, Volume 36, Issue 6, pp 641–643 | Cite as

Once Bitten Twice Shy: Thinking Carefully Before Adopting the EQ-5D-5L

  • Jeff RoundEmail author

The EQ-5D-5L

The Euro-Qol group introduced the EQ-5D-5L descriptive system in 2009 [1], with the first publication describing the tool appearing in 2011 [2]. This revised version of the EQ-5D instrument introduced five response levels, alongside changes to the wording used to describe responses in the mobility domain. The five-level version of the EQ-5D descriptive system was developed in response to perceived failings of the three response-level EQ-5D-3L, notably in its sensitivity to changes in health [3], but also ceiling effects [2] and an ‘uneven’ distribution of responses as measured by the valuation tariff [4].

The first UK valuation study of the 5L descriptive system was formally available in 2017 [4]. As Brazier, Bryan and Briggs recently summarize [5], the 5L version of the instrument has been found to reduce ceiling effects and exhibits a more even distribution of responses. Hernandez et al. [6] have shown that as a consequence of the changes to the tool and the new...



The author would like to thank the Univeristy of Bristol Health Economics Journal Club for the discussion that informed this commentary. All errors or omissions are the author’s own.


No specific funding was received for the preparation of this work.

Compliance with ethical standards

Conflicts of interest

The author has no conflicts of interest to declare.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Population Health Sciences, Bristol Medical SchoolUniversity of BristolBristolUK

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