Abstract
Purpose
The EQ-5D-5L was developed to compensate for a high ceiling effect and lack of descriptive richness of the EQ-5D-3L. We evaluated psychometric properties of EQ-5D-5L in the general population.
Methods
Six hundred of adults were sampled from the general population in South Korea using a multistage stratified quota sampling method. Participants completed the EQ-5D-5L, EQ-5D-3L, and SF-36v2. One hundred participants were resurveyed for reliability evaluation. The ceiling effect, known-groups construct validity, convergent and discriminant validity, and reliability of EQ-5D-5L were evaluated.
Results
A smaller proportion of participants answered ‘no problem’ to all dimensions of EQ-5D-5L (61.2 %) than EQ-5D-3L (65.7 %, p < 0.01), indicating a reduced ceiling effect. Female, elderly, low-educated, and low-income participants reported health problems more frequently, indicating known-groups construct validity. The mobility dimension of EQ-5D-5L was better correlated with the physical component score (|r| = 0.48) than the mental component score (|r| = 0.25) of the SF-36v2, and the anxiety/depression dimension was better correlated with mental component score (|r| = 0.45) than physical component score (|r| = 0.34), indicating convergent and discriminant validity. The intraclass correlation coefficient of EQ-5D-5L index was 0.75.
Conclusions
The EQ-5D-5L has a smaller ceiling effect than the EQ-5D-3L and is a valid and reliable instrument to measure health-related quality of life in the general population.
Similar content being viewed by others
Abbreviations
- EQ-5D-3L:
-
3-Level version of EQ-5D
- EQ-5D-5L:
-
5-Level version of EQ-5D
- HRQoL:
-
Health-related quality of life
- VAS:
-
Visual analogue scale
- ICC:
-
Intraclass correlation coefficient
- SF-36v2:
-
Version 2.0 of the short-form 36
- PF:
-
Physical functioning
- RP:
-
Role-physical
- BP:
-
Bodily pain
- GH:
-
General health
- VT:
-
Vitality
- SF:
-
Social functioning
- RE:
-
Role-emotional
- MH:
-
Mental health
- PCS:
-
Physical component summary
- MCS:
-
Mental component summary
References
Savoia, E., Fantini, M. P., Pandolfi, P. P., Dallolio, L., & Collina, N. (2006). Assessing the construct validity of the Italian version of the EQ-5D: Preliminary results from a cross-sectional study in North Italy. Health Qual Life Outcomes, 4, 47.
Kontodimopoulos, N., Pappa, E., Niakas, D., Yfantopoulos, J., Dimitrakaki, C., & Tountas, Y. (2008). Validity of the EuroQoL (EQ-5D) instrument in a Greek general population. Value Health, 11(7), 1162–1169.
Badia, X., Schiaffino, A., Alonso, J., & Herdman, M. (1998). Using the EuroQoI 5-D in the Catalan general population: Feasibility and construct validity. Quality of Life Research, 7(4), 311–322.
Chang, T. J., Tarn, Y. H., Hsieh, C. L., Liou, W. S., Shaw, J. W., & Chiou, X. G. (2007). Taiwanese version of the EQ-5D: Validation in a representative sample of the Taiwanese population. Journal of the Formosan Medical Association, 106(12), 1023–1031.
Shafie, A. A., Hassali, M. A., & Liau, S. Y. (2011). A cross-sectional validation study of EQ-5D among the Malaysian adult population. Quality of Life Research, 20(4), 593–600.
The EuroQol Group. (1990). EuroQol–a new facility for the measurement of health-related quality of life. Health Policy, 16(3), 199–208.
Janssen, M. F., Birnie, E., Haagsma, J. A., & Bonsel, G. J. (2008). Comparing the standard EQ-5D three-level system with a five-level version. Value Health, 11(2), 275–284.
Johnson, J. A., & Pickard, A. S. (2000). Comparison of the EQ-5D and SF-12 health surveys in a general population survey in Alberta, Canada. Medicinal Care, 38(1), 115–121.
Sun, S., Chen, J., Johannesson, M., Kind, P., Xu, L., Zhang, Y., et al. (2011). Population health status in China: EQ-5D results, by age, sex and socio-economic status, from the National Health Services Survey 2008. Quality of Life Research, 20(3), 309–320.
Burstrom, K., Johannesson, M., & Diderichsen, F. (2001). Health-related quality of life by disease and socio-economic group in the general population in Sweden. Health Policy, 55(1), 51–69.
Johnson, J. A., & Coons, S. J. (1998). Comparison of the EQ-5D and SF-12 in an adult US sample. Quality of Life Research, 7(2), 155–166.
Herdman, M., Gudex, C., Lloyd, A., Janssen, M., Kind, P., Parkin, D., Bonsel, G., & Badia, X. (2011). Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research, 20(10), 1727–1736.
Kim, S. H., Kim, H. J., Lee, S. I., & Jo, M. W. (2012). Comparing the psychometric properties of the EQ-5D-3L and EQ-5D-5L in cancer patients in Korea. Quality of Life Research, 21(6), 1065–1073.
Pickard, A. S., De Leon, M. C., Kohlmann, T., Cella, D., & Rosenbloom, S. (2007). Psychometric comparison of the standard EQ-5D to a 5 level version in cancer patients. Medical Care, 45(3), 259–263.
McHorney, C. A., Ware, J. E., Jr, & Raczek, A. E. (1993). The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Medical Care, 31(3), 247–263.
Lee, Y. K., Nam, H. S., Chuang, L. H., Kim, K. Y., Yang, H. K., Kwon, I. S., et al. (2009). South Korean time trade-off values for EQ-5D health states: Modeling with observed values for 101 health states. Value Health, 12(8), 1187–1193.
Lubetkin, E. I., Jia, H., Franks, P., & Gold, M. R. (2005). Relationship among sociodemographic factors, clinical conditions, and health-related quality of life: Examining the EQ-5D in the U.S. general population. Quality of Life Research, 14(10), 2187–2196.
Myint, P. K., Luben, R. N., Surtees, P. G., Wainwright, N. W., Bingham, S. A., Wareham, N. J., et al. (2009). Effect of age and sex on the relationship between different socioeconomic indices and self-reported functional health in the EPIC-Norfolk population-based study. Annals of Epidemiology, 19(5), 289–297.
Han, M. A., Ryu, S. Y., Park, J., Kang, M. G., Park, J. K., & Kim, K. S. (2008). Health-related quality of life assessment by the EuroQol-5D in some rural adults. Journal of Preventive Medicine and Public Health, 41(3), 173–180.
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.
Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20, 37–46.
Shrout, P. E., & Fleiss, J. L. (1979). Intraclass correlations: Uses in assessing rater reliability. Psychological Bulletin, 86(2), 420–428.
Wang, H., Kindig, D. A., & Mullahy, J. (2005). Variation in Chinese population health related quality of life: Results from a EuroQol study in Beijing, China. Quality of Life Research, 14(1), 119–132.
Sen, A. (2002). Health: Perception versus observation. BMJ, 324(7342), 860–861.
Fu, A. Z., & Kattan, M. W. (2006). Racial and ethnic differences in preference-based health status measure. Current Medical Research and Opinion, 22(12), 2439–2448.
Wang, H. M., Patrick, D. L., Edwards, T. C., Skalicky, A. M., Zeng, H. Y., & Gu, W. W. (2012). Validation of the EQ-5D in a general population sample in urban China. Quality of Life Research, 21(1), 155–160.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kim, T.H., Jo, MW., Lee, Si. et al. Psychometric properties of the EQ-5D-5L in the general population of South Korea. Qual Life Res 22, 2245–2253 (2013). https://doi.org/10.1007/s11136-012-0331-3
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11136-012-0331-3