Comparing the performance of the EQ-5D-3L and the EQ-5D-5L in young Portuguese adults

Background Some studies have reported a ceiling effect in EQ-5D-3L, especially in healthy and/or young individuals. Recently, two further levels have been included in its measurement model (EQ-5D-5L). The purposes of this study were (1) to assess the properties of the EQ-5D-5L in comparison with the standard EQ-5D-3L in a sample of young adults, (2) to foreground the importance of collecting qualitative data to confirm, validate or refine the EQ-5D questionnaire items and (3) to raise questions pertaining to the wording in these questionnaire items. Methods The data used came from a sample of respondents aged 30 or under (n = 624). They completed both versions of the EQ-5D, which were compared in terms of feasibility, level of inconsistency and ceiling effect. Agreement between the instruments was assessed using correlation coefficients and Bland-Altman plots. Known-groups validity of the EQ-5D-5L was also assessed using non-parametric tests. The discriminative properties were compared using receiver operating characteristic curves. Finally, four interviews were conducted for retrospective reports to elicit respondents’ understanding and perceptions of the format, instructions, items, and responses. Results Quantitative results show a ceiling effect reduction of 25.3 % and a high level agreement between both indices. Known-groups validity was confirmed for the EQ-5D-5L. Explorative interviews indicated ambiguity and low degree of certainty in regards to conceptualizing differences between levels moderate-slight across three dimensions. Conclusions The EQ-5D-5L performed better than the EQ-5D-3L. However, the explorative interviews demonstrated several limitations in the EQ-5D questionnaire wording and high context-dependent answers point to lack of illnesses’ experience amongst young adults.

Comparing Atlantic and Mediterranean populations of the velvet belly lanternshark, Etmopterus spinax, with comments on the efficiency of density-dependent compensatory mechanisms

Etmopterus spinax is a small-sized deep-water lantern shark that occurs in the Eastern Atlantic and the Mediterranean. Differences in depth distribution, densities, size at maturity and fecundity were compared between a population that has suffered high levels of fishing mortality during the last decades (Southern Portugal in the northeast Atlantic) and a population where low fishing pressure below 500 m occurs at present or has occurred in the last decades (Northern Alboran Sea in the western Mediterranean). The density of this species, as derived by experimental bottom trawl survey, off the coast of Southern Portugal, is substantially lower than in the Northern Alboran Sea throughout the entire depth range. The Atlantic population is maturing at smaller sizes than the Mediterranean population and has a lower mean fecundity. Specifically, sizes at maturity for Southern Portugal and the Northern Alboran Sea were, respectively, 25.39 and 28.31 cm TL for males and 30.86 and 34.18 cm TL for females, while mean fecundities for Southern Portugal and the Northern Alboran Sea were, respectively, 9.94 and 11.06 oocytes per mature female. This work demonstrated the possible presence of density-dependent mechanisms in the Southern Portuguese population of E. spinax that has lowered the size at maturity as a possible result of excessive fishing mortality. However, given that this is an aplacentary viviparous shark, where fecundity is dependent on female size, this compensatory mechanism seems to have a limited efficiency.