A Comparison of the EQ-5D-3L and EQ-5D-5L

Abstract

Introduction The EQ-5D-3L (3L) and EQ-5D-5L (5L) are both frequently used measures of health status. Previous studies have found the EQ-5D-5L to have superior measurement properties but no study has compared the two measures in a large general population survey using matched respondents. Methods Using data from the GP Patient Survey, coarsened exact matching was used to match individuals completing the 3L in 2011 with those completing the 5L in 2012. Measurement properties were assessed for a general population and multimorbid population (chronic conditions ≥ 2), with ceiling effects, informativity and distribution of response compared. Changes in the direction of response, as well as the impact on utility distributions, were quantified. Results Matching resulted in a cohort of 1, 023,218 respondents (2011: 511,609; 2012: 511,609) for analysis. Ceiling effects for the 5L were lower than the 3L (43.8% vs. 54.4%). The 5L had improved informativity and broader spread of responses than the 3L (5L top 50 profiles: 77.4% vs. 3L: 98.8%). Overall, there was an upwards shift in utility values for the 5L versus the 3L as respondents using the 5L reported ill health more frequently but with less severity. Measurement improvements and effects on utility values were more pronounced for the multimorbid population. Conclusion The 5L had superior measurement properties than the 3L and should be preferred in general population surveys and for use in individuals with multimorbidity. At increasing levels of morbidity, the 5L is currently associated with higher utility values than the 3L. Electronic supplementary material The online version of this article (https ://doi.The EQ-5D-5L has superior measurement properties to the EQ-5D-3L and should be preferred in general population and multimorbid populations.The EQ-5D-5L leads respondents to report more illhealth. However, it is less severe than when using the EQ-5D-3L.For higher-levels of multimorbidity, use of the EQ-5D-5L in England will currently lead to higher utility values than the EQ-5D-3L, irrespective of the tariff used.

Measurement properties of EQ-5D-3L and EQ-5D-5L in recording self-reported health status in older patients with substantial multimorbidity and polypharmacy

“…Consistent with most other studies [16,41,42] including an assessment of the subgroup of multimorbid patients in a study by Thompson et al [11], in our sample we observed a reduction in ceiling effects from using the EQ-5D-5L (22%) compared to the EQ-5D-3L (29%). The EQ-5D-5L therefore appears to better capture variability in health status among those who have a high level of health, compared with the EQ-5D-3L.…”

“…Also consistent with all the studies identified in a systematic review by Buchholz et al in 2018 [16] was our finding of an overall improvement in informativity from using the 5L compared to the 3L. This was the consequence of a substantially higher Shannon evenness index score for the mobility item of the 5L compared with the 3L; which was also observed in a study of multimorbid adults by Thompson et al [11]. However, informativity in our study was higher on the 3L than with the 5L for self-care.…”

“…We are aware of two previous studies which have compared the 3L and 5L versions of EQ-5D for people of any age with multimorbidity (defined in these studies as ≥ 2 chronic conditions) [11,12]. Our study is the first we are aware of, to examine the responsiveness of the 3L or 5L in a population with substantial multimorbidity (our sample presented with a mean of 11.5 chronic conditions upon entry into our study) and polypharmacy (defined for this study, as 5 or more different regular drugs for more than 30 days).…”

Validity of the EQ-5D-5L questionnaire among the general population of Poland

“…The recently published study by Thompson et al is also a kind of "indirect study". Still, authors used the matching method to join individuals completing the EQ-5D-3L with those completing the EQ-5D-5L, and thus increasing the sample size [70].…”

A Comparison of Six Approaches for Measuring Utility Values Among Patients With Locally Advanced Cervical Cancer: a Cross-sectional Study

“…However, each dimension of EQ-5D-5L has 5 response categories: 1) no problem; 2) slight problems; 3) moderate problems; 4) severe problems; and 5) extreme problems. Previous studies found that EQ-5D-5L have superior measurement properties than EQ-5D-3L [32][33][34][35]. The value set of EQ-5D-5L was developed based on standardized valuation study protocol (EQ-VT) developed by the EuroQol Group [36].…”