The EQ-5D-5L Improves on the EQ-5D-3L for Health-related Quality-of-life Assessment in Patients Undergoing Total Hip Arthroplasty

Abstract

Background The EQ-5D is a generic health survey that can be used to compare improvement across different interventions, measure changes in health-related quality of life over time, or to explore cost-effectiveness among treatments, hospitals, or providers. The original EQ-5D survey has three response options for each of five health dimensions; however, with so few response options, ceiling and floor effects are problematic in some populations. A new version, called the EQ-5D-5L, was developed, which gives respondents five answer options (the ''5L'' refers to five response levels, which is in contrast to the original survey's three levels). However, the validity of this version has not, to our knowledge, been evaluated in patients undergoing total hip arthroplasty (THA). Questions/purposes The purposes of this study were (1) to characterize the redistribution of responses using the new version; (2) to describe the ceiling and floor effects in the current three-level version and identify whether the new EQ-5D-5L survey diminished these effects; and (3) to understand the convergent validity of the new version with the old and the EQ visual analog scale. Methods Both versions of the survey were administered either preoperatively or 1 to 6 years after THA, allowing at least 2 weeks between administrations. Responses to the two versions were compared to determine response redistribution properties, ceiling and floor effects, and convergent validity. Sample sizes were determined so that the study would have 90% power to detect a Spearman correlation over 0.7 when comparing the responses of the three-level survey with the five-level survey and allowing for a rate of 25% loss to followup.

The Age of BLood Evaluation (ABLE) randomised controlled trial: description of the UK-funded arm of the international trial, the UK cost–utility analysis and secondary analyses exploring factors associated with health-related quality of life and health-care costs during the 12-month follow-up

“…[52][53][54]56,57 Some studies have shown a high level of agreement between the two measures. 50,51,54,57,59 There have been no studies comparing the two instruments in critical care survivors.…”

“…49 Several studies have compared the EQ-5D-3L and the EQ-5D-5L in different countries in both general population samples and specific patient groups, but none of these has examined the two measures in critical care patients. [49][50][51][52][53][54][55][56][57][58][59] The aim of the present study was to compare EQ-5D-3L scores with EQ-5D-5L scores in critical care survivors in the UK. The sample for the present study comprised 359 patients treated at any of the 20 participating UK centres.…”

Measuring Health and Broader Well-Being Benefits in the Context of Opiate Dependence: The Psychometric Performance of the ICECAP-A and the EQ-5D-5L

“…Within the UK, the EuroQol-5D (EQ-5D) is the most commonly used preference-based measure [3], and the one recommended by NICE for HTA submissions [4]. Since 2011, a five-level version of the EQ-5D (EQ-5D-5L) has replaced the previous three-level version (EQ-5D-3L) [5], and emerging evidence indicates improved psychometric performance [6][7][8][9].…”

“…Despite the positive emerging evidence for the psychometric properties of the ICECAP-A [32][33][34][35] and EQ-5D-5L [6][7][8][9], no evidence is yet available for the context of opiate dependence. Even though some supporting evidence for the EQ-5D-3L and other similar health-focused measures exists for this context [36][37][38][39], such measures are used with caution in economic evaluations [40,41].…”

Comparison of Eq-5d-3l and Eq-5d-5l for Health-Related Quality of Life Measurement in Indonesian Population With Several Conditions

“…There have been many previous studies conducted to compare the psychometric properties of EQ-5D-3L and EQ-5D-5L in many population and settings, for instances study in general population in the Netherlands 7 and in Greece 8 study in healthy and/or young individuals in Portugal 9 , study in six Euroepan countries (Denmark, England, Italy, the Netherlands, Poland, and Scotland) involving eight patient groups with chronic conditions (cardiovascular disease, respiratory disease, depression, diabetes, liver disease, personality disorders, arthritis, and stroke) 10 , study in population with chronic conditions in Canada 11 , study in osteoarthritis patients in Canada 12 , study in stroke patients in Poland 13 , study in patients with Total Hip Arthroplasty in Sweden 14 , study in Type 2 diabetes mellitus patients in Thailand 15 and in China 16 and study in rheumatoid arthritis patients in UK 17 Most of studies found that EQ-5D-5L had better psychometric properties compared to 3L. However, to the best of our knowledge such study has not been conducted in Indonesian population.…”