New OHE Publication Compares 3L and 5L Versions of EQ-5D as Measures of General Population Health

New publication by OHE’s Yan Feng, Nance Devlin and Mike Herdman in Health and Quality of Life Outcomes, comparing the 3L and 5L versions of EQ-5D as measures of general population health.

A paper by OHE’s Yan Feng, Nance Devlin and Mike Herdman has recently been published in Health and Quality of Life Outcomes. The paper compares the 3L and 5L versions of the EQ-5D instruments as measures of self-reported health status in representative samples of the English general population. The study was funded by a research grant from the EuroQol Research Foundation.

There are two versions of the EQ-5D for use in adult populations, one with 3 response levels in each of the instrument’s 5 dimensions (EQ-5D-3L) and one with 5 levels in each dimension (EQ-5D-5L). This study is the first to report results comparing the performance of the two versions of the EQ-5D instruments in the context of a general health survey. 

EQ-5D-5L data were available from 996 randomly selected respondents who took part in the EQ-5D-5L value set for England study between November 2012 and March 2013. EQ-5D-3L data were available from 7294 participants included in the 2012 Health Survey for England. 

Responses on the 3L and 5L versions of EQ-5D were compared by examining the distributions of self-reported health on the two versions, both in terms of the profile (dimensions) and the EQ-VAS. To determine the extent of variations in score according to respondent characteristics, the authors analysed health status on the descriptive profile, EQ-5D Index, and EQ-VAS of both versions of EQ-5D by age, sex, and educational background. 

Their results suggest that the 5L version of EQ-5D led to a considerably reduced ceiling effect and a larger proportion of respondents reporting severe health problems compared to the 3L. The 5L version also led to the use of a wider spread of health states; just 3 health states on the 3L covered 75% of the sample, compared to 12 states on the 5L. 

Both versions showed poorer health status in older respondents, females, and those in a lower educational category. The EQ-5D-5L descriptive system, though not the Index or EQ-VAS, discriminated better between age groups than the 3L. There were no appreciable differences between the two versions in their ability to discriminate between groups defined by gender or educational level.

The authors conclude that the new, expanded 5L version of EQ-5D may be a more useful instrument for the measurement of health status in population health surveys than the original 3L version.

Reference: Feng Y, Devlin N and Herdman M., 2015. Assessing the health of the general population in England: how do the three- and five-level versions of EQ-5D compare? Health and Quality of Life Outcomes, 13: 171. 

Acknowledgements: Funding for this study was provided by a grant from the EuroQol Group. The views and opinions expressed in this paper are those of the authors, and do not necessarily represent the views of the EuroQol Group. We are grateful to the Health Information Centre for providing access to the HSE data used in this analysis. The EQ-5D-5L Value Set for England study was funded by a Department of Health Policy Research Programme grant. Views expressed in this paper are those of the authors, and not the Department of Health.