Self-Reported Health Status of the General Adult U.S. Population as Assessed by the EQ-5D and Health Utilities Index

Thomas Jefferson University, Filadelfia, Pennsylvania, United States
Medical Care (Impact Factor: 3.23). 12/2005; 43(11):1078-86. DOI: 10.1097/01.mlr.0000182493.57090.c1
Source: PubMed


This study aimed to describe the self-reported health status of the general adult U.S. population using 3 multi-attribute preference-based measures: the EQ-5D, Health Utilities Index Mark 2 (HUI2), and Mark 3 (HUI3).
We surveyed the general adult U.S. population using a probability sample with oversampling of Hispanics and non-Hispanic blacks. Respondents to this home-visit survey self-completed the EQ-5D and HUI2/3 questionnaires. Overall health index scores of the target population and selected subgroups were estimated and construct validity of these measures was assessed by testing a priori hypotheses.
Completed questionnaires were collected from 4048 respondents (response rate: 59.4%). The majority of the respondents were women (52.0%); the mean age of the sample was 45 years, with 14.8% being 65 or older. Index scores (standard errors) for the general adult U.S. population as assessed by the EQ-5D, HUI2, and HUI3 were 0.87 (0.01), 0.86 (0.01), and 0.81 (0.01), respectively. Generally, younger, male and Hispanic or non-Hispanic black adults had higher (better) index scores than older, female and other racial/ethnic adults; index scores were higher with higher educational attainment and household income. The 3 overall preference indices were strongly correlated (Pearson's r: 0.67-0.87), but systematically different, with intraclass correlation coefficients between these indices ranging from 0.59 to 0.77.
This study provides U.S. population norms for self-reported health status on the EQ-5D, HUI2, and HUI3. Although these measures appeared to be valid and demonstrated similarities, health status assessed by these measures is not exactly the same.

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    • "In the original version of the instrument, each dimension in the descriptive system is assessed using 3 levels of severity [5]. In order to reduce high ceiling effects (i.e. the proportion of respondents reporting the best possible health on EQ-5D who are therefore unable to record any improvement in health status) reported in some populations6789101112, and to increase the instrument's sensitivity to changes in health, a new version of the instrument was developed using the same 5 dimensions, but with 5 levels of severity in each [13]. Studies in Germany [14] and South Korea [15] indicated that the ceiling effect was reduced in the 5L version but, as far as we are aware, only Craig et al. (2014) directly compared the performance of the 3L and 5L versions of EQ-5D in a general population sample [16]. "
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    ABSTRACT: The EQ-5D is a brief, generic measure of health status that can be easily incorporated into population health surveys. 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). We compared the two versions as measures of self-reported health status in representative samples of the English general population. EQ-5D-5L data were available from 996 respondents selected at random from residential postcodes who took part in the EQ-5D-5L value set for England study. 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 score distributions 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, we analysed health status reporting on the descriptive profile, EQ-5D Index, and EQ-VAS of both versions of EQ-5D by age, sex, and educational background. We used X 2 to test for differences between respondent categories when analyzing EQ-5D profile data and the t test when analyzing EQ-5D Index and VAS scores. 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 and the EQ-5D-5L descriptive system, though not the Index or 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 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.
    Full-text · Article · Dec 2015 · Health and Quality of Life Outcomes
    • "The evidence for the aetiology of PLDS is not well established . Similar symptoms occur in the general population without a history of LB, which is the major limitation in the investigation of its possible causality [11] [12]. The infectious cause of the complaints could not be assessed; identification of a pathogen in patients with non-specific symptoms after antibiotic treatment for LB was not possible. "
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    ABSTRACT: The aim of the study was to find out whether patients with antibodies against Borrelia burgdorferi sensu lato (sl) or who report a history of erythema migrans (EM) or tick bite are more likely to have nonspecific symptoms such as musculoskeletal pain, fatigue, sensory disorder and headache. The study group comprised 423 subjects with nonspecific symptoms tested for antibodies against B. burgdorferi sl between July 2012 and December 2014 because of suspicion of Lyme borreliosis (LB). Of these, 285 were females (67%) and 138 males (33%); the median age was 53 years (range 7-89). Patients with confirmed diagnosis of LB and patients with a known underlying disease, which could influence the development of the symptoms, were excluded from the evaluation. Subjects were assigned to the seronegative group or one of three seropositive groups and the history of EM and tick bite was also recorded. Statistical analysis was performed using single chi-square tests of independence and multiple logistic regression models. No differences in occurrence of nonspecific symptoms were observed between patients grouped according to antibody status. History of EM showed no significant effect on any of the nonspecific symptoms. History of tick bite was weakly correlated with joint pain and joint swelling (P<0.05). In conclusion, it is highly unlikely that the complaints are related to a previous infection with B. burgdorferi sl. The results show that testing patients with nonspecific symptoms for antibodies against B. burgdorferi sl in everyday clinical setting does not provide any useful information about their etiology. Copyright © 2015. Published by Elsevier Ltd.
    No preview · Article · Aug 2015 · Clinical Microbiology and Infection
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    • "The EQ-5D is a widely used health utility index that can be derived from SF-36 scales [26]. It provides a single general measure of health status that can be used in economic analyses and to track the impact of healthcare interventions, and has been shown to be useful in a number of conditions [27] [28] [29] [30] [31] [32]. "
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    ABSTRACT: Objective: Researchers have identified significant limitations in some currently used measures of health literacy. The purpose of this paper is to present data on the relation of health-related quality of life, health status, and health service utilization to performance on a new measure of health literacy in a nonpatient population. Methods: The new measure was administered to 475 English- and Spanish-speaking community-dwelling volunteers along with existing measures of health literacy and assessments of health-related quality of life, health status, and healthcare service utilization. Relations among measures were assessed via correlations and health status and utilization was tested across levels of health literacy using ANCOVA models. Results: The new health literacy measure is significantly related to existing measures of health literacy as well as to participants' health-related quality of life. Persons with lower levels of health literacy reported more health conditions, more frequent physical symptoms, and greater healthcare service utilization. Conclusion: The new measure of health literacy is valid and shows relations to measures of conceptually related constructs such as quality of life and health behaviors. Practice implications: FLIGHT/VIDAS may be useful to researchers and clinicians interested in a computer administered and scored measure of health literacy.
    Full-text · Article · May 2014 · Patient Education and Counseling
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