A comparative study of EQ-5D-5L and SF-6D scales based on patients receiving oral anticoagulant therapy

OBJECTIVE: Oral anticoagulant therapy is widely used for the prevention and treatment of thromboembolic diseases, yet it imposes significant burdens on patients’ health-related quality of life (HRQoL). This study aimed to compare the performance of two generic preference-based measures (GPBMs), the EQ-5D-5 L and SF-6D, in assessing HRQoL among patients receiving oral anticoagulant therapy, and to further explore the factors influencing their HRQoL. METHODS: A multicenter, cross-sectional survey was conducted across 14 hospitals in China. Patients receiving oral anticoagulant therapy were enrolled and completed the EQ-5D-5 L, SF-6D, anticoagulation satisfaction (assessed by DASS), health literacy (assessed by HLS-SF9), and self-efficacy (assessed by NGSES-SF). Ceiling and floor effects, the association and agreement between the two measures, known-group validity and multi-factor analysis were assessed. RESULTS: A total of 379 patients receiving oral anticoagulant therapy were included in the analysis. The mean (standard deviation) utility scores were 0.837 (0.187) for the EQ-5D-5 L and 0.729 (0.132) for SF-6D. The EQ-5D-5 L demonstrated a higher ceiling effect (21.11%) compared with SF-6D (1.32%). The Pearson’s correlation coefficient between EQ-5D-5 L and SF-6D was 0.724, and the intraclass correlation coefficient (ICC) was 0.557. Patients with higher anticoagulation satisfaction, health literacy, and self-efficacy reported significantly better quality of life. The EQ-5D-5 L showed better ability to distinguish differences in a wider range of clinical factors, including the type of thrombotic diseases, anticoagulant medications, and comorbidities, compared with the SF-6D, which only detected differences in the duration of anticoagulation, number of medications, and history of thrombotic events. CONCLUSION: Both EQ-5D-5 L and SF-6D demonstrated satisfactory construct validity in assessing patients undergoing oral anticoagulant therapy, with EQ-5D-5 L showing a higher ceiling effect and superior discriminative ability for disease-specific differentiation. Given the distinct characteristics and performance of the EQ-5D-5 L and SF-6D, these instruments should not be used interchangeably in patients receiving anticoagulant therapy. These findings offer valuable insights for optimizing HRQoL assessment and management in patients receiving oral anticoagulant therapy.