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Measurement of the quality of life in rheumatic disorders using the EuroQol

  [ 138 votes ]   [ Discuss This Article ]
By Wolfe F, Hawley DJ • • July 5, 1997

The EuroQol is a validated quality of life (QOL) scale that
has been used in population and clinical studies, and has been
reported in patients with rheumatoid arthritis (RA). It is
short, simple to complete, and might be suitable for surveys
of rheumatic disease patients. The properties of this
instrument were investigated in a postal survey of 1372
rheumatic disease patients, including 537 with RA, 319 with
osteoarthritis (OA) and 516 with fibromyalgia. In addition,
simultaneous measurements of functional disability, pain,
psychological status, global severity and demographic
characteristics were made. EuroQol scores (0.57) were
significantly lower than VAS health state scores (0.67) and
arthritis-related global severity scores (0.62). QOL was
similar in RA and OA, but lower in fibromyalgia, across all
instruments. The distribution of EuroQol scores had many gaps
and was not continuous. EuroQol did not reflect VAS QOL scores
at EuroQol levels below 0.5, and the mean score difference
between the instruments below that level was 0.43. Many
patients with low EuroQol scores (including some with health
states that were 'worse than death') had high VAS scores.
These differences appear to have arisen because disability,
pain and depression questions ask about mild or moderate
problems, but not both, thereby forcing scale compression in
the mid ranges. In addition, the 'severe' value is so
extremely abnormal that few patients endorse it. Finally,
penalty scores are applied to those with at least one
maximally abnormal score. The scoring properties and
distributional aspects of the EuroQol indicate substantial
problems in its use in rheumatic disease patients.

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