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      Comparing the EQ-5D-3 L and EQ-5D-5 L: studying measurement and scores in Indonesian type 2 diabetes mellitus patients

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          Abstract

          Background

          The EuroQoL five-dimensional instrument (EQ-5D) is the favoured preference-based instrument to measure health-related quality of life (HRQoL) in several countries. Two versions of the EQ-5D are available: the 3-level version (EQ-5D-3 L) and the 5-level version (EQ-5D-5 L). This study aims to compare specific measurement properties and scoring of the EQ-5D-3 L (3 L) and EQ-5D-5 L (5 L) in Indonesian type 2 diabetes mellitus (T2DM) outpatients.

          Methods

          A survey was conducted in a hospital and two primary healthcare centres on Sulawesi Island. Participants were asked to complete the two versions of the EQ-5D instruments. The 3 L and 5 L were compared in terms of distribution and ceiling, discriminative power and test-retest reliability. To determine the consistency of the participants’ answers, we checked the redistribution pattern, i.e., the consistency of a participant’s scores in both versions.

          Results

          A total of 198 T2DM outpatients (mean age 59.90 ± 11.06) completed the 3 L and 5 L surveys. A total of 46 health states for 3 L and 90 health states for 5 L were reported. The ‘11121’ health state was reported most often: 17% in the 3 L and 13% in the 5 L. The results suggested a lower ceiling effect for 5 L (11%) than for 3 L (15%). Regarding redistribution, only 6.1% of responses were found to be inconsistent in this study. The 5 L had higher discriminative power than the 3 L version. Reliability as reflected by the index score was 0.64 for 3 L and 0.74 for 5 L. Pain/discomfort was the dimension mostly affected, whereas the self-care dimension was the least affected.

          Conclusions

          This study suggests that the 5 L-version of the EQ-5D instrument performs better than the 3 L-version in T2DM outpatients in Indonesia, regarding measurement and scoring properties. As such, our study supports the use of the 5 L as the preferred health-related quality of life measurement tool.

          We did not do a trial but this study was approved by the Medical Ethics Committee of Universitas Gadjah Mada Yogyakarta, Indonesia (document number KE/FK/1188/EC, 12 November 2014, amended 16 March 2015).

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          Most cited references 15

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          Faeco-prevalence of Campylobacter jejuni in urban wild birds and pets in New Zealand

          Background Greater attention has been given to Campylobacter jejuni (C. jejuni) prevalence in poultry and ruminants as they are regarded as the major contributing reservoirs of human campylobacteriosis. However, relatively little work has been done to assess the prevalence in urban wild birds and pets in New Zealand, a country with the highest campylobacteriosis notification rates. Therefore, the aim of the study was to assess the faeco-prevalence of C. jejuni in urban wild birds and pets and its temporal trend in the Manawatu region of New Zealand. Findings A repeated cross-sectional study was conducted from April 2008 to July 2009, where faecal samples were collected from 906 ducks, 835 starlings, 23 Canadian goose, 2 swans, 2 pied stilts, 498 dogs and 82 cats. The faeco-prevalence of C. jejuni was 20% in ducks, 18% in starlings, 9% in Canadian goose, 5% in dogs and 7% in cats. The faeco-prevalence of C. jejuni was relatively higher during warmer months of the year in ducks, starlings and dogs while starlings showed increased winter prevalence. No such trend could be assessed in Canadian goose, swans, pied stilts and cats as samples could not be collected for the entire study period from these species. Conclusions This study estimated the faeco-prevalence of C. jejuni in different animal species where the prevalence was relatively high during warmer months in general. However, there was relative increase in winter prevalence in starlings. The urban wild bird species and pets may be considered potential risk factors for human campylobacteriosis in New Zealand, particularly in small children.
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            From translation to version management: a history and review of methods for the cultural adaptation of the EuroQol five-dimensional questionnaire.

            The EuroQol five-dimensional (EQ-5D) questionnaire is used worldwide as a patient-reported outcome (PRO) instrument for the measurement and valuation of health. Several variants of the instrument now exist, including versions with three and five levels of severity and one for respondents aged 8 to 14 years. From the outset, a demand for new language versions of the EQ-5D questionnaire meant that there was a need to implement standardized procedures, which ensured that such versions were produced following international recommendations for the cultural adaptation of patient-reported outcomes. The availability of new variants and formats of the instrument, such as telephone-administered or electronic formats, complicated the task of providing and controlling the quality of cultural adaptations. Although cultural adaptations of the instrument are widely used, the procedures currently used to produce them have not been widely disseminated. The present article therefore describes the evolution of the production of other language versions of the instrument from the earliest days of simultaneous production and translation of the EQ-5D questionnaire to the more recent, broader-based strategy of version management. We describe current adaptation procedures and innovations within those procedures. We also describe how version management is organized within the EuroQol Group, review aspects related to quality control, and provide an overview of the number of currently available language versions for each variant of the EQ-5D questionnaire: three-level, five-level, and youth versions. We conclude by discussing some of the relevant issues related to cultural adaptation for frequently used instruments such as the EQ-5D questionnaire. © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Published by International Society for Pharmacoeconomics and Outcomes Research (ISPOR) All rights reserved.
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              Health Related Quality of Life in Patients with Type 2 Diabetes Mellitus in Iran: A National Survey

              Introduction The aim of this study was to measure health-related quality of life (HRQoL) in Iranian people with Type 2 Diabetes Mellitus using two different measures and examines which socio-demographic and diabetes-related characteristics are associated with better quality of life based on a nationally distributed sample. Methods A multi-stage cluster sampling method was used to select 3472 subjects as a part of Iranian surveillance of risk factors of non-communicable disease (ISRFNCD). EuroQol-5 Dimensions questionnaire (EQ-5D) and Visual Analog Scale (VAS) were employed to measure HRQoL. Binary logistic and Tobit regression models were used to investigate factors associated with EQ-5D results. Results The mean age of subjects was 59.4 years (SD = 11.7), 61.3% were female and had 8.08 years (SD = 6.7) known duration of diabetes. The patients reported “some or extreme problems” most frequently in Pain/Discomfort (69.3%) and Anxiety/Depression (56.6%) dimensions of EQ-5D. The mean EQ-5D and VAS score were 0.70 (95% CI 0.69–0.71) and 56.8 (95% CI 56.15–57.5) respectively. Female gender, lower education, unemployment, long duration of diabetes, diabetes-related hospitalization in past years and having nephropathy and lower extremity lesions were associated with higher probabilities of reporting “some or extreme problems” in most dimensions of EQ-5D in binary logistic regression models. The same factors in addition to retinopathy were significantly associated with lower levels of HRQoL in Tobit regression analysis too. Conclusions The study findings indicate that patients with diabetes in Iran suffer from relatively poor HRQoL. Therefore much more attention should be paid to main determinants of HRQoL to identify and implement appropriate policies for achieving better management of diabetes and ultimately improving the quality of life of diabetic patients in this region.
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                Author and article information

                Contributors
                bustanul.arifin.ury@gmail.com , ury.bustanul.arifin@gmail.com , b.arifin@rug.nl
                Journal
                Health Qual Life Outcomes
                Health Qual Life Outcomes
                Health and Quality of Life Outcomes
                BioMed Central (London )
                1477-7525
                7 February 2020
                7 February 2020
                2020
                : 18
                Affiliations
                [1 ]GRID grid.4494.d, ISNI 0000 0000 9558 4598, Department of Health Sciences, , University of Groningen, University Medical Center Groningen, University of Groningen, Hanzeplein 1, ; Groningen, 9700 RB The Netherlands
                [2 ]GRID grid.412001.6, ISNI 0000 0000 8544 230X, Faculty of Pharmacy, , Hasanuddin University, ; Makassar, Indonesia
                [3 ]Institute of Science in Healthy Ageing & healthcaRE (SHARE), University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands
                [4 ]Disease Prevention and Control Division, Banggai Laut Regency Health, Population Control and Family Planning Service, Central Sulawesi, Indonesia (Bidang Pencegahan dan Pengendalian Penyakit, Dinas Kesehatan, Pengendalian Penduduk & Keluarga Berencana, Pemerintah Daerah Kabupaten Banggai Laut, Jl. Jogugu Zakaria No. 1, Banggai, Sulawesi Tengah, Indonesia
                [5 ]GRID grid.4830.f, ISNI 0000 0004 0407 1981, Unit of Pharmacotherapy, Epidemiology & Economics (PTE2), Department of Pharmacy, , University of Groningen, ; Groningen, The Netherlands
                [6 ]GRID grid.11553.33, ISNI 0000 0004 1796 1481, Department of Developmental Psychology, , Faculty of Psychology, Universitas Padjadjaran, ; Jatinangor, Indonesia
                [7 ]GRID grid.443684.9, Faculty of Pharmacy, , Universitas Muslim Indonesia, ; Makassar, Sulawesi Selatan Indonesia
                [8 ]Pharmacy Department, Ibnu Sina Hospital, Makassar, Sulawesi Selatan Indonesia
                [9 ]GRID grid.412001.6, ISNI 0000 0000 8544 230X, Division of Endocrinology and Metabolism, Department of Internal Medicine Faculty of Medicine Hasanuddin University Makassar, ; Makassar, Indonesia
                [10 ]GRID grid.8570.a, Department of Pharmacology and Therapy, Faculty of Medicine, Public Health and Nursing, , Universitas Gadjah Mada, ; Yogyakarta, Indonesia
                [11 ]GRID grid.8570.a, Clinical Epidemiology and Biostatsitic Unit, Faculty of Medicine, Public Health and Nursing, , Universitas Gadjah Mada, ; Yogyakarta, Indonesia
                [12 ]Department of Epidemiology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
                [13 ]GRID grid.4830.f, ISNI 0000 0004 0407 1981, Department of Economics, Econometrics & Finance, Faculty of Economics & Business, , University of Groningen, ; Groningen, The Netherlands
                [14 ]GRID grid.440745.6, Department of Pharmacology and Therapy, Faculty of Medicine, , Universitas Airlangga, ; Surabaya, Indonesia
                Article
                1282
                10.1186/s12955-020-1282-y
                7006062
                32028954
                © The Author(s). 2020

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                Funding
                Funded by: Beasiswa Pendidikan Indonesia (BPI)/ LPDP (the Indonesian Endowment Fund for Education, Ministry of Finance of Republic of Indonesia)
                Award ID: 20130821080334
                Award Recipient :
                Funded by: University of Groningen in the Netherlands.
                Award ID: 134502
                Award Recipient :
                Funded by: Beasiswa Pendidikan Indonesia (BPI)/ LPDP (the Indonesian Endowment Fund for Education, Ministry of Finance of Republic of Indonesia)
                Award ID: 20130821080334
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100001721, Rijksuniversiteit Groningen;
                Award ID: project code 134502
                Award Recipient :
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                Health & Social care

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