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. 2020 May 20;10:8307. doi: 10.1038/s41598-020-57647-x

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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The cross-lagged model hypothesized to analyze the longitudinal association among anxiety, depression and health-related quality of life (HRQoL) summary index. Note: HRQoL is measured by EQ-5D summary index with higher score on EQ-5D index indicating better quality of life in mobility, self-care, usual activities, pain/discomfort and anxiety/depression; Numbers above arrows indicate standardized correlation coefficients; Thick arrows indicate the paths of interest, which are the bidirectional, longitudinal paths between anxiety/depression and HRQoL. The overall model fit was x²/df = 1.102; CFI = 1.000, RMSEA = 0.030.