Quality of Life Research

, Volume 27, Issue 5, pp 1323–1333 | Cite as

Health state utilities and subjective well-being among psoriasis vulgaris patients in mainland China

  • Liu Liu
  • Shunping LiEmail author
  • Yue Zhao
  • Jianglin Zhang
  • Gang Chen



To investigate the validity of direct and indirect health state utility (HSU) and subjective well-being measures in psoriasis vulgaris patients.


A convenience sampling framework was used to successively recruit patients with psoriasis vulgaris from the outpatient clinics of a tertiary hospital in Changsha, Central South China. Participants completed time trade-off (TTO), standard gamble (SG), the five-level EQ-5D (EQ-5D-5L), the WHO-5 well-being index, and the psoriasis disability index (PDI). The concurrent and known-groups validity of HSUs and well-being index in psoriasis patients were firstly studied. The agreements among HSUs and the relationship between HSU and well-being measures were further explored.


A valid sample of 343 patients was analyzed. Mean HSU and well-being scores elicited from the EQ-5D-5L/TTO/SG and WHO-5 were 0.90/0.85/0.88 and 13.69, respectively. The Spearman correlation (concurrent validity) was the strongest between PDI and WHO-5 (r = 0.45), followed by with EQ-5D-5L (0.38), SG (r = 0.20), and the TTO (r = 0.18). The pairwise intraclass correlation coefficients among the three HSU measures were < 0.30. The known-groups validity was evident in all measures except for the SG. Exploratory factor analysis further suggests a complementary relationship between the EQ-5D-5L and WHO-5.


There is a poor agreement between direct and indirect methods on measuring HSU with psoriasis vulgaris. Results from this study recommend that the EQ-5D-5L is the most preferred method to elicit HSU from psoriasis vulgaris patients in mainland China. It is important to further analyze the subjective well-being in addition to the HSU to fully understand the impact of psoriasis.


Psoriasis vulgaris Health state utility EQ-5D-5L Time trade-off Standard gamble Well-being 



The authors thank all the participants for their time and effort. Responsibility for any remaining errors lies solely with the authors.


The project was sponsored by the Scientific Research Foundation for the Returned Overseas Chinese Scholars, State Education Ministry (No. [2015]311).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was approved by the Ethics Review Board of the School of Medicine, Shandong University (Reference No. LL-201401044), and the research adhered to the tenets of the Declaration of Helsinki.

Informed consent

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

Supplementary material

11136_2018_1819_MOESM1_ESM.docx (18 kb)
Supplementary material 1 (DOCX 18 KB)


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of Health Care ManagementShandong UniversityJinanChina
  2. 2.Key Laboratory of Health Economics and Policy ResearchNHFPC (Shandong University)JinanChina
  3. 3.Department of Dermatology, Heping HospitalChangzhi Medical CollegeChangzhiChina
  4. 4.Department of Dermatology, Xiangya HospitalCentral South UniversityChangshaChina
  5. 5.Centre for Health Economic, Monash Business SchoolMonash UniversityMelbourneAustralia

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