |
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AimThis study aimed to examine the validity of EQ-5D-5L among HFrEF patients in Malaysia, and to explore the measurement equivalence of three main language versions.MethodsWe surveyed HFrEF patients from two hospitals in Malaysia, using Malay, English or Chinese versions of EQ-5D-5L. EQ-5D-5L dimensional scores were converted to utility scores using the Malaysian value set. A confirmatory factor analysis longitudinal model was constructed. The utility and visual analog scale (VAS) scores were evaluated for validity (convergent, known-group, responsiveness), and measurement equivalence of the three language versions.Results200 HFrEF patients (mean age = 61 years), predominantly male (74%) of Malay ethnicity (55%), completed the admission and discharge EQ-5D-5L questionnaire in Malay (49%), English (26%) or Chinese (25%) languages. 173 patients (86.5%) were followed up at 1-month post-discharge (1MPD). The standardized factor loadings and average variance extracted were ≥ 0.5 while composite reliability was ≥ 0.7, suggesting convergent validity. Patients with older age and higher New York Heart Association (NYHA) class reported significantly lower utility and VAS scores. The change in utility and VAS scores between admission and discharge was large, while the change between discharge and 1MPD was minimal. The minimal clinically important difference for utility and VAS scores was ±0.19 and ±11.01, respectively. Malay and English questionnaire were equivalent while the equivalence of Malay and Chinese questionnaire was inconclusive.LimitationThis study only sampled HFrEF patients from two teaching hospitals, thus limiting the generalizability of results to the entire heart failure population.ConclusionEQ-5D-5L is a valid questionnaire to measure health-related quality of life and estimate utility values among HFrEF patients in Malaysia. The Malay and English versions of EQ-5D-5L appear equivalent for clinical and economic assessments. |
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2024-12-31T05:34:19Z |
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