The performance relationship between the EQ-5D-5L composite "Anxiety/Depression" dimension and anxiety and depression symptoms in a large, general population sample

Authors

• Emily Stella Scott, Erasmus University of Rotterdam
• Erica I. Lubetkin, CUNY School of MedicineFollow
• Mathieu F. Janssen, Erasmus University of Rotterdam
• John N. Yfantopolous, National and Kapodistrian University of Athens
• Gouke J. Bonsel, EuroQol Research Foundation
• Juanita A. Haagsma, Erasmus University of Rotterdam

Document Type

Article

Publication Date

9-2024

Abstract

Purpose

This cross-sectional study aims to understand the relationship between responses on the Anxiety/Depression (A/D) dimension of the EQ-5D-5L and symptoms of anxiety and depression on the GAD-7 and PHQ-9 instruments. In doing so, we investigate the comparative performance of the dimension between diagnostic groups (i.e. anxiety (GAD-7); depression (PHQ-9); anxiety & depression versus none). We additionally investigate the discriminatory performance between sub-populations based on gender, age, education and self-reported chronic conditions.

Methods

19,902 general population participants completed a health survey in May/June 2020, from five European countries and the United States. Performance of A/D was calculated using the Area Under the Receiver Operating Characteristic curve (AUROC), and was compared to having anxiety (GAD-7 ≥ 8), depression (PHQ-9 ≥ 10) and both versus none for the total population and sub-populations. Several additional sensitivity analyses were conducted, including calculations of the optimal A/D cut-off.

Results

The performance in the total sample was good (AUROC > 0.8) and did not differ significantly between diagnostic groups. The performance differed significantly between the age groups, with worse performance in the younger groups, and differed between those with a singular chronic condition, with worse performance in those indicating having an anxiety or depression disorder. The performance did not differ significantly by gender, education, nor total chronic conditions.

Conclusion

The A/D dimension captures symptoms of anxiety, depression or both equally well. Performance is worse in the younger population. Interpretation in those with a self-reported anxiety or depression disorder should be further investigated. This is the first-of-its-kind large population sample performance analysis, where we present evidence that the performance of the A/D dimension differs between ages, and thus intra-age comparative results may be flawed.

Comments

This article was originally published in Quality of Life Research, available at https://doi.org/10.1007/s11136-024-03754-5

Recommended Citation

Scott, Emily Stella; Lubetkin, Erica I.; Janssen, Mathieu F.; Yfantopolous, John N.; Bonsel, Gouke J.; and Haagsma, Juanita A., "The performance relationship between the EQ-5D-5L composite "Anxiety/Depression" dimension and anxiety and depression symptoms in a large, general population sample" (2024). CUNY Academic Works.
https://academicworks.cuny.edu/cm_pubs/6