Construct validity of the EQ-5D in low-income Chinese American primary care patients Erica I. Lubetkin 1 , Haomiao Jia 2 & Marthe R. Gold 1 1 Department of Community Health and Social Medicine, CUNY Medical School 138th Street and Convent Avenue, Harris Hall – Fourth Floor, New York, NY (E-mail: lubetkin@med.cuny.edu); 2 Department of Community Medicine, Mercer University School of Medicine, 1550 College Street, Macon, GA, USA Accepted in revised form 18 December 2003 Abstract Objectives: Although the EQ-5D has been used with increasing frequency to measure health-related quality of life, to date, the measure’s validity has not been examined in Chinese American immigrants. We eval- uated the construct validity of the EQ-5D by testing its performance with respect to sociodemographic and clinical characteristics of the population and comparing responses on the EQ dimensions with the SF-36 subscales. Methods: The study surveyed low-income Chinese patients attending a community health center in New York City’s Chinatown. Participants received self-administered versions of the EQ-5D and SF-36 and additional questions regarding demographic and clinical information. Results: 856 patients were approached and data were collected from 523 patients (61%). Analysis of the EQ-5D responses by socio- demographic and clinical variables found significant differences among categories of age, gender, marital status, number of medical problems, self-rated health, and specific medical problems. Correlations between similar dimensions and subscale scores were stronger between the two measures than dissimilar ones. Patients without impairments on a given EQ dimension tended to have higher SF-36 subscale scores than patients reporting ‘any’ impairment (i.e. some/moderate or severe). Conclusions: The results provide initial support for the construct validity of the EQ-5D in our sample. Further studies should compare the performance of the EQ-5D with other preference-based measures in Chinese persons and examine the valuations that both low-income and Chinese persons place on core aspects of health. Key words: Asian-Americans, Health status, Primary care, Socioeconomic status, Survey Introduction Measures of health status and health-related quality of life (HRQL) have been used with increasing frequency to monitor the health of individuals and populations. Although these instruments may share a broadly similar goal, i.e. measuring self-rated health, the architects of the measures have pursued different emphases in the domains of health that they cover, in the range of function that they inquire about, and in the spe- cific objectives of particular measures. For exam- ple, some measures are conceived of as monitoring clinical changes, while others seek to measure the health of populations [1, 2]. Measures such as the Medical Outcomes Study 36-item Short Form (SF-36) Health Survey [3], a health profile designed primarily for monitoring clinical outcomes, yield separate scores for differ- ent areas or components of health. By contrast, preference-based measures permit all surveyed domains of health to be combined into a single number, making them useful for cost-effectiveness analyses [4, 5]. Many of these measures have been translated into multiple languages and adminis- tered in populations with markedly varied Quality of Life Research 13: 1459–1468, 2004. Ó 2004 Kluwer Academic Publishers. Printed in the Netherlands. 1459