Quality of Life Research

, Volume 28, Issue 1, pp 153–162 | Cite as

Psychometric performance assessment of Malay and Malaysian English version of EQ-5D-5L in the Malaysian population

  • Asrul Akmal ShafieEmail author
  • Annushiah Vasan Thakumar
  • Ching Jou Lim
  • Nan Luo



To determine the psychometric properties and performance of Malay and English versions of the EQ-5D-5L descriptive instrument in the general Malaysian population.


1137 members of the Malaysian general public were sampled in this national study. Respondents were recruited by quota sampling of urbanicity, gender, age, and ethnicity. In face-to-face interviews, respondents first answered the EQ-5D-5L questionnaire administered using the EQ-Valuation Technology software, and then completed the EQ-5D-3L questionnaire on paper. A subgroup of the respondents were given paper form of EQ-5D-5L for completion within 2 weeks for test–retest reliability. Ceiling effects, response redistribution, informativity, and convergent validity were compared between EQ-5D-5L and ED-5D-3L separately by Malay and English language versions.


The proportion of ‘full health’ responses (11111) drastically decreased by 25.55% and 15.74% in the Malay and English language versions indicating lower ceiling effects in EQ-5D-5L. Inconsistencies from response redistribution was below 6% for all dimensions across languages. The measure of relative informativity was comparatively higher in EQ-5D-5L than in EQ-5D-3L in both language versions, with the exception of dimensions mobility and pain/discomfort in the English version. Convergent validity in terms of correlation with EQ-VAS was relatively better for EQ-5D-5L dimensions, with pain/discomfort of the Malay version having the strongest correlation (|r| = 0.37). Also, reliability testing revealed moderate to poor agreements on all 5L dimensions.


EQ-5D-5L fared better in terms of psychometric performance compared to EQ-5D-3L for both language versions. This encourages the application of the EQ-5D-5L in health-related research in Malaysia.


EQ-5D-5L EQ-5D-3L Psychometric properties Validity Reliability 



This study was co-funded by EuroQol Research Foundation and Universiti Sains Malaysia’s Research University Grant.

Compliance with ethical standards

Conflict of interest

Nan Luo is a member of EuroQol Research Foundation. There is no other conflict of interest.

Ethics approval

The study received ethical approval from the Malaysia Medical Research & Ethics Committee (ID NMRR-13-1377-18574) and was conducted in accordance with the Declaration of Helsinki.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Discipline of Social & Administrative PharmacyUniversiti Sains MalaysiaPenangMalaysia
  2. 2.Saw Swee Hock School of Public HealthNational University of SingaporeSingaporeSingapore

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