A randomised equivalence study of the EQ-5D-5L Shona versions: evaluation of measurement equivalence between digital and paper formats.

INTRODUCTION

Routine assessment of health-related quality of life (HRQoL) of people living with HIV (PLHIV) is essential. We evaluated measurement equivalence between the digital and paper versions of the Shona EQ-5D-5L and examined known-groups validity.

METHODS AND MATERIALS: We conducted a parallel randomised study in Zimbabwe with 700 participants allocated equally to the digital and paper groups.

RESULTS

The study included 611 participants with a mean age of 37.5 years (SD 12.2). Most were female (70.7%), had secondary education (67.9%), and reported financial inadequacy (68.7%). The digital and paper versions of the EQ-5D-5L Shona demonstrated measurement equivalence. Older age (AOR = 0.60; 95% CI 0.41-0.88; p = 0.008), food insecurity (AOR = 1.80; 95% CI 1.20-2.80; p = 0.01), financial insecurity (AOR = 1.72; 95% CI 1.10-2.69; p = 0.017), and elevated CMD symptoms (AOR = 0.45; 95% CI 0.29-0.68; p < 0.001) were associated with lower HRQoL.

CONCLUSION

This study demonstrated measurement equivalence between the digital and paper versions of the EQ-5D-5L Shona. Both versions can therefore be used confidently in routine clinical care and research. The findings also highlight the need for tailored interventions to improve HRQoL among PLHIV.