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Introduction
Skills and Expertise
Publications
Publications (97)
Objective:
To study socio-economic inequalities in patient-reported outcomes in primary hip and knee arthroplasty (THA/TKA) patients for osteoarthritis, using two analytical techniques.
Methods:
We obtained data from 44732 THA and 30756 TKA patients with preoperative and 12-month follow-up PROMs between 2014-2020 from the Dutch Arthroplasty Regi...
Background
Still little is known about the impact of post COVID-19 condition (PC) on health-related quality of life (HRQOL) and mental well-being. We compared participants with PC with three groups: an acute COVID-19 infection (AC) only, at least one chronic condition (CC) but no COVID-19, or no condition at all, healthy (PH). Between these disease...
Introduction:
For patients with generalized myasthenia gravis (gMG), the association between symptom severity, often measured with the Myasthenia Gravis Activities of Daily Living (MG-ADL) instrument, and utility values is unknown.
Methods:
Data was analyzed from the phase 3 ADAPT trial, which included adult patients with gMG randomly assigned t...
Objectives
This study presents a country-specific 3-level version of EQ-5D population norms for the European older population.
Methods
Norm data were obtained from the fourth wave of the Survey of Health, Ageing and Retirement in Europe, and determined, for each EQ-5D dimension, the EQ–visual analog scale (EQ-VAS) and EQ-5D index values by 7 age g...
Background
The COVID-19 pandemic affected the mental health of the general population through multiple pathways. The aim of this study was to examine anxiety, depression, self-confidence, and social connectedness among the general population of eight countries during the COVID-19 pandemic, their underlying factors, and vulnerable groups.
Methods
A...
This study aimed to investigate socioeconomic and health-related determinants and recent life events and their relation to changes in health-related quality of life (HRQoL) and mental well-being during the first year of the COVID-19 pandemic. A web-based survey was administered repeatedly to participants from Greece, Italy, the Netherlands, the Uni...
Objectives:
The aim of this study was to compare the responsiveness of EQ-5D-3L (3L) with EQ-5D-5L (5L) descriptive systems and value sets in two independent samples (rehabilitation and stroke patients).
Methods:
Descriptive system results were compared cross-sectionally, and descriptive responsiveness was tested by calculating changed level res...
Introduction
The effects of the COVID-19 pandemic caused considerable psychological and physical effects in healthy and diseased New Yorkers aside from the effects in those who were infected. We investigated the relationship between known risk-enhancing and health-promoting factors (social and medical), comorbidity indicators, and, as the primary o...
Purpose
To determine feasibility and validity of the EQ-5D-3L in the elderly European population.
Methods
Secondary data analysis based on the study of health, ageing, and retirement in Europe (SHARE) to determine the percentage of missing items for EQ-5D dimensions and EQ VAS, and to demonstrate convergent/divergent validity with measures include...
Objectives
There has been a growing interest in the use of EQ-5D health outcomes measures in Latin America and the Caribbean. Population norms data provide a benchmark against which clinicians, researchers, and policy makers can compare the health status of patient, treatment, or demographic groups. This study aimed to provide EQ-5D-5L population n...
Purpose
‘Bolt-on’ dimensions are additional items added to multi-attribute utility instruments (MAUIs) such as EQ-5D that measure constructs not included in the core descriptive system. The use of bolt-ons has been proposed to improve the content validity and responsiveness of the descriptive system in certain settings and health conditions. EQ-5D...
Objectives
Evidence comparing utilities for adults and children consistently report higher utility values for child health states. This study investigates the reasons why child health states are valued differently.
Methods
A total of 80 respondents (United Kingdom, Belgium, The Netherlands) participated in 1.5-hour face-to-face interviews. Respond...
Background:
Fatigue is a common and often disturbing sequela of serious chronic health conditions. In the widely applied HRQL instrument, the EQ-5D, this aspect is not included directly, for its assumed lack of additional information. We investigated the validity of this assumption by determining the gain-if any-of an additional fatigue item to th...
Purpose
To assess the measurement properties of EQ-5D-3L and EQ-5D-5L in patients with a major lower limb amputation (LLA).
Methods
This was a retrospective register-based study using data from the Swedish Amputation and Prosthetics Registry (SwedeAmp). Patients with a six-months follow-up (including either EQ-5D-3L or EQ-5D-5L) after a major unil...
Objectives
The EQ-5D-3L and EQ-5D-5L instruments have been used in studies of patient and demographic groups in Colombia, but to date there are no 5L population norms. This study aimed to produce a set of EQ-5D-5L population norms for Colombia and to see what insights into health inequality in Colombia can be discerned from these norms.
Methods
Th...
Aim
The EQ-5D is a generic measure of health that is widely applied for health economic and non-economic purposes. Population norms can be used to facilitate the interpretation of EQ-5D data. The objective of this study was to develop a set of pooled normative EQ-5D-3L values for the five largest European economies (EUR5).
Methods
EQ-5D-3L index v...
Objective: This study explored the additive value of the multi-item EuroQol 5-Dimension 5-Level (EQ-5D-5L) as an outcome measure in health inequality analyses, relative to the single-item EuroQol visual analog scale (EQ VAS).
Methods: A sample comprising the general population from Italy, the Netherlands, and United Kingdom (UK) completed the EQ-5D...
Objectives
Our study aimed to (1) assess health-related quality of life (HRQoL) and mental well-being of healthy and diseased persons in the general population during the early stage of the COVID-19 pandemic and (2) examine the relationship between HRQoL and mental well-being and individual characteristics and government response against COVID-19,...
Background
Health fluctuations even within a single day are typical in multiple sclerosis (MS), but are not captured by widely used questionnaires like the EQ-5D-5L. This exploratory study aimed to develop an ambulatory assessment (AA) version of the EQ-5D-5L (EQ-5D-AA) where patients rate their health on mobile phones multiple times per day over s...
Introduction
Myasthenia gravis (MG) is a rare, chronic, autoimmune disease, mediated by immunoglobulin G antibodies, which causes debilitating muscle weakness. As with most rare diseases, there is little patient-reported data with which to understand and address patient needs. This study explores the impact of MG in the real world from the patient...
Background
Fatigue negatively influences health-related quality of life. It is questionable whether fatigue is sufficiently covered by the EQ-5D. This study investigated whether fatigue is covered by the existing domains of the EQ-5D.
Methods
A Dutch general population sample completed the EQ-5D (3L and 5L version) and the Rivermead Post-Concussio...
Background
The EQ-5D instrument is increasingly used in clinical and resource allocation decision making in developed and developing countries. EQ-5D valuation and population norms studies have been undertaken for Trinidad and Tobago, however no population norms or value sets have been generated for the other Caribbean countries. The aims of this s...
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....
Purpose
Although the EQ-5D has a long history of use in a wide range of populations, the newer five-level version (EQ-5D-5L) has not yet had such extensive experience. This systematic review summarizes the available published scientific evidence on the psychometric properties of the EQ-5D-5L.
Methods
Pre-determined key words and exclusion criteria...
Objectives
The standard quality-adjusted life year (QALY) model (SQM) assumes time–utility independence within constant health states and additive independence when health varies over time. The validity of SQM has been challenged through reported violations of these assumptions. An alternative approach that relaxes these assumptions is to assign a...
Objectives
The question of whether additional dimensions should be added to the EQ-5D, so-called bolt-ons, has been researched since the 1990s. Several candidate bolt-ons have been tested. The aim of this systematic review was to provide an overview of EQ-5D bolt-on studies, including the origin of possible suitable bolt-ons, their format, and meth...
Background:
The Swedish National Quality Registries (NQRs) contain individual-level health care data for specific patient populations, or patients receiving specific interventions. Approximately 90% of the 105 Swedish NQRs include any patient-reported outcome measure, with EQ-5D being the most common. As there has been no general overview of EQ-5D...
Introduction:
Health-related quality of life (HRQL) is an important outcome in burn care and research. An advantage of a generic HRQL instrument, like the EQ-5D, is that it enables comparison of outcomes with other conditions and the general population. However, the downside is that it does not include burn specific domains, like scar issues or it...
PurposeThis study investigated the psychometric yield of extension of the EQ-5D-5L with a cognitive domain (EQ-5D+C) in a mixed cohort of trauma patients with repeated data.MethodsA stratified sample of patients that presented at the emergency department filled out a follow-up survey 6 and 12 months after trauma. The surveys included the EQ-5D-5L+C...
It is important when analysing EQ VAS data to understand the nature of this element of the EQ-5D questionnaire and the measurement properties that it has. (For a more detailed discussion, see Feng et al. 2014.) The EQ VAS has a unique design that does not conform to conventional Visual Analogue Scale (VAS) formats, and the widely-observed propertie...
Our focus, throughout this book, is on the analysis of EQ-5D data. The book is designed to meet the needs of those who have, or are planning to, collect EQ-5D data. Our hope is that this book will encourage all analysts, both those new to the EQ-5D and those experienced in using EQ-5D questionnaires, to make full use of the data provided by respond...
In the analyses described in Chapters 3 and 4, the objects of interest are EQ-5D values or EQ VAS scores measured at one or more points in time for one person or a group of people.
Profile data form the cornerstone of analyses of EQ-5D data and, in many cases, are likely to be the primary focus of interest. In this chapter, we provide an overview of methods that can be used to describe the profile data from respondents at a given point in time, and to describe the changes in profiles between different points in time.
Despite the potential richness of the EQ-5D descriptive system demonstrated in the previous chapters, the instrument was originally developed as a measure of health status that could serve as the basis for summarising and comparing health outcomes (Williams 2005).
Objectives:
(1) To evaluate the effect of adding a vision dimension ('bolt-on') to the 5-level EQ-5D (EQ-5D-5L) and 3-level EQ-5D (EQ-5D-3L) on their responsiveness, and (2) to compare the responsiveness of a vision 'bolt-on' EQ-5D-3L (EQ-5D-3L + V) with SF-6D and Health Utilities Index Mark 3 (HUI3) to the benefit of cataract surgery.
Methods:...
Background:
The EQ-5D domain pain/discomfort (PD) uses one item to capture pain and other aspects of discomfort, like itching. This study explored how pain, itching and the EQ-5D-5L PD domain relate to each other in a sample of burn patients.
Methods:
Adult burn patients completed the EQ-5D-5L and the Patient and Observer Scar Assessment Scale (...
Background
The use of 'bolt-on' descriptors has been proposed to improve the sensitivity and responsiveness of the EQ-5D in certain contexts. An Australia/UK collaboration is developing bolt-ons for vision (5L-Vis) and cognition (5L-Cog) for self-and proxy-completion, using qualitative and quantitative methods. The application of qualitative method...
This open access book is the first published guide about how to analyse data produced by the EQ-5D, one of the most widely used Patient Reported Outcomes questionnaires world wide. The authors provide practical, clear and comprehensive guidance in five concise chapters. Following an overview of the EQ-5D and its analysis, we describe how the questi...
OBJECTIVES
Evidence suggests that, in specific circumstances, the EQ-5D is insensitive to changes or differences in health status. One possible solution is to add 'bolt-on' dimensions to the core EQ-5D dimensions, to provide additional information about the impact of certain conditions or symptoms on health. In this study, we developed EQ-5D-5L bol...
Purpose
This study investigated the psychometric gain, if any, from the extension of the EQ-5D with a cognition bolt-on (EQ-5D + C) in a large cohort injury patients with and without traumatic brain injury (TBI).
Methods
Hospitalized adult injury patients filled out a survey 1 month after initial admission. The survey included the EQ-5D-3L, the co...
Introduction
The EQ-5D is frequently used to understand the development of health-related quality of life (HRQL) following injury. However, the lack of a cognition dimension is generally felt as disadvantageous as many injuries involve cognitive effects. We aimed to assess the added value of a cognitive dimension in a cohort of injury patients.
Me...
The EQ-5D instrument is now used in many health systems as a health outcomes measure. Recently an EQ-5D valuation study was conducted for Trinidad and Tobago, but thus far there have been no population norms published for Trinidad and Tobago or for any Caribbean country. The objective of this study is to provide a set of population norms, and to in...
Table A. Absolute differences in VAS and EQ-5D Index Values between the highest and lowest income groups by age and gender. Table B. Absolute differences in VAS and EQ-5D Index Values between the highest and lowest education groups by age and gender. Table C. Absolute differences in VAS and EQ-5D Index Values between respondents with- and without-...
This study provides EQ-5D population norms for 20 countries (N = 163,838), which can be used to compare profiles for patients with specific conditions with data for the average person in the general population in a similar age and/or gender group. Descriptive EQ-5D data are provided for the total population, by gender and by seven age groups. Provi...
Background
It is not clear whether 5-level EQ-5D (EQ-5D-5L) utilities based on recently developed value sets are more responsive than 3-level EQ-5D (EQ-5D-3L) utilities.
Objectives
The study aims were to compare (1) the responsiveness of EQ-5D-5L and EQ-5D-3L utilities and (2) the responsiveness of these utilities with the Short Form–6 Dimension (...
Background: This study aims to assess the specific difference of the health-related quality of life between people with Parkinson’s and non-Parkinson’s. Methods: A total of 1710 people were drawn from a prospective study with a smartphone-based survey named ‘100 for Parkinson’s’ to assess health-related quality of life. The EQ-5D-5L descriptive sys...
The article Comparing the UK EQ-5D-3L and English EQ-5D-5L Value Sets, written by Brendan Mulhern, Yan Feng, Koonal Shah, Mathieu F. Janssen, Michael Herdman, Ben van Hout, Nancy Devlin was originally published electronically on the publisher's internet portal (currently SpringerLink) on February 23, 2018 without open access.
Background:
Since the introduction of the five-level version of the EQ-5D (5L), many studies have comparatively investigated the measurement properties of the original three-level version (3L) with the 5L version.
Objective:
The aim of this study was to consolidate the available evidence on the performance of both instruments.
Methods:
A syste...
Background
Three EQ-5D value sets (EQ-5D-3L, crosswalk, and EQ-5D-5L) are now available for cost-utility analysis in the UK and/or England. The value sets’ characteristics differ, and it is important to assess the implications of these differences. Objective
The aim of this paper is to compare the three value sets. Methods
We carried out analysis c...
Objective:
This study describes the first empirical head-to-head comparison of EQ-5D-3L (3L) and EQ-5D-5L (5L) value sets for multiple countries.
Methods:
A large multinational dataset, including 3L and 5L data for eight patient groups and a student cohort, was used to compare 3L versus 5L value sets for Canada, China, England/UK (5L/3L, respect...
Introduction
Inconsistency in the time trade-off (TTO) task in EQ-5D-5L occurs when a respondent gives a higher value to a logically worse health state, the occurrence of inconsistency compromises the quality of the data. It is not yet clear which factors are associated with individual level inconsistency. Relating inconsistency to the characterist...
Individual level inconsistency.
(DTA)
IntroductionThe EQ-5D is a standardised instrument designed for use as a generic measure of health outcome. It was (and is) intended to provide information about a ‘common core’ of dimensions known to be relevant across a range of conditions; however, the five dimensions may not fully capture the health-related impacts of certain conditions. This s...
Measuring Income-Related Inequity In Self-Assessed Health Using The EQ-5D In 7 Countries
Background: Health states defined by multiattribute instruments such as the EuroQol five-dimensional questionnaire with five response levels (EQ-5D-5L) can be valued using time trade-off (TTO) or discrete choice experiment (DCE) methods. A key feature of the tasks is the order in which the health state dimensions are presented. Respondents may use...
Background:
Studies to produce value sets for preference-based measures of health require definition of a full health upper anchor if the values are to be used to calculate quality-adjusted life years. Recent value sets derived for the EQ-5D-5L instrument have described the upper anchor as "full health," whereas older valuation studies for the EQ-...
Background:
The aim of this study was to investigate the validity and reliability of the HeartQoL instrument in a population of stable coronary patients.
Design:
Analyses are based on the cross-sectional EUROASPIRE IV (EUROpean Action on Secondary and Primary prevention through Intervention to Reduce Events) survey.
Methods:
Patients with a di...
Background
Most previous studies concerning the validity of the EQ-5D-3L items refer to applications of only a single language version of the EQ-5D-3L in only one country. Therefore, there is little information concerning the extent to which the results can be generalised across different language versions and/or different countries. Here the valid...
To date, evidence to support the construct validity of the EQ-5D-5L has primarily focused on cross-sectional data. The aims of this study were to examine the responsiveness of EQ-5D-5L in patients with stroke and to compare it with responsiveness of EQ-5D-3L and visual analogue scale (EQ VAS).
We performed an observational longitudinal cohort study...
Purpose:
To assess EQ-5D-5L (5L) validity in patients with acute stroke, in comparison with EQ-5D-3L (3L).
Methods:
Cross-sectional study of 408 patients during index hospitalization. We compared 5L and 3L in terms of feasibility, frequency of unique health states, ceiling effect and discriminatory power (informativity). We assessed construct va...
Objective
To estimate an interim five-level EuroQol five-dimensional (EQ-5D-5L) value set for Poland on the basis of the crosswalk methodology developed by the EuroQol Group.
Methods
On the basis of data from 3691 respondents from six European countries, the EuroQol Group has developed a method of obtaining interim value sets for the EQ-5D-5L by m...
This chapter presents the population norm data using EQ-5D for each country. EQ-5D norms are reported for EQ VAS and EQ-5D index values, and for self-reported problems on each of the five dimensions of the EQ-5D descriptive system, all classified by age and gender. These EQ-5D norms can be used as reference data to compare patients with specific co...
This chapter presents the data sources and methods of the book. General population surveys are accumulated from 24 countries (Table 2.1). Descriptive statistics are used to provide EQ-5D population norms by age and gender categories for EQ VAS, EQ-5D index values, and for the five dimensions. Correlations between country-specific EQ-5D data (EQ VAS...
This chapter demonstrates that cross-country differences exist in EQ-5D outcomes after the population data is standardized for demographic differences. These cross-country differences in the general level of health are explained by looking at macro data on the economic and health system characteristics of each country. Results show that it is the p...
This chapter specifically addresses the distribution of health within the population and the degree to which age, gender, education level and country are responsible for inequalities in self-reported health. Usual activities and pain/discomfort were the highest contributors to overall inequalities in self-assessed health in most countries. Educatio...
The EQ-5D instrument, as a standardized, cross-culturally validated measure of self-assessed health has a hugely important role in understanding population health within and across countries. Over the past two decades a wealth of international population health survey data have been accumulated by the EuroQol Group from research conducted in many c...
The EuroQol five-dimensional (EQ-5D) questionnaire is a generic measure widely used for the assessment of health status. Research has suggested that it may be insensitive to the burdens associated with particular conditions. This study was designed to explore the feasibility of developing and valuing a disease-specific "bolt-on" version of the EQ-5...
Introduction
This study was designed to test the feasibility and face validity of the composite time trade-off (composite TTO), a new approach to TTO allowing for a more consistent elicitation of negative health state values.
Methods
The new instrument combines a conventional TTO to elicit values for states regarded better than dead and a lead-tim...
