US population norms for the EQ-5D-5L and comparison of norms from face-to-face and online samples

Abstract

Purpose Normative scores (norms) allow for comparisons between population(s) of interest and the general population, which is useful for burden of disease studies and cost-effectiveness analysis. The primary aim of this study was to estimate US visual analogue scale (EQ VAS) and utility-based norms for the EQ-5D-5L using the face-to-face sample. The secondary aim was to compare norms estimated in the face-to-face and online populations. Methods This study estimated population norms from two general population surveys: (a) face-to-face and (b) online. In these surveys, respondents provided their health state using the EQ-5D-5L health classifier and the EQ VAS. Descriptive statistics, including mean, standard deviation (SD), 95% confidence interval, and median for the 5L utility and EQ VAS were estimated for each sample and across relevant respondent characteristics to serve as the basis for US EQ-5D-5L norms Results Face-to-face sample respondents (n = 1134) were representative of the US adult general population. In this sample, mean (SD) utility decreased with increasing age until age 45 or greater (age 45–54: 0.816 (0.249) age 55–64: 0.815 (0.243) age 65–74: 0.824 (0.217) age 75 + : 0.811 (0.218)). With increasing age, more problems were reported on all dimensions except anxiety/depression; a smaller proportion of respondents age 65 and older reported problems with anxiety/depression (23.8%) as compared to the youngest respondents (42.1%). Online (n = 2018) mean utility and EQ VAS values were consistently lower than the face-to-face sample. Conclusions The availability of US EQ-5D-5L norms facilitates interpretation and understanding of general population and patient health.

Norwegian Population Norms for the EQ-5D-5L: Results From a General Population Survey

“…This data is highly important to Norwegian users of PROMs in clinical and health services research, and the Norwegian NQRs, where EQ-5D-5L is by far the most widely used patient-reported instrument. The survey was speci cally designed for the collection of norm data, whereas published data for several countries followed the collection EQ-5D valuation data for national scoring algorithms [2,14,15,17,20] or as part of other health surveys [24,25]. The former followed EuroQol Valuation Technology and survey requirements including computer-assisted face-to-face interviews and sample sizes of approximately 1000, although the EQ-5D-5L and EQ VAS are generally completed by means of pen and paper in this context [5,14].…”

“…However, given the over-representation of females and those with higher education levels, the data are not fully representative for the Norwegian general population. While not all EQ-5D-5L studies included a comparison with the general population, those that have also found over representation in relation to females [20], younger [21] and older age groups [20], and higher education levels [2,14,23,25]. This may be problematic for the aggregated columns of all respondents, but users can easily weight the data to their own needs.…”

“…National population norms are increasingly available for the EQ-5D-5L and to date include 14 countries: Bulgaria [14], China [15], Germany [16], Hong Kong [17], Italy [18], Indonesia [19], Ireland [20], Japan [21], Poland [22], Slovenia [23], Spain [24], Trinidad and Tobago [25], USA [2] and Vietnam [26]. Data were collected by computer assisted interview, face-to-face interview, on-line and self-completed (pen and paper).…”

“…Samples size ranged from approximately 1000 [14], the level required for EQ-5D-5L valuation studies, to over 20 000 in the Spanish National Health Survey [24]. Most studies reported norms for the EQ-5D-5L dimensions, index and EQ VAS scores across categories of age and sex, with other socioeconomic variables including education level, being less widely reported [2,[14][15][16][17][18][19][20][21][22][23][24][25][26]. This is the rst study to derive population norms for the EQ-5D-5L by means of a postal survey based on a nationally representative sample of Norwegians adults.…”

Reference Data and Known-Groups Validity of the EQ-5D-5L for Vietnam

“…The EQ-VAS reference data can often yield a table of mean(s)/median(s) EQ-VAS scores by age-sex groups, while the mean(s)/median(s) EQ-5D-5L indexes were derived from the national value set for the EQ-5D-5L indexes reference data [20]. The population norms using the EQ-5D-5L were developed globally, from Western countries [21][22][23][24][25][26][27][28][29][30] to Asian countries [31][32][33][34][35][36][37]. A hint of population norms using the EQ-5D-5L for the Vietnamese has been done elsewhere, but the study included an urban population only, and furthermore, used Thai preferences [37].…”