Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups: a multi-country study
Participants (n = 3,919) from six countries, including eight patient groups with chronic conditions (cardiovascular disease, respiratory disease, depression, diabetes, liver disease, personality disorders, arthritis, and stroke) and a student cohort, completed the 3L and 5L and, for most participants, also dimension-specific rating scales. The 3L and 5L were compared in terms of feasibility (missing values), redistribution properties, ceiling, discriminatory power, convergent validity, and known-groups validity.
Missing values were on average 0.8 % for 5L and 1.3 % for 3L. In total, 2.9 % of responses were inconsistent between 5L and 3L. Redistribution from 3L to 5L using EQ dimension-specific rating scales as reference was validated for all 35 3L–5L-level combinations. For 5L, 683 unique health states were observed versus 124 for 3L. The ceiling was reduced from 20.2 % (3L) to 16.0 % (5L). Absolute discriminatory power (Shannon index) improved considerably with 5L (mean 1.87 for 5L versus 1.24 for 3L), and relative discriminatory power (Shannon Evenness index) improved slightly (mean 0.81 for 5L versus 0.78 for 3L). Convergent validity with WHO-5 was demonstrated and improved slightly with 5L. Known-groups validity was confirmed for both 5L and 3L.
The EQ-5D-5L appears to be a valid extension of the 3-level system which improves upon the measurement properties, reducing the ceiling while improving discriminatory power and establishing convergent and known-groups validity.
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- Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups: a multi-country study
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Quality of Life Research
Volume 22, Issue 7 , pp 1717-1727
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- Health-related quality of life
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- Author Affiliations
- 1. Department of Medical Psychology and Psychotherapy, Erasmus MC, Erasmus University, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
- 2. Center for Pharmacoeconomics Research, College of Pharmacy, University of Illinois at Chicago, 833 South Wood St, MC886, Chicago, IL, USA
- 3. HealthQuest, Wyspiańskiego 4/5, 01-577, Warsaw, Poland
- 4. Department of Endocrinology, Osteoporosis Clinic, Odense University Hospital, Kløvervænget 6, 1st floor, 5000, Odense C, Denmark
- 5. Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Krakowskie Przedmieście 26/28, 00-927, Warsaw, Poland
- 6. Research Centre on Public Health, University of Milano Bicocca, Villa Serena, Via Pergolesi 33, 20052, Monza, Italy
- 7. CHARTA Foundation, Milan, Italy
- 8. Oxford Outcomes (ICON plc), Searcourt Tower, West Way, Oxford, OX2 0JJ, UK