Skip to main content

Advertisement

SpringerLink
Log in

Measuring health-related quality of life among adults in Singapore: population norms for the EQ-5D

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

To provide population norms for the Euro-QoL-5D (EQ-5D) according to age, sex, ethnicity and language version using a representative sample of adults aged 18 years and above in the Singapore population.

Methods

A total of 5,594 respondents who completed the self-administrated paper-based EQ-5D in the Singapore Mental Health Study were included in this study. Socio-demographic characteristics were captured using a structured questionnaire.

Results

The mean age of the sample was 40 years, females comprised 52.2 % of the sample and 78 % were of Chinese descent. Pain/discomfort was the most frequently reported problem (15.3 %) followed by anxiety/depression (8.2 %), whilst self-care (0.5 %) was the least frequently reported problem in the Singapore population. Multiple linear regression analysis revealed that younger age, higher income, those employed and those administered English version of the questionnaire were significantly associated with higher EQ-5D index.

Conclusions

This article provides important population norms for the EQ-5D for measuring health-related quality of life (HRQOL) both in clinical settings and in the research context. Our results suggest that socio-demographic factors should be taken into account when assessing HRQOL among adults in Singapore.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Lopez, A. D., Mathers, C. D., Ezzati, M., Jamison, D. T., & Murray, C. J. (2006). Global and regional burden of disease and risk factors, 2001: Systematic analysis of population health data. Lancet, 367(9524), 1747–1757.

    Article  PubMed  Google Scholar 

  2. EuroQol. (1990). EuroQol–a new facility for the measurement of health-related quality of life. The EuroQol Group. Health Policy, 16(3), 199–208.

    Article  Google Scholar 

  3. Singapore Department of Statistics. (2010). Population trends 2010: Department of statistics. Ministry of Trade & Industry: Republic of Singapore.

    Google Scholar 

  4. Quah, J. H., Luo, N., Ng, W. Y., How, C. H., & Tay, E. G. (2011). Health-related quality of life is associated with diabetic complications, but not with short-term diabetic control in primary care. Annals of the Academy of Medicine Singapore, 40(6), 276–286.

    Google Scholar 

  5. Zhang, X. H., Li, S. C., Fong, K. Y., & Thumboo, J. (2009). The impact of health literacy on health-related quality of life (HRQoL) and utility assessment among patients with rheumatic diseases. Value Health, 12(Suppl 3), S106–S109.

    Article  PubMed  Google Scholar 

  6. Luo, N., Ng, W. Y., Lau, P. N., Au, W. L., & Tan, L. C. (2010). Responsiveness of the EQ-5D and 8-item Parkinson’s Disease Questionnaire (PDQ-8) in a 4-year follow-up study. Quality of Life Research, 19(4), 565–569.

    Article  PubMed  Google Scholar 

  7. Xie, F., Pullenayegum, E. M., Li, S. C., Hopkins, R., Thumboo, J., & Lo, N. N. (2010). Use of a disease-specific instrument in economic evaluations: Mapping WOMAC onto the EQ-5D utility index. Value Health, 13(8), 873–878.

    Article  PubMed  Google Scholar 

  8. Chow, W. H., Chang, P., Lee, S. C., Wong, A., Shen, H. M., & Verkooijen, H. M. (2010). Complementary and alternative medicine among Singapore cancer patients. Annals of the Academy of Medicine Singapore, 39(2), 129–135.

    Google Scholar 

  9. Ong, S. C., Mak, B., Aung, M. O., Li, S. C., & Lim, S. G. (2008). Health-related quality of life in chronic hepatitis B patients. Hepatology, 47(4), 1108–1117.

    Article  PubMed  Google Scholar 

  10. Luo, N., Low, S., Lau, P. N., Au, W. L., & Tan, L. C. (2009). Is EQ-5D a valid quality of life instrument in patients with Parkinson’s disease? A study in Singapore. Annals of the Academy of Medicine Singapore, 38(6), 521–528.

    Google Scholar 

  11. Gao, F., Ng, G. Y., Cheung, Y. B., Thumboo, J., Pang, G., Koo, W. H., et al. (2009). The Singaporean English and Chinese versions of the EQ-5D achieved measurement equivalence in cancer patients. Journal of Clinical Epidemiology, 62(2), 206–213.

    Article  PubMed  Google Scholar 

  12. Wee, H. L., Loke, W. C., Li, S. C., Fong, K. Y., Cheung, Y. B., Machin, D., et al. (2007). Cross-cultural adaptation and validation of Singapore Malay and Tamil versions of the EQ-5D. Annals of the Academy of Medicine Singapore, 36(6), 403–408.

    Google Scholar 

  13. Luo, N., Chew, L. H., Fong, K. Y., Koh, D. R., Ng, S. C., Yoon, K. H., et al. (2003). Do English and Chinese EQ-5D versions demonstrate measurement equivalence? An exploratory study. Health Qual Life Outcomes, 1, 7.

    Article  PubMed  Google Scholar 

  14. Luo, N., Chew, L. H., Fong, K. Y., Koh, D. R., Ng, S. C., Yoon, K. H., et al. (2003). Validity and reliability of the EQ-5D self-report questionnaire in English-speaking Asian patients with rheumatic diseases in Singapore. Quality of Life Research, 12(1), 87–92.

    Article  PubMed  CAS  Google Scholar 

  15. Luo, N., Chew, L. H., Fong, K. Y., Koh, D. R., Ng, S. C., Yoon, K. H., et al. (2003). Validity and reliability of the EQ-5D self-report questionnaire in Chinese-speaking patients with rheumatic diseases in Singapore. Annals of the Academy of Medicine Singapore, 32(5), 685–690.

    CAS  Google Scholar 

  16. Kind, P., Dolan, P., Gudex, C., & Williams, A. (1998). Variations in population health status: Results from a United Kingdom national questionnaire survey. British Medical Journal, 316(7133), 736–741.

    Article  PubMed  CAS  Google Scholar 

  17. Golicki, D., Niewada, M., Jakubczyk, M., Wrona, W., & Hermanowski, T. (2010). Self-assessed health status in Poland: EQ-5D findings from the Polish valuation study. Polskie Archiwum Medycyny Wewnetrznej, 120(7–8), 276–281.

    PubMed  Google Scholar 

  18. Luo, N., Johnson, J. A., Shaw, J. W., Feeny, D., & Coons, S. J. (2005). Self-reported health status of the general adult U.S. population as assessed by the EQ-5D and Health Utilities Index. Medical Care, 43(11), 1078–1086.

    Article  PubMed  Google Scholar 

  19. Fryback, D. G., Dunham, N. C., Palta, M., Hanmer, J., Buechner, J., Cherepanov, D., et al. (2007). US norms for six generic health-related quality-of-life indexes from the National Health Measurement study. Medical Care, 45(12), 1162–1170.

    Article  PubMed  Google Scholar 

  20. 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.

    Article  PubMed  Google Scholar 

  21. Burström, K., Johannesson, M., & Diderichsen, F. (2001). Swedish population health-related quality of life results using the EQ-5D. Quality of Life Research, 10(7), 621–635.

    Article  PubMed  Google Scholar 

  22. Perneger, T. V., Combescure, C., & Courvoisier, D. S. (2010). General population reference values for the French version of the EuroQol EQ-5D health utility instrument. Value Health, 13(5), 631–635.

    Article  PubMed  Google Scholar 

  23. Sorensen, J., Davidsen, M., Gudex, C., Pedersen, K. M., & Bronnum-Hansen, H. (2009). Danish EQ-5D population norms. Scandinavian Journal of Public Health, 37(5), 467–474.

    Article  PubMed  Google Scholar 

  24. Tsuchiya, A., Ikeda, S., Ikegami, N., Nishimura, S., Sakai, I., Fukuda, T., et al. (2002). Estimating an EQ-5D population value set: The case of Japan. Health Economics, 11(4), 341–353.

    Article  PubMed  Google Scholar 

  25. 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.

    Article  PubMed  Google Scholar 

  26. Oppe, M., & De Charro, F. (2004). Population norms and their uses. In A. Szende & A. Williams (Eds.), Measuring Self-Reported Population Health: An International Perspective based on EQ-5D. Budapest: SpringMed Publishing Ltd.

    Google Scholar 

  27. Fayers, P., & Machin, D. (2007). Quality of life: The assessment, analysis and interpretation of patient-reported outcomes. England: Wiley.

  28. Subramaniam, M., Vaingankar, J., Heng, D., Kwok, K. W., Lim, Y. W., Yap, M., et al. (2012). The Singapore Mental Health Study: An overview of the methodology. International Journal of Methods in Psychiatric Research, 21(2), 149–157.

    Article  PubMed  Google Scholar 

  29. Dolan, P. (1997). Modelling valuations for EuroQol health states. Medical Care, 35, 1095–1108.

    Article  PubMed  CAS  Google Scholar 

  30. Chadwick, D. (2001). Monotherapy comparative trials: Equivalence and differences in clinical trials. Epilepsy Research, 45(101), 103.

    Google Scholar 

  31. Rohmel, J. (1998). Therapeutic equivalence investigations: Statistical considerations. Statistics in Medicine, 17, 1703–1714.

    Article  PubMed  CAS  Google Scholar 

  32. Sun, S., Chen, J., Johannesson, M., Kind, P., Xu, L., Zhang, Y., et al. (2011). Regional differences in health status in China: Population health-related quality of life results from the National Health Services Survey 2008. Health Place, 17(2), 671–680.

    Article  PubMed  Google Scholar 

  33. 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.

    Article  PubMed  CAS  Google Scholar 

  34. 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.

    Article  PubMed  Google Scholar 

  35. Cleemput, I. (2004). Can we explain inter-country differences in levels of health? In A. Szende & A. Williams (Eds.), Measuring Self-Reported Population Health: An International Perspective based on EQ-5D. Budapest: SpringMed Publishing Ltd.

    Google Scholar 

  36. Mathers, C. D., & Schofield, D. J. (1998). The health consequences of unemployment: The evidence. Medical Journal of Australia, 168(4), 178–182.

    PubMed  CAS  Google Scholar 

  37. Björklund, A., & Eriksson, T. (1998). Unemployment and mental health: Evidence from research in the Nordic countries. International Journal of Social Welfare, 7, 219–235.

    Article  Google Scholar 

  38. Eden, L., Ejlertsson, G., & Petersson, J. (1999). Quality of life among early retirees. Experimental Aging Research, 25(4), 471–475.

    Article  PubMed  CAS  Google Scholar 

  39. Luo, N., Johnson, J. A., Shaw, J. W., & Coons, S. J. (2009). Relative efficiency of the EQ-5D, HUI2, and HUI3 index scores in measuring health burden of chronic medical conditions in a population health survey in the United States. Medical Care, 47(1), 53–60.

    Article  PubMed  CAS  Google Scholar 

  40. Brazier, J., Jones, N., & Kind, P. (1993). Testing the validity of the Euroqol and comparing it with the SF-36 health survey questionnaire. Quality of Life Research, 2(3), 169–180.

    Article  PubMed  CAS  Google Scholar 

  41. Pullenayegum, E. M., Tarride, J. E., Xie, F., & O’Reilly, D. (2011). Calculating utility decrements associated with an adverse event: Marginal Tobit and CLAD coefficients should be used with caution. Medical Decision Making, 1(6), 790–799.

    Google Scholar 

  42. Sullivan, P. (2001). Are Utilities Bounded at 1.0? Implications for Statistical Analysis and Scale Development. Medical Decision Making, 31(6), 787–789.

    Article  Google Scholar 

Download references

Acknowledgments

The study was funded by the Singapore Millennium Foundation and the Ministry of Health, Singapore.

Author information

Authors and Affiliations

  1. Research Division, Institute of Mental Health, Singapore, Singapore

    Edimansyah Abdin, Mythily Subramaniam, Janhavi Ajit Vaingankar & Siow Ann Chong

  2. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

    Nan Luo

Authors
  1. Edimansyah Abdin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mythily Subramaniam
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Janhavi Ajit Vaingankar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nan Luo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Siow Ann Chong
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Edimansyah Abdin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Abdin, E., Subramaniam, M., Vaingankar, J.A. et al. Measuring health-related quality of life among adults in Singapore: population norms for the EQ-5D. Qual Life Res 22, 2983–2991 (2013). https://doi.org/10.1007/s11136-013-0405-x

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-013-0405-x

Keywords

Search

Navigation