Psychometric Validation of EQ-5D-5L in Individuals With Chronic Spinal Cord Injury in China

The EQ-5D is a brief measure for assessing health-related quality of life (HRQoL), but chronic spinal cord injury (CSCI) related psychometric evaluation of the EQ-5D-5L has not been explored. We conducted a validation study on the Chinese version of the EQ-5D-5L for individuals with CSCI in China. A cross-sectional study was conducted in the Shanghai Sunshine Rehabilitation Center. The floor and ceiling effects, internal consistency, test and retest reliability, discriminatory power (only for EQ-5D-5L), convergent validity (using Spearman correlation coefficients), and known-group validity of the EQ-5D-5L and visual analog scale (VAS) were analyzed. A total of 271 individuals with CSCI were included in analysis. The mean (SD) utility and VAS scores were 0.46 (0.31) and 66.8 (20.3), respectively, and they showed no floor or ceiling effects. The EQ-5D-5L demonstrated acceptable internal consistency (Cronbach's α = 0.84) and test-retest reliability. The average Shannon index (H') and Shannon Evenness index (J') of the EQ-5D-5L were 2.01 and 0.86, respectively. Satisfactory convergent validity was shown by the correlation analysis among the 5 EQ-5D-5L dimensions, EQ-5D-5L utility, EQ-VAS, the World Health Organization quality-of-life scale brief version, 7-item generalized anxiety disorder scale (GAD-7), 9-item patient health questionnaire (PHQ-9), and General Self-Efficacy Scale (GSES). Utility and VAS scores showed the predicted pattern among a priori known groups, with effect sizes ranging from 0.06 to 0.72 for the EQ-5D-5L, and 0.02 to 1.08 for the VAS. The EQ-5D-5L is a reliable and valid measure of HRQoL for individuals with CSCI in China.