Quality of Life Research

, Volume 28, Issue 12, pp 3153–3161 | Cite as

A comprehensive catalogue of EQ-5D scores in chronic disease: results of a systematic review

  • Lisa Van WilderEmail author
  • Elke Rammant
  • Els Clays
  • Brecht Devleesschauwer
  • Nele Pauwels
  • Delphine De Smedt



Chronic diseases are associated with impaired health-related quality of life (HRQoL) outcomes. Comparison of HRQoL outcomes between different diseases and with the general population is of major importance to health economists, epidemiologists, clinicians, and policy makers. The aim of this systematic literature review was to develop a catalogue with EQ-5D scores in chronic non-communicable diseases, and to compare these scores with reference values from the general population.


MEDLINE, Embase, and Web of Science were systematically searched independently by two reviewers. Studies were included if they reported mean EQ-5D index values for the adult population and if these scores were compared with the general population. The QualSyst tool for quantitative research was used for quality appraisal.


Two hundred and seven articles met the inclusion criteria. An extensive catalogue summarizes the EQ-5D scores in a wide variety of chronic diseases. Mean EQ-5D index values ranged between − 0.20 and 1. Lower EQ-5D scores are reported in chronic diseases compared to the general population, specifically in neurological disorders. Most of the diseases demonstrate a substantial disutility, although a minority of diseases have equal or even higher index scores than the general population.


A comprehensive, international catalogue has been developed to provide EQ-5D index scores for diverse chronic diseases compared with reference values based on the available literature. The catalogue gives a clear overview of the existing EQ-5D scores and can be rapidly accessed by researchers worldwide for different applications such as health economic evaluations, decision making, resource allocation, and other policy objectives. Future studies should focus on unexamined diseases and specific patient groups to expand the evidence base on HRQoL in chronic diseases.


Health-related quality of life Utility EQ-5D Catalogue Chronic disease Cost-effectiveness analysis Health economic evaluation Systematic review 



This study was funded by a Grant from Ghent University (Grant No. 01N02618) (Bijzonder Onderzoeksfonds, BOF).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

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Supplementary material 1 (PDF 229 kb)
11136_2019_2300_MOESM2_ESM.pdf (716 kb)
Supplementary material 2 (PDF 716 kb)
11136_2019_2300_MOESM3_ESM.pdf (3.8 mb)
Supplementary material 3 (PDF 3942 kb)


  1. 1.
    World Health Organization. (2014). Global status report on noncommunicable diseases 2014. Retrieved August, 1, 2018, from;jsessionid=DE930A0A052CB03AB73898D75695E8F7?sequence=1.
  2. 2.
    World Health Organization. (2013). Global action plan for the prevention and control of noncommunicable diseases 2013–2020. Retrieved August, 1, 2018, from
  3. 3.
    Megari, K. (2013). Quality of life in chronic disease patients. Health Psychology Research,1(3), e27.CrossRefGoogle Scholar
  4. 4.
    GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet,392(10159), 1789–1858.CrossRefGoogle Scholar
  5. 5.
    Schipper, H., & Olweny, C. (1996). Quality of life studies: definitions and conceptual issues. In B. Spilker (Ed.), Quality of Life and Pharmacoeconomics in Clinical Trials (pp. 11–23). Philadelphia: Lippincott-Raven Publishers.Google Scholar
  6. 6.
    Grool, A. M., van der Graaf, Y., Visseren, F. L., de Borst, G. J., Algra, A., & Geerlings, M. I. (2012). Self-rated health status as a risk factor for future vascular events and mortality in patients with symptomatic and asymptomatic atherosclerotic disease: The SMART study. Journal of Internal Medicine,272(3), 277–286.CrossRefGoogle Scholar
  7. 7.
    Spertus, J. A., Jones, P., McDonell, M., Fan, V., & Fihn, S. D. (2002). Health status predicts long-term outcome in outpatients with coronary disease. Circulation,106(1), 43–49.CrossRefGoogle Scholar
  8. 8.
    Mapes, D. L., Lopes, A. A., Satayathum, S., McCullough, K. P., Goodkin, D. A., Locatelli, F., et al. (2003). Health-related quality of life as a predictor of mortality and hospitalization: The Dialysis Outcomes and Practice Patterns Study (DOPPS). Kidney International,64(1), 339–349.CrossRefGoogle Scholar
  9. 9.
    Kind, P., Lafata, J. E., Matuszewski, K., & Raisch, D. (2009). The use of QALYs in clinical and patient decision-making: Issues and prospects. Value Health,12(Suppl 1), S27–S30.CrossRefGoogle Scholar
  10. 10.
    Ko, Y., & Coons, S. J. (2006). Self-reported chronic conditions and EQ-5D index scores in the US adult population. Current Medical Research and Opinion,22(10), 2065–2071.CrossRefGoogle Scholar
  11. 11.
    Whitehead, S. J., & Ali, S. (2010). Health outcomes in economic evaluation: The QALY and utilities. British Medical Bulletin,96, 5–21.CrossRefGoogle Scholar
  12. 12.
    Kang, E. J., & Ko, S. K. (2009). A catalogue of EQ-5D utility weights for chronic diseases among noninstitutionalized community residents in Korea. Value Health,12(Suppl 3), S114–S117.CrossRefGoogle Scholar
  13. 13.
    Dolan, P. (1997). Modeling valuations for EuroQol health states. Medical Care,35(11), 1095–1108.CrossRefGoogle Scholar
  14. 14.
    Group, T. E. (1990). EuroQol—A new facility for the measurement of health-related quality of life. Health Policy,16(3), 199–208.CrossRefGoogle Scholar
  15. 15.
    Sullivan, P. W., Slejko, J. F., Sculpher, M. J., & Ghushchyan, V. (2011). Catalogue of EQ-5D scores for the United Kingdom. Medical Decision Making,31(6), 800–804.CrossRefGoogle Scholar
  16. 16.
    Dyer, M. T., Goldsmith, K. A., Sharples, L. S., & Buxton, M. J. (2010). A review of health utilities using the EQ-5D in studies of cardiovascular disease. Health and Quality of Life Outcomes,8, 13.CrossRefGoogle Scholar
  17. 17.
    Sassi, F. (2006). Calculating QALYs, comparing QALY and DALY calculations. Health Policy Plan,21(5), 402–408.CrossRefGoogle Scholar
  18. 18.
    JPT, H. (2011). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. The Cochrane Collaboration. Retrieved April, 24, 2018, from
  19. 19.
    McGowan, J., Sampson, M., Salzwedel, D. M., Cogo, E., Foerster, V., & Lefebvre, C. (2016). PRESS peer review of electronic search strategies: 2015 Guideline Statement. Journal of Clinical Epidemiology,75, 40–46.CrossRefGoogle Scholar
  20. 20.
    Kmet, L. M., & Cook, L. S. (2004). Standard quality assessment criteria for evaluating primary research papers from a variety of fields. Alberta Heritage Foundation for Medical Research (AHFMR),2011, 1–22.Google Scholar
  21. 21.
    Bramer, G. R. (1988). International statistical classification of diseases and related health problems. Tenth revision. World Health Stat Q,41(1), 32–36.PubMedGoogle Scholar
  22. 22.
    Devlin, N. J., & Brooks, R. (2017). EQ-5D and the EuroQol Group: Past, present and future. Applied Health Economics and Health Policy,15(2), 127–137.CrossRefGoogle Scholar
  23. 23.
    National Institute for Health and Clinical Excellence (NICE). (2013). Guide to the Methods of Technology Appraisal. London: NICE.Google Scholar
  24. 24.
    Cohen, R. D. (2002). The quality of life in patients with Crohn’s disease. Alimentary Pharmacology & Therapeutics,16(9), 1603–1609.CrossRefGoogle Scholar
  25. 25.
    de Jong, W., Kaptein, A. A., van der Schans, C. P., Mannes, G. P., van Aalderen, W. M., Grevink, R. G., et al. (1997). Quality of life in patients with cystic fibrosis. Pediatric Pulmonology,23(2), 95–100.CrossRefGoogle Scholar
  26. 26.
    Coman, A. C., Borzan, C., Vesa, C. S., & Todea, D. A. (2016). Obstructive sleep apnea syndrome and the quality of life. Clujul Medical,89(3), 390.PubMedPubMedCentralGoogle Scholar
  27. 27.
    Muller-Nordhorn, J., Roll, S., Bohmig, M., Nocon, M., Reich, A., Braun, C., et al. (2006). Health-related quality of life in patients with pancreatic cancer. Digestion,74(2), 118–125.CrossRefGoogle Scholar
  28. 28.
    van der Have, M., van der Aalst, K. S., Kaptein, A. A., Leenders, M., Siersema, P. D., Oldenburg, B., et al. (2014). Determinants of health-related quality of life in Crohn’s disease: A systematic review and meta-analysis. J Crohns Colitis,8(2), 93–106.CrossRefGoogle Scholar
  29. 29.
    Zhao, C., Wong, L., Zhu, Q., & Yang, H. (2018). Prevalence and correlates of chronic diseases in an elderly population: A community-based survey in Haikou. PLoS ONE,13(6), e0199006.CrossRefGoogle Scholar
  30. 30.
    Wolff, J. L., Starfield, B., & Anderson, G. (2002). Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Archives of Internal Medicine,162(20), 2269–2276.CrossRefGoogle Scholar
  31. 31.
    Sullivan, P. W., Lawrence, W. F., & Ghushchyan, V. (2005). A national catalog of preference-based scores for chronic conditions in the United States. Medical Care,43(7), 736–749.CrossRefGoogle Scholar
  32. 32.
    Cherepanov, D., Palta, M., Fryback, D. G., & Robert, S. A. (2010). Gender differences in health-related quality-of-life are partly explained by sociodemographic and socioeconomic variation between adult men and women in the US: Evidence from four US nationally representative data sets. Quality of Life Research,19(8), 1115–1124.CrossRefGoogle Scholar
  33. 33.
    Kind, P., Dolan, P., Gudex, C., & Williams, A. (1998). Variations in population health status: Results from a United Kingdom national questionnaire survey. BMJ,316(7133), 736–741.CrossRefGoogle Scholar
  34. 34.
    Hajian-Tilaki, K., Heidari, B., & Hajian-Tilaki, A. (2017). Are gender differences in health-related quality of life attributable to sociodemographic characteristics and chronic disease conditions in elderly people? Int J Prev Med,8, 95.PubMedPubMedCentralGoogle Scholar
  35. 35.
    Saarni, S. I., Harkanen, T., Sintonen, H., Suvisaari, J., Koskinen, S., Aromaa, A., et al. (2006). The impact of 29 chronic conditions on health-related quality of life: A general population survey in Finland using 15D and EQ-5D. Quality of Life Research,15(8), 1403–1414.CrossRefGoogle Scholar
  36. 36.
    Wailoo, A., Hernandez Alava, M., Grimm, S., Pudney, S., Gomes, M., & Sadique, Z. (2017). Comparing the EQ-5D-3L and 5L versions. What are the implications for cost effectiveness estimates?Google Scholar
  37. 37.
    Subramaniam, M., Soh, P., Vaingankar, J. A., Picco, L., & Chong, S. A. (2013). Quality of life in obsessive-compulsive disorder: Impact of the disorder and of treatment. CNS Drugs,27(5), 367–383.CrossRefGoogle Scholar
  38. 38.
    Shrive, F. M., Ghali, W. A., Johnson, J. A., Donaldson, C., & Manns, B. J. (2007). Use of the U.S. and U.K. scoring algorithm for the EuroQol-5D in an economic evaluation of cardiac care. Medical Care,45(3), 269–273.CrossRefGoogle Scholar
  39. 39.
    Tengs, T. O., & Wallace, A. (2000). One thousand health-related quality-of-life estimates. Medical Care,38(6), 583–637.CrossRefGoogle Scholar
  40. 40.
    Zhao, Y., Li, S. P., Liu, L., Zhang, J. L., & Chen, G. (2017). Does the choice of tariff matter? A comparison of EQ-5D-5L utility scores using Chinese, UK, and Japanese tariffs on patients with psoriasis vulgaris in Central South China. Medicine (Baltimore),96(34), e7840.CrossRefGoogle Scholar
  41. 41.
    Dolan, P. (1997). Aggregating health state valuations. J Health Serv Res Policy,2(3), 160–165. (discussion 166–167).CrossRefGoogle Scholar
  42. 42.
    De Smedt, D., Clays, E., Annemans, L., & De Bacquer, D. (2014). EQ-5D versus SF-12 in coronary patients: Are they interchangeable? Value Health,17(1), 84–89.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Public Health and Primary Care, University HospitalGhent UniversityGhentBelgium
  2. 2.Department of Radiation Oncology and Experimental Cancer ResearchGhent UniversityGhentBelgium
  3. 3.Department of Epidemiology and Public HealthSciensanoBrusselsBelgium
  4. 4.Department of Veterinary Public Health and Food SafetyGhent UniversityMerelbekeBelgium
  5. 5.The Knowledge Center for Health GhentGhent UniversityGhentBelgium

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