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.

Measurement of Donnan potentials in gels by in situ microelectrode voltammetry

This work describes the electrochemical methodology for the determination of the Donnan potential from diffusion-limited steady-state voltammograms of acrylamide gels. The technique is based upon the measurement of gel–sol systems that have reached Donnan equilibrium and contain Cd2+ as a probe ion. Au-amalgam microelectrodes are used to measure the Cd concentration in the gel phase relative to the solution phase, thus permitting comparison of the Cd voltammograms obtained in both phases. This approach yields two independent measures of the Donnan potential resulting from (i) the potential shift relative to the reference electrode, and (ii) the enhancement of the Cd2+ wave. Two suites of acrylamide gels containing 0.2% and 0.5% Na-acrylate were studied as a function of ionic strength by varying [NaNO3] and maintaining a constant concentration of the electroactive probe ion, [Cd2+] = 1 · 10 5 mol/L in the equilibrating solutions. Independent model predictions of the Donnan potential as a function of ionic strength that consider the effects of differential swelling on the charge density, the influence of a mixed electrolyte on the potential developed in the gel at the limit of low ionic strength and the effects of incomplete dissociation of the carboxylic functional groups were in agreement with the Donnan potentials independently measured by the twofold steady-state voltammetric approach.