Abstract
Purpose
Many factors have been associated with health-related quality of life (HRQOL), and researchers often have tried to rank these contributing factors. Variable importance quantifies the net independent contribution of each individual predictor in a set of predictors to the prediction accuracy of the outcome. This study assessed relative importance (RI) of selected contributing factors to respondents’ physically unhealthy days (PUD), mentally unhealthy days (MUD), activity limitation days (ALD), and EuroQol EQ-5D index derived from the Healthy Days measures (dEQ-5D).
Methods
Using data from the 2021 Behavioral Risk Factor Surveillance Systems (BRFSS), we estimated the RI of seven socio-demographics and seventeen chronic conditions and risk behaviors. A variable’s importance was measured as the average increase in the coefficient of determination after adding the variable to all possible sub-models.
Results
After controlling for socio-demographics, arthritis and no physical activity were the most important variables for PUD with a RI of 10.5 and 10.4, respectively, followed by depression (RI = 8.5) and COPD (RI = 8.3). Depression was the most important variable for MUD with RI = 23.0 while all other 16 predictors had a RI < 7.0. Similar results were observed for ALD and dEQ-5D: depression was the most important predictor (RI = 16.3 and 15.2, respectively), followed by no physical activity, arthritis, and COPD (RI ranging from 7.1 to 9.2).
Conclusion
This study quantified and ranked selected contributing factors of HRQOL. Results of this analysis also can be used to validate HRQOL measures based on domain knowledge of HRQOL.
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Both authors contributed to the study conception. HJ was in charge of the design, methodology, software, data curation, and analysis. Both authors were involved in the writing, editing, and visualization. Both authors read and approved the final manuscript.
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This study was a secondary data analysis of the BRFSS data which were public access data. The data are available at the U.S. Centers for Disease Control and Prevention (CDC) website: https://www.cdc.gov/brfss/annual_data/annual_2021.html. The BRFSS does not include personal identifiable information and does not meet the requirements of human subjects research as defined by the Department of Health and Human Services. Ethical approval was not required.
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Jia, H., Lubetkin, E.I. Relative importance of selected predictors of health-related quality-of-life (HRQOL) among U.S. adults. Qual Life Res (2024). https://doi.org/10.1007/s11136-024-03632-0
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DOI: https://doi.org/10.1007/s11136-024-03632-0