Comparing EQ-5D-5L and SF-6Dv2 in Measuring Health Status of People Living With HIV/AIDS in China

OBJECTIVES: To compare measurement properties of EuroQol Five Dimensions Questionnaire (EQ-5D-5L) and Short Form Six-Dimension (SF-6Dv2) among people living with HIV/AIDS (PLWHA) in China.

METHODS: All PLWHA were recruited from two hospitals in Jinan and Qingdao, Shandong Province, China from November 2023 to January 2024. The existing Chinese-specific value sets of EQ-5D-5L and SF-6Dv2 were used to calculate the health utility scores (HUS) . The agreement of HUSs was evaluated by intraclass correlation coefficient (ICC) and Bland-Altman plot. Convergent validity of HUSs and similar dimensions were assessed using Spearman’s correlation coefficient. Known-group validity of the HUSs and EQ-VAS scores was assessed by comparing the scores of PLWHA at different infection stages, and the scores of PLWHA with and without comorbidities. Additionally, factors affecting HUS difference were explored with Tobit regression analysis.

RESULTS: 313 respondents (94.3% males, mean age 38.12±11.09 years, 9% CD4<200 cells/mm³) completed paper-based measures during face-to-face interviews. 48.24% of respondents reported no problems on all dimensions of EQ-5D-5L, whilst 10.22% in SF-6Dv2. The strong correlation and agreement between two measures was observed according to Spearman’s rank correlation (0.71) and ICC (0.74). Bland-Altman plot indicated that HUSs were generally higher in EQ-5D-5L, and the mean HUS was higher in EQ-5D-5L than in SF-6Dv2 (0.92 vs 0.78). Tobit regression showed that socioeconomic and clinical factors had a significant influence on the difference in HUSs (P< 0.05) . Meanwhile, strong correlation was detected for two similar dimensions (Pain/Discomfort of EQ-5D and Pain of SF-6D; Anxiety/Depression of EQ-5D and Mental Health of SF-6D). All the three scores could discriminate the difference in the known-groups. Both HUSs were more sensitive than EQ-VAS score.

CONCLUSIONS: Both EQ-5D-5L and SF-6Dv2 HUSs have acceptable measurement properties among PLWHA in China. Nevertheless, they may not be interchangeable given the systematic difference in HUSs between the EQ-5D-5L and SF-6Dv2.