Quality of Life Research

, Volume 24, Issue 7, pp 1767–1774 | Cite as

The EQ-5D-5L index score is more discriminative than the EQ-5D-3L index score in diabetes patients

  • Chen-Wei Pan
  • Hong-Peng Sun
  • Xingzhi Wang
  • Qinghua Ma
  • Yong Xu
  • Nan Luo
  • Pei WangEmail author



To compare the discriminative power of the index scores of EQ-5D-5L (5L) and EQ-5D-3L (3L) in diabetes patients in China.


A consecutive sample of type 2 diabetes mellitus (T2DM) patients in the clinics self-completed the two versions of EQ-5D. The 3L index score was obtained from the Chinese 3L value set; the 5L index score was predicted from the 3L index score using an interim scoring. Relative efficiency (RE) of the 5L and 3L index scores was calculated to compare their ability in differentiating between T2DM patients with and without one of ten clinical conditions. The efficiency of the 5L and 3L health state classification systems was assessed using the Shannon index (H′) and in terms of ceiling effects.


A total of 289 T2DM patients participated in this study. The 5L score was systematically lower than the 3L score for T2DM patients with and without a condition (range −0.36 to −0.06). The 5L score exhibited higher discriminative power in nine of ten conditions, with the mean RE value being 1.92. 5L had higher H′ values than 3L in all the five EQ-5D dimensions: mobility (1.14 vs. 0.70), self-care (0.44 vs. 0.33), usual activities (0.72 vs. 0.47), pain/discomfort (1.58 vs. 1.10), and anxiety/depression (1.03 vs. 0.67). The overall ceiling effects decreased from 56.7 % (3L) to 36.7 % (5L).


The 5L index score is more discriminative than the 3L index score in T2DM patients and therefore is preferable for use in this population.


EQ-5D-3L EQ-5D-5L Preference Diabetes Discriminative power China 



This study was supported by the National Nature Science Foundation of China (81402761) and Nature Science Foundation of Jiangsu, China (BK20140361).


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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Chen-Wei Pan
    • 1
  • Hong-Peng Sun
    • 1
  • Xingzhi Wang
    • 2
  • Qinghua Ma
    • 3
  • Yong Xu
    • 1
  • Nan Luo
    • 2
  • Pei Wang
    • 2
    Email author
  1. 1.Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public HealthMedical College of Soochow UniversitySuzhouChina
  2. 2.Saw Swee Hock School of Public HealthNational University of SingaporeSingaporeSingapore
  3. 3.The 3rd People’s Hospital of Xiangcheng DistrictSuzhouChina

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