Validation and comparison of five preference-based measures among age-related macular degeneration patients: evidence from mainland China

Qual Life Res. 2022 May;31(5):1561-1572. doi: 10.1007/s11136-021-03047-1. Epub 2021 Dec 2.


Purpose: To compare the psychometric properties of five preference-based measures (PBMs) among patients with age-related macular degeneration (AMD) in mainland China, including three health-related quality of life (HRQoL) measures [the 15D, the Assessment of Quality of Life (AQoL)-7D, and EQ-5D-5L] and two capability wellbeing measures [the ICEpop CAPability measure for Adults (ICECAP-A) and ICECAP measure for Older people (ICECAP-O)].

Methods: A convenience sampling framework was used to successively recruit inpatients with AMD who attended a large ophthalmic hospital in Jinan, China. Psychometric properties (known-group validity, concurrent validity, and sensitivity) were assessed. The agreements between PBMs were reported.

Results: A valid sample of 210 AMD inpatients (median duration: 12 months) was analyzed. Overall, the AQoL-7D had the best performance based on the psychometric tests been conducted. Sufficient evidence was found on psychometric properties for other 2 preference-based HRQoL measures. The ICECAP-A outperformed ICECAP-O on known-group validity and concurrent validity whereas opposite results were found on sensitivity. The Bland-Altman plots indicate that there was no pair of PBMs that could be used interchangeably.

Conclusions: The AQoL-7D had shown better psychometric properties than other four PBMs based on Chinese AMD inpatients. The EQ-5D-5L demonstrated sufficient psychometric properties and given the availability of a Chinese-specific tariff and the recommendations of China guidelines for pharmacoeconomic evaluations, it may be prioritized to be used in China. Capability wellbeing instruments could also be considered given they provide information that goes beyond health. Further evidence on responsiveness and reliability for all five PBMs among AMD patients is required.

Keywords: Age-related macular degeneration; Capability wellbeing; Health-related quality of life; Preference-based assessment; Psychometric properties.

MeSH terms

  • Adult
  • Aged
  • China
  • Humans
  • Macular Degeneration*
  • Psychometrics / methods
  • Quality of Life* / psychology
  • Reproducibility of Results
  • Surveys and Questionnaires