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Psychometric properties of SF-36, EQ-5D, and HADS in patients with chronic pain.
Dalarna University, School of Education, Health and Social Studies, Medical Science. Karolinska Institutet; Center for Clinical Research Dalarna - Uppsala University, Falun.ORCID iD: 0000-0001-7767-4589
Dalarna University, School of Education, Health and Social Studies, Medical Science.ORCID iD: 0000-0002-6923-7140
2019 (English)In: Pain, ISSN 0304-3959, E-ISSN 1872-6623Article in journal (Refereed) Epub ahead of print
Abstract [en]

Recent research has highlighted a need for the psychometric evaluation of instruments targeting core domains of the pain experience in chronic pain populations. In this study, the measurement properties of SF-36, EQ-5D, and HADS were analyzed within the item response-theory framework based on data from 35,908 patients. To assess the structural validity of these instruments, the empirical representations of several conceptually substantiated latent structures were compared in a cross-validation procedure. The most structurally sound representations were selected from each questionnaire and their internal consistency reliability computed as a summary of their precision. Lastly, questionnaire scores were correlated to each other to evaluate their convergent and discriminant validity. Our results supported that SF-36 is an acceptable measure of two independent constructs of physical and mental health. In contrast, although the approach to summarize the HRQoL construct of EQ-5D as a unidimensional score was valid, its low reliability rendered practical model implementation of doubtful utility. Finally, rather than being separated into two subscales of anxiety and depression, HADS was a valid and reliable measure of overall emotional distress. In support of convergent and discriminant validity, correlations between questionnaires showed that theoretically similar traits were highly associated whereas unrelated traits were not. Our models can be applied to score SF-36 and HADS in chronic pain patients, but we recommend against using the EQ-5D model due to its low reliability. These results are useful for researchers and clinicians involved in chronic pain populations, as questionnaires' properties determine their discriminating ability in patient status assessment.

Place, publisher, year, edition, pages
2019.
National Category
Clinical Medicine
Research subject
Health and Welfare
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URN: urn:nbn:se:du-31009DOI: 10.1097/j.pain.0000000000001700PubMedID: 31568237OAI: oai:DiVA.org:du-31009DiVA, id: diva2:1362727
Available from: 2019-10-21 Created: 2019-10-21 Last updated: 2019-10-21

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