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THE INFLUENCE OF NEUROLOGICAL DEFICITS ON THE EQ-5D DIMENSIONS
Background and Aims
The EuroQol Group 5-Dimension Self-Reported Questionnaire (EQ-5D) may not cover the full range of deficits relevant to patients with ischemic stroke, such as aphasia, dysarthria, hemianopia and neglect.We aimed to quantify and compare the influence of neurological deficits on the five dimensions of the EQ-5D in patients with ischemic stroke.
We used data of the Interventional Management of Stroke (IMS) III trial. The association between neurological deficits (NIHSS sum score and individual NIHSS item scores) and each EQ-5D dimension was assessed with univariable ordinal logistic regression. The explained variance of each model was estimated with Nagelkerke’s pseudo R2.
In total, 525 surviving patients were included in this study. The association between the NIHSS sum score and each EQ-5D dimension was statistically significant. The NIHSS sum score explained 54.2% of the variation in mobility, 60.0% in self-care, 56.9% in usual activities, 12.6% in pain/discomfort, and 9.2% in anxiety/depression. The explained variance in pain/discomfort was 0.5% for aphasia, 2.9% for dysarthria, 6.8% for sensory loss, 5.5% for hemianopia, and 2.9% for neglect.
In patients with ischemic stroke, the influence of neurological deficits on the EQ-5D dimensions mobility, self-care, and usual activities is substantial, but small on the dimensions pain/discomfort and anxiety/depression. This confirms our hypothesis that it may not be clear that discomfort caused by aphasia and neglect could be included in the dimension pain/discomfort. A small change in the way this dimension is proposed to the patient, might improve health-related quality of life assessment in stroke patients.