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Background <p>Expanding follow-up services for survivors of critical illness requires short and reliable instrument sets. The WHO Disability Assessment Schedule (WHODAS) 2.0 and the EuroQol 5-Dimensions 5-Level (EQ-5D-5L) are recommended to assess disability and health-related quality of life (HrQoL), respectively. As they may measure partially overlapping constructs, we assessed their relationship.</p> Methods <p>We conducted a secondary analysis of the multicenter cluster-randomized controlled Enhanced Recovery after Intensive Care (ERIC) trial (ClinicalTrials.gov: NCT03671447). At follow-ups scheduled 6&#xa0;months after ICU discharge, critical illness survivors and caregivers completed the EQ-5D-5L, the patient-reported and the&#xa0;proxy-reported 12-item WHODAS 2.0. We employed local polynomial regressions, correlation coefficients,&#xa0;and linear regressions to analyze the global and domain-specific relationships between the EQ-5D-5L and the WHODAS 2.0.</p> Results <p>We analyzed 700 patients with a median EQ-5D-5L index value of 0.81 [IQR 0.52 to 0.94], a median patient-reported WHODAS 2.0 sum score of 11 [IQR 3 to 23], and a median proxy-reported WHODAS 2.0 sum score of 16 [IQR 6 to 28]. The EQ-5D-5L index value highly correlated with patient-reported (Spearman: − 0.84 [95% CI − 0.86 to − 0.82]) and proxy-reported (Spearman: − 0.70 [− 0.76 to − 0.64]) WHODAS 2.0 sum scores. Corresponding domains were also highly correlated, with the patient-reported WHODAS 2.0 aligning more closely with the EQ-5D-5L than the proxy-reported WHODAS 2.0. We found ceiling and floor effects for both instruments, indicating limitations for detecting mild disabilities and high HrQoL. In multivariable linear&#xa0;regressions, the patient-reported and proxy-reported WHODAS 2.0 sum scores (both − 0.02 [95% CI − 0.02 to − 0.02], <i>p</i> &lt; 0.01) and WHODAS 2.0 domain scores for mobility, self-care, and life activities were predictors of the EQ-5D-5L index value and respective EQ-5D-5L domain scores.</p> Conclusions <p>Our results suggest a high correlation between the patient-reported and proxy-reported WHODAS 2.0 and the EQ-5D-5L, particularly in their corresponding domains. To economize post-ICU assessments, there may be no need to use both instruments simultaneously.</p>

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Health-related quality of life correlates with patient-reported and proxy-reported disability in critical illness survivors: a secondary analysis of the ERIC trial

  • 期刊论文

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  • 发表日期：

    2025年4月23日

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  • Elena Ribet Buse,
  • Julius J. Grunow,
  • Claudia D. Spies,
  • Björn Weiss,
  • Nicolas Paul

摘要

Background

Expanding follow-up services for survivors of critical illness requires short and reliable instrument sets. The WHO Disability Assessment Schedule (WHODAS) 2.0 and the EuroQol 5-Dimensions 5-Level (EQ-5D-5L) are recommended to assess disability and health-related quality of life (HrQoL), respectively. As they may measure partially overlapping constructs, we assessed their relationship.

Methods

We conducted a secondary analysis of the multicenter cluster-randomized controlled Enhanced Recovery after Intensive Care (ERIC) trial (ClinicalTrials.gov: NCT03671447). At follow-ups scheduled 6 months after ICU discharge, critical illness survivors and caregivers completed the EQ-5D-5L, the patient-reported and the proxy-reported 12-item WHODAS 2.0. We employed local polynomial regressions, correlation coefficients, and linear regressions to analyze the global and domain-specific relationships between the EQ-5D-5L and the WHODAS 2.0.

Results

We analyzed 700 patients with a median EQ-5D-5L index value of 0.81 [IQR 0.52 to 0.94], a median patient-reported WHODAS 2.0 sum score of 11 [IQR 3 to 23], and a median proxy-reported WHODAS 2.0 sum score of 16 [IQR 6 to 28]. The EQ-5D-5L index value highly correlated with patient-reported (Spearman: − 0.84 [95% CI − 0.86 to − 0.82]) and proxy-reported (Spearman: − 0.70 [− 0.76 to − 0.64]) WHODAS 2.0 sum scores. Corresponding domains were also highly correlated, with the patient-reported WHODAS 2.0 aligning more closely with the EQ-5D-5L than the proxy-reported WHODAS 2.0. We found ceiling and floor effects for both instruments, indicating limitations for detecting mild disabilities and high HrQoL. In multivariable linear regressions, the patient-reported and proxy-reported WHODAS 2.0 sum scores (both − 0.02 [95% CI − 0.02 to − 0.02], p < 0.01) and WHODAS 2.0 domain scores for mobility, self-care, and life activities were predictors of the EQ-5D-5L index value and respective EQ-5D-5L domain scores.

Conclusions

Our results suggest a high correlation between the patient-reported and proxy-reported WHODAS 2.0 and the EQ-5D-5L, particularly in their corresponding domains. To economize post-ICU assessments, there may be no need to use both instruments simultaneously.