EQ-5D and beyond: OHE’s contributions to EuroQol research and meetings

Measuring and valuing health outcomes is arguably what makes health economics such a unique and sometimes controversial discipline. The idea of putting a numerical value on an individual’s health state may not sit right with some people but in reality, it’s often central to healthcare decision-making through its use to generate QALYs in economic evaluation. One of the most common ways to measure quality of life is using the EQ-5D, a patient reported outcome measure developed by the EuroQol Foundation.

Here at the OHE, we conduct a range of research on topics related to the EQ-5D from conceptualisation, development, and valuation. This insight summarises key takeaways from the UK&I EQ-5D Researchers Meeting on February 20th in London and looks ahead to the 5th EuroQol Early Career Researcher Meeting and the 9th EuroQol Academy Meeting from March 11th to 13th in Barcelona.

Last week, researchers from across the UK and Ireland met at Holborn’s Conway Hall for a day of stimulating presentations and insightful discussions. On behalf of the OHE team that attended, our thanks go to Andrew Lloyd and Louise Longworth for organising the meeting and EuroQol for funding.

Among the research presented, Professor Oliver Rivero-Arias called attention to the methodological challenges of valuing the EQ-5D-Y (the youth version of the EQ-5D); these include who should complete the valuation tasks (adults, adolescents or children), what age should the theoretical child whose health is being valued be, what methods should be used (e.g. Time Trade Off (TTO), Composite TTO (cTTO), Discrete Choice Experiment (DCE)), how should changes in the relevant value set be accounted for in the calculation of QALYs if an intervention spans across multiple value sets (e.g. EQ-5D-Y and EQ-5D).

OHE’s David Mott is active in this research area; he is currently contributing to the development of UK EQ-5D-Y-3L value set and was part of a number of projects which are described in following publications:

• Mott et al. (2021) Valuing EQ-5D-Y health states using a discrete choice experiment: do adult and adolescent preferences differ?
• Kreimeier et al. (2022) EQ-5D-Y Value Set for Germany
• Mott et al. (2022) Analytical Considerations When Anchoring Discrete Choice Experiment Values Using Composite Time Trade-Off Data: The Case of EQ-5D-Y-3L

Other interesting topics included James Koh’s (2023) research into quality-adjusted life expectancy inequalities by mortality and health-related quality of life, Sally L Sansom et al.’s research on evaluating the psychometric properties of patient and carer-reported outcome measures in the context of genome sequencing and Emma McManus et al.’s research on the quality of life of individuals at elevated risk of type 2 diabetes: analysis of 150,000 EQ-5D responses.

The meeting closed with a much-anticipated preview of EuroQol’s Bolt-on Toolbox by Professor Fanni Rencz. Bolt-ons are additional dimensions that can be attached to the EQ-5D to capture aspects of health-related quality of life not sufficiently covered by the five core dimensions. Fanni presented the results of a comprehensive literature review that aimed to understand the extent to which bolt-ons have been developed and tested; she found that numerous domains with even more versions have been researched. Among these include domains for cognition, vision, hearing, energy, sleep/fatigue, skin irritation and more. Despite the extensive research undertaken over the past couple of decades, questions remain around the concept of bolt-ons, their implications for valuation and whether their use undermines the EQ-5D as generic measure of quality of life.

These topics will no doubt be discussed and debated at length at the 9th EuroQol Academy Meeting, where the theme will be “Bolt-ons”. Five OHE team members will be in attendance in various capacities, and are looking forward to engaging with recent research, contributing to discussions, and catching up with our collaborators from around the world.

If you’d like to hear more about OHE’s research in this area or discuss collaboration opportunities, please don’t hesitate to contact us at info@ohe.org.