• M J Harrison, L M Davies, N J Bansback, M J McCoy, S M M Verstappen, K Watson, D P M Symmons, and British Society for Rheumatology Biologics Register Control Centre Consortium.
• ARC Epidemiology Unit, Stopford Building, The University of Manchester, Oxford Road, Manchester, M13 9PT, UK. mark.harrison@manchester.ac.uk
• Qual Life Res. 2009 Nov 1; 18 (9): 1195-205.

PurposeComparative evidence regarding the responsiveness of the EQ-5D and SF-6D in arthritis patients is conflicting and insufficient across the range of disease severity. We examined the comparative responsiveness of the EQ-5D and SF-6D in cohorts of patients with early inflammatory disease through to severe rheumatoid arthritis (RA).MethodsResponsiveness was tested using the effect size (ES) and standardised response mean (SRM). Correlation of change in EQ-5D and SF-6D with disease specific measures was tested using Pearson correlations and the Steiger's Z test. Treatment response and self-reported change were used as anchors of important change.ResultsThe EQ-5D was more responsive to deterioration (ES ratio (EQ-5D/SF-6D): 1.6-3.0) and the SF-6D more responsive to improvement (ES ratio (SF-6D/EQ-5D): 1.1-1.8) in health. The SF-6D did not respond well to deterioration in patients with established severe RA (ES and SRM 0.08). The EQ-5D provided larger absolute mean change estimates but with greater variance compared to the SF-6D.ConclusionsThe comparative responsiveness of the EQ-5D and SF-6D differs according to the direction of change. The level of mean change of the EQ-5D relative to the SF-6D has implications for cost-effectiveness analysis. Use of the SF-6D in patients with severe progressive disease may be inappropriate.

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