Validation of the Quality of Life and Function Five Domain Scale (QFS-5) against the EuroQol-5D (EQ-5D)

Validation of the Quality of Life and Function Five Domain Scale (QFS-5) against the EuroQol-5D (EQ-5D) | medRxiv /* */ /* */ <!-- <!-- /*! * yepnope1.5.4 * (c) WTFPL, GPLv2 */ (function(a,b,c){function d(a){return"[object Function]"==o.call(a)}function e(a){return"string"==typeof a}function f(){}function g(a){return!a||"loaded"==a||"complete"==a||"uninitialized"==a}function h(){var a=p.shift();q=1,a?a.t?m(function(){("c"==a.t?B.injectCss:B.injectJs)(a.s,0,a.a,a.x,a.e,1)},0):(a(),h()):q=0}function i(a,c,d,e,f,i,j){function k(b){if(!o&&g(l.readyState)&&(u.r=o=1,!q&&h(),l.onload=l.onreadystatechange=null,b)){"img"!=a&&m(function(){t.removeChild(l)},50);for(var d in y[c])y[c].hasOwnProperty(d)&&y[c][d].onload()}}var j=j||B.errorTimeout,l=b.createElement(a),o=0,r=0,u={t:d,s:c,e:f,a:i,x:j};1===y[c]&&(r=1,y[c]=[]),"object"==a?l.data=c:(l.src=c,l.type=a),l.width=l.height="0",l.onerror=l.onload=l.onreadystatechange=function(){k.call(this,r)},p.splice(e,0,u),"img"!=a&&(r||2===y[c]?(t.insertBefore(l,s?null:n),m(k,j)):y[c].push(l))}function j(a,b,c,d,f){return q=0,b=b||"j",e(a)?i("c"==b?v:u,a,b,this.i++,c,d,f):(p.splice(this.i++,0,a),1==p.length&&h()),this}function k(){var a=B;return a.loader={load:j,i:0},a}var l=b.documentElement,m=a.setTimeout,n=b.getElementsByTagName("script")[0],o={}.toString,p=[],q=0,r="MozAppearance"in l.style,s=r&&!!b.createRange().compareNode,t=s?l:n.parentNode,l=a.opera&&"[object Opera]"==o.call(a.opera),l=!!b.attachEvent&&!l,u=r?"object":l?"script":"img",v=l?"script":u,w=Array.isArray||function(a){return"[object Array]"==o.call(a)},x=[],y={},z={timeout:function(a,b){return b.length&&(a.timeout=b[0]),a}},A,B;B=function(a){function b(a){var a=a.split("!"),b=x.length,c=a.pop(),d=a.length,c={url:c,origUrl:c,prefixes:a},e,f,g;for(f=0;f<d;f++)g=a[f].split("="),(e=z[g.shift()])&&(c=e(c,g));for(f=0;f<b;f++)c=x[f](c);return c}function g(a,e,f,g,h){var i=b(a),j=i.autoCallback;i.url.split(".").pop().split("?").shift(),i.bypass||(e&&(e=d(e)?e:e[a]||e[g]||e[a.split("/").pop().split("?")[0]]),i.instead?i.instead(a,e,f,g,h):(y[i.url]?i.noexec=!0:y[i.url]=1,f.load(i.url,i.forceCSS||!i.forceJS&&"css"==i.url.split(".").pop().split("?").shift()?"c":c,i.noexec,i.attrs,i.timeout),(d(e)||d(j))&&f.load(function(){k(),e&&e(i.origUrl,h,g),j&&j(i.origUrl,h,g),y[i.url]=2})))}function h(a,b){function c(a,c){if(a){if(e(a))c||(j=function(){var a=[].slice.call(arguments);k.apply(this,a),l()}),g(a,j,b,0,h);else if(Object(a)===a)for(n in m=function(){var b=0,c;for(c in a)a.hasOwnProperty(c)&&b++;return b}(),a)a.hasOwnProperty(n)&&(!c&&!--m&&(d(j)?j=function(){var a=[].slice.call(arguments);k.apply(this,a),l()}:j[n]=function(a){return function(){var b=[].slice.call(arguments);a&&a.apply(this,b),l()}}(k[n])),g(a[n],j,b,n,h))}else!c&&l()}var h=!!a.test,i=a.load||a.both,j=a.callback||f,k=j,l=a.complete||f,m,n;c(h?a.yep:a.nope,!!i),i&&c(i)}var i,j,l=this.yepnope.loader;if(e(a))g(a,0,l,0);else if(w(a))for(i=0;i (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0];var j=d.createElement(s);var dl=l!='dataLayer'?'&l='+l:'';j.src='//www.googletagmanager.com/gtm.js?id='+i+dl;j.type='text/javascript';j.async=true;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-P4HH5NV'); Skip to main content Home About Submit ALERTS / RSS Search for this keyword Advanced Search Validation of the Quality of Life and Function Five Domain Scale (QFS-5) against the EuroQol-5D (EQ-5D) View ORCID Profile Zahinoor Ismail , Ibadat Warring , Dylan X Guan , Pierre Chue , Andrea Bardell , View ORCID Profile Clive Ballard , View ORCID Profile Byron Creese , Anne Corbett , Ellie Pickering , Pamela Roach , View ORCID Profile Eric E Smith doi: https://doi.org/10.1101/2025.08.31.25334811 Zahinoor Ismail 1 Hotchkiss Brain Institute, University of Calgary; Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Zahinoor Ismail For correspondence: ismailz{at}ucalgary.ca Ibadat Warring 1 Hotchkiss Brain Institute, University of Calgary; Find this author on Google Scholar Find this author on PubMed Search for this author on this site Dylan X Guan 1 Hotchkiss Brain Institute, University of Calgary; Find this author on Google Scholar Find this author on PubMed Search for this author on this site Pierre Chue 2 Department of Psychiatry, University of Alberta; Find this author on Google Scholar Find this author on PubMed Search for this author on this site Andrea Bardell 3 Department of Psychiatry, University of Ottawa; Find this author on Google Scholar Find this author on PubMed Search for this author on this site Clive Ballard 4 Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK; Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Clive Ballard Byron Creese 5 Brunel University, London, UK.; Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Byron Creese Anne Corbett 6 Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK. Find this author on Google Scholar Find this author on PubMed Search for this author on this site Ellie Pickering 4 Clinical and Biomedical Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK; Find this author on Google Scholar Find this author on PubMed Search for this author on this site Pamela Roach 1 Hotchkiss Brain Institute, University of Calgary; Find this author on Google Scholar Find this author on PubMed Search for this author on this site Eric E Smith 1 Hotchkiss Brain Institute, University of Calgary; Find this author on Google Scholar Find this author on PubMed Search for this author on this site ORCID record for Eric E Smith Abstract Info/History Metrics Data/Code Preview PDF Abstract INTRODUCTION: Quality of life (QoL) captures objective life conditions, subjective wellbeing, and personal aspirations. There is growing interest in ability-based, patient-centred instruments that are not confounded by health outcomes. The Quality of Life and Function Five Domain Scale (QFS-5) applies a multi-dimensional approach to measurement of QoL with a focus on abilities and life engagement. METHODS: The QFS-5 was validated in 1610 participants aged ≥ 50 from the Canadian Platform for Research Online to Investigate Health, Quality of Life, Cognition, Behaviour, Function, and Caregiving in Aging (CAN-PROTECT). Internal consistency was assessed using Cronbach′s alpha and item-total correlations. Confirmatory factor analysis (CFA) evaluated domain structure. Criterion validity was tested through Pearson′s correlation with the EuroQol-5D (EQ-5D). Convergent and discriminant validity were evaluated from associations with cognitive, mental health, and functional measures. Floor and ceiling effects were investigated. RESULTS: The QFS-5 demonstrated excellent internal consistency ( α = 0.92); CFA supported the proposed domain structure with strong item loadings. Criterion validity was confirmed with correlation of -0.61 against the EQ-5D; higher symptom burden on related scales were associated with lower QFS-5 scores. Floor effects were minimal, while modest ceiling effects were observed in some domains. No significant floor or ceiling effects were found in participants living with frailty. CONCLUSION: The QFS-5 establishes validity, reliability, and effective use of an ability-based domain structure within a sample of mostly cognitively unimpaired, community-dwelling older adults. The QFS-5 aligns with EQ-5D measurements, demonstrating its potential utility in research and clinical practice to measure relevant patient reported QoL outcomes. Competing Interest Statement ZI has served as advisor/consultant for CADTH, Eisai, Lilly, Lundbeck/Otsuka, Novo Nordisk, and Roche. AB has received consulting and speaking fees from Abbvie, Otsuka, Lundbeck, and Janssen. CB has no direct disclosures related to the current paper. With respect to broader disclosures CB has received consultancy honoraria from Acadia, BMS, TauRx, Maplight, Abbvie, Lilly, Janssen, NovoNordisk, Biogen and Roche pharmaceutical companies over the last 3 years. Funding Statement The CAN-PROTECT study was supported by Gordie Howes CARES, and the Evans Family Fund via the Hotchkiss Brain Institute, at the University of Calgary. ZI is supported by the Canadian Institutes of Health Research (Grant BCA 527734) and the NIHR UK Exeter Biomedical Research Centre. IW is supported by the Canadian Vascular Training Platform (VAST) and CIHR Canada Graduate Research Scholarship. DXG is supported by the Hotchkiss Brain Institute, Vascular Training Platform, CIHR, Alzheimer Society of Canada, and Killam Trust. The funders did not influence study design, collection, analysis, interpretation, writing, or decision to submit for publication. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The CAN-PROTECT study received ethics approval from the Conjoint Health Research Ethics Board at the University of Calgary (REB21-1065). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability Interested researchers may contact ismailz{at}ucalgary.ca to request access to the data. Copyright The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY 4.0 International license . View the discussion thread. Back to top Previous Next Posted September 02, 2025. Download PDF Data/Code Email Thank you for your interest in spreading the word about medRxiv. 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Share Validation of the Quality of Life and Function Five Domain Scale (QFS-5) against the EuroQol-5D (EQ-5D) Zahinoor Ismail , Ibadat Warring , Dylan X Guan , Pierre Chue , Andrea Bardell , Clive Ballard , Byron Creese , Anne Corbett , Ellie Pickering , Pamela Roach , Eric E Smith medRxiv 2025.08.31.25334811; doi: https://doi.org/10.1101/2025.08.31.25334811 Share This Article: Copy Citation Tools Validation of the Quality of Life and Function Five Domain Scale (QFS-5) against the EuroQol-5D (EQ-5D) Zahinoor Ismail , Ibadat Warring , Dylan X Guan , Pierre Chue , Andrea Bardell , Clive Ballard , Byron Creese , Anne Corbett , Ellie Pickering , Pamela Roach , Eric E Smith medRxiv 2025.08.31.25334811; doi: https://doi.org/10.1101/2025.08.31.25334811 Citation Manager Formats BibTeX Bookends EasyBib EndNote (tagged) EndNote 8 (xml) Medlars Mendeley Papers RefWorks Tagged Ref Manager RIS Zotero Tweet Widget Facebook Like Google Plus One Subject Area Psychiatry and Clinical Psychology Subject Areas All Articles Addiction Medicine (568) Allergy and Immunology (863) Anesthesia (297) Cardiovascular Medicine (4421) Dentistry and Oral Medicine (443) Dermatology (382) Emergency Medicine (606) Endocrinology (including Diabetes Mellitus and Metabolic Disease) (1507) Epidemiology (15212) Forensic Medicine (30) Gastroenterology (1121) Genetic and Genomic Medicine (6581) Geriatric Medicine (667) Health Economics (996) Health Informatics (4520) Health Policy (1366) Health Systems and Quality Improvement (1611) Hematology (539) HIV/AIDS (1264) Infectious Diseases (except HIV/AIDS) (15906) Intensive Care and Critical Care Medicine (1103) Medical Education (620) Medical Ethics (144) Nephrology (667) Neurology (6580) Nursing (345) Nutrition (998) Obstetrics and Gynecology (1141) Occupational and Environmental Health (956) Oncology (3324) Ophthalmology (970) Orthopedics (369) Otolaryngology (420) Pain Medicine (435) Palliative Medicine (129) Pathology (663) Pediatrics (1689) Pharmacology and Therapeutics (691) Primary Care Research (710) Psychiatry and Clinical Psychology (5432) Public and Global Health (9212) Radiology and Imaging (2193) Rehabilitation Medicine and Physical Therapy (1368) Respiratory Medicine (1194) Rheumatology (593) Sexual and Reproductive Health (709) Sports Medicine (529) Surgery (709) Toxicology (99) Transplantation (288) Urology (265) (function(){function c(){var b=a.contentDocument||a.contentWindow.document;if(b){var d=b.createElement('script');d.innerHTML="window.__CF$cv$params={r:'9ff40fd65d9f4807',t:'MTc3OTM3MTU0OQ=='};var a=document.createElement('script');a.src='/cdn-cgi/challenge-platform/scripts/jsd/main.js';document.getElementsByTagName('head')[0].appendChild(a);";b.getElementsByTagName('head')[0].appendChild(d)}}if(document.body){var a=document.createElement('iframe');a.height=1;a.width=1;a.style.position='absolute';a.style.top=0;a.style.left=0;a.style.border='none';a.style.visibility='hidden';document.body.appendChild(a);if('loading'!==document.readyState)c();else if(window.addEventListener)document.addEventListener('DOMContentLoaded',c);else{var e=document.onreadystatechange||function(){};document.onreadystatechange=function(b){e(b);'loading'!==document.readyState&&(document.onreadystatechange=e,c())}}}})();