Reliability and validity of EuroQol-5 Dimensions-5 Levels in patients with haematologic malignancies: a cross-sectional study in China.

TTO utility scores varied across the three haematologic malignancy groups, with acute leukaemia patients scoring highest.

• TTO utility scores were highest in AL (0.798), followed by lymphoma (0.755) and MM (0.693).
• The study enrolled 158 patients consecutively admitted to a leading tertiary care hospital in China between January and August 2024.
• Patient groups comprised MM (n=50), AL (n=63), and lymphoma (n=45).

EQ-5D utility values were consistently higher than TTO utility scores across all three patient groups.

• This pattern of EQ-5D overestimation relative to TTO was observed in MM, AL, and lymphoma groups.
• TTO-elicited utility scores were used as the reference standard for criterion validity assessment.
• The study used a cross-sectional observational design to assess HRQoL using both EQ-5D and TTO instruments.

EQ-5D demonstrated the best psychometric performance in patients with multiple myeloma.

• MM patients showed excellent internal consistency with Cronbach's α=0.899.
• Criterion validity in MM was the strongest among the three groups, with Spearman's correlation r=0.538 (p<0.001) with TTO.
• MM also showed high structural validity on exploratory factor analysis.
• These results support the use of EQ-5D as an HRQoL instrument in the MM population.

EQ-5D showed moderate validity in patients with acute leukaemia.

• Spearman's correlation between EQ-5D and TTO in AL patients was r=0.386 (p=0.002).
• The AL group comprised 63 patients.
• The correlation was statistically significant but weaker than that observed in MM patients.

EQ-5D showed poor validity in patients with lymphoma.

• Spearman's correlation between EQ-5D and TTO in lymphoma patients was r=0.230 (p=0.129).
• The correlation was not statistically significant in the lymphoma group.
• The lymphoma group comprised 45 patients.
• The poor psychometric performance raises concerns about the appropriateness of EQ-5D as a standalone instrument for HRQoL in lymphoma.

Chronic kidney failure was significantly associated with greater TTO-EQ-5D utility discrepancy in patients with acute leukaemia.

• In patients with AL, chronic kidney failure was significantly associated with greater TTO-EQ-5D utility discrepancy (coefficient=0.213, p=0.035).
• This finding suggests that adjustments for clinical characteristics such as chronic kidney failure may improve the accuracy of EQ-5D utility values in AL patients.
• Patient characteristics associated with discrepancies between EQ-5D and TTO utilities were examined as a secondary outcome.