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Background <p>Patients with hematologic malignancies (HMs) often experience psychological distress, significantly impairing health-related quality of life (HRQoL) and deteriorating clinical prognosis. Although the widely used instrument EuroQol 5-Dimension 5-Level (EQ-5D-5L) has been validated in the general population for accurately identifying the psychological symptoms, its performance in HM patients remains unclear. We aimed to investigate whether the EQ-5D-5L questionnaire anxiety/depression (A/D) dimension, when already collected for HRQoL assessment, correlates with anxiety and depression symptoms and may potentially flag patients who may warrant further psychiatric evaluation.</p> Methods <p>Enrolled HM patients were invited to complete the EQ-5D-5L questionnaire. The anxiety/depression symptoms were additionally assessed using the symptom-specific tools Generalized Anxiety Disorder 7-item scale (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Spearman correlation analysis was performed to examine the correlation between the EQ-5D-5L A/D dimension and GAD-7/PHQ-9. The sensitivity and specificity of the A/D dimension were evaluated using GAD-7/PHQ-9 as a comparative measure. The associations between patient characteristics and responses on the A/D dimension were explored.</p> Results <p>The A/D dimension exhibited moderate-to-strong correlations with GAD-7 grade (r = 0.607, <i>P</i> &lt; 0.001), PHQ-9 grade (r = 0.579, <i>P</i> &lt; 0.001), and combined GAD-7/PHQ-9 grade (r = 0.603, <i>P</i> &lt; 0.001). For identifying the presence of anxiety/depression, the A/D dimension showed high specificity (94.3–98.6%) but relatively low sensitivity (47.2–60.0%). A subset of patients classified as having anxiety or depression according to the GAD-7/PHQ-9 reported no emotional problems on the A/D dimension. Further analysis revealed that patients with higher education level tended to report lower symptom severity on the A/D dimension.</p> Conclusions <p>The EQ-5D-5L A/D dimension showed moderate-to-strong correlation with GAD-7 and PHQ-9 among HM patients. Based on its limited sensitivity but high specificity, it may serve as a supplementary indicator within routine HRQoL assessments rather than a standalone screening tool. Due to the relatively small sample size and exploratory design of our study, further multicenter investigations with larger sample sizes are needed to validate our findings.</p>

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Agreement between the EQ-5D-5L anxiety/depression dimension and GAD-7/PHQ-9 for psychological distress assessment in patients with hematologic malignancies

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月4日

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  • Fenfang Tong,
  • Yue Zhang,
  • Tingting Cheng,
  • Shiyu Wang,
  • Yan Chen,
  • Wei Qin,
  • Yajing Xu

摘要

Background

Patients with hematologic malignancies (HMs) often experience psychological distress, significantly impairing health-related quality of life (HRQoL) and deteriorating clinical prognosis. Although the widely used instrument EuroQol 5-Dimension 5-Level (EQ-5D-5L) has been validated in the general population for accurately identifying the psychological symptoms, its performance in HM patients remains unclear. We aimed to investigate whether the EQ-5D-5L questionnaire anxiety/depression (A/D) dimension, when already collected for HRQoL assessment, correlates with anxiety and depression symptoms and may potentially flag patients who may warrant further psychiatric evaluation.

Methods

Enrolled HM patients were invited to complete the EQ-5D-5L questionnaire. The anxiety/depression symptoms were additionally assessed using the symptom-specific tools Generalized Anxiety Disorder 7-item scale (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Spearman correlation analysis was performed to examine the correlation between the EQ-5D-5L A/D dimension and GAD-7/PHQ-9. The sensitivity and specificity of the A/D dimension were evaluated using GAD-7/PHQ-9 as a comparative measure. The associations between patient characteristics and responses on the A/D dimension were explored.

Results

The A/D dimension exhibited moderate-to-strong correlations with GAD-7 grade (r = 0.607, P < 0.001), PHQ-9 grade (r = 0.579, P < 0.001), and combined GAD-7/PHQ-9 grade (r = 0.603, P < 0.001). For identifying the presence of anxiety/depression, the A/D dimension showed high specificity (94.3–98.6%) but relatively low sensitivity (47.2–60.0%). A subset of patients classified as having anxiety or depression according to the GAD-7/PHQ-9 reported no emotional problems on the A/D dimension. Further analysis revealed that patients with higher education level tended to report lower symptom severity on the A/D dimension.

Conclusions

The EQ-5D-5L A/D dimension showed moderate-to-strong correlation with GAD-7 and PHQ-9 among HM patients. Based on its limited sensitivity but high specificity, it may serve as a supplementary indicator within routine HRQoL assessments rather than a standalone screening tool. Due to the relatively small sample size and exploratory design of our study, further multicenter investigations with larger sample sizes are needed to validate our findings.