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Validation of the EuroQol questionnaire in cardiac rehabilitation
  1. B Schweikert1,*,
  2. H Hahmann2,
  3. R Leidl1,*
  1. 1Ludwig-Maximilians University, Munich School of Management, Health Economics and Management, Munich, Germany
  2. 2Schwabenlandklinik, Isny-Neutrauchburg, Germany
  1. Correspondence to:
    Bernd Schweikert
    MSc, Ludwig-Maximilians University, Munich School of Management, Health Economics and Management, Ludwigstraße 28 RG, D-80539 Munich, Germany; schweikert{at}


Objective: To analyse the psychometric properties of the EuroQol questionnaire (EQ-5D) applied to patients with acute coronary syndromes (ACS).

Setting: Rehabilitation hospital.

Patients and design: 106 consecutive patients with ACS (51% myocardial infarction, 42% coronary artery bypass grafting, 7% angina) completed the EQ-5D, the 36 item short form health survey (SF-36), and the MacNew questionnaire at admission, at discharge, and three months after inpatient cardiac rehabilitation. Acceptance, validity, reliability, and responsiveness of the EQ-5D were tested.

Results: The EQ-5D was highly accepted. The EQ-5D index showed substantial ceiling effects after rehabilitation. As expected the EQ-5D visual analogue scale (VAS) score (70.3 v 57.1) and EQ-5D index (77.8 v 64.5) were significantly better for patients with myocardial infarction than for patients who underwent surgery (both p ⩽ 0.001). Significant correlations were found between the EQ-5D VAS score, EQ-5D index, and domains of the SF-36 (r  =  0.21 to r  =  0.74). The correlation with the MacNew subscores and with the global score ranged between 0.55 and 0.78. With repeated measurement the EQ-5D showed reasonable reliability in stable patients with intraclass correlation ranging between 0.91 and 0.54. EQ-5D was responsive in patients who indicated improvement in health states between admission and discharge (effect size 0.74–0.82).

Conclusion: The psychometric properties of the EQ-5D were satisfying. It is a reasonably valid, reliable, and responsive instrument for patients with ACS. It may be useful in clinical research and epidemiological studies to generate preference based valuations of health related quality life.

  • ACS, acute coronary syndromes
  • EQ-5D, EuroQol questionnaire
  • HRQoL, health related quality of life
  • MI, myocardial infarction
  • NYHA, New York Heart Association
  • SF-36, 36 item short form health survey
  • VAS, visual analogue scale
  • cardiac rehabilitation
  • quality of life
  • EuroQol questionnaire
  • EQ-5D

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  • * Also the GSF National Research Centre for Environment and Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany

  • Published Online First 29 March 2005

  • Conflicting interest statement: We hereby declare that there are no conflicting interests for any of the authors of this manuscript.