Responsiveness of the EQ-5D in patients with proximal humeral fractures

Background This study evaluated the internal and external responsiveness of the EuroQol EQ-5D (EuroQol Group, Rotterdam, The Netherlands) health status component, defined as the instrument’s ability to capture clinically important changes in patients with a proximal humeral fracture within the context of a prospective study. Materials and methods To evaluate the internal responsiveness of the EQ-5D, the observed change and the standardized response mean (SRM) in relation to the change in the EQ-5D index score were calculated. To calculate external responsiveness, an external criterion (EC) was constructed by using the Disabilities of the Arm, Shoulder and Hand (DASH) score. Receiver operating characteristic (ROC) curves and logistic regression analysis were used in the evaluation. Results The mean change score from prefracture status to the 4-month follow-up for the EQ-5D was −20.9 and the corresponding SRM was 0.90, indicating good internal responsiveness. The clearly improved or clearly deteriorated patients according to the EC (DASH) reported change scores of approximately 12 points in the EQ-5D, corresponding to moderately strong SRMs, which, together with the results of the ROC analyses and logistic regression, indicated a good external responsiveness. Conclusion The EQ-5D displayed good internal and external responsiveness in patients with proximal humeral fractures and can be recommended for use as a quality of life measure in patients with this particular injury.