Abstract
BackgroundStudies comparing the measurement properties of EQ-5D 3L (3L) and EQ-5D 5L (5L) are limited to specific patient populations with small sample sizes. Using a general population sample, we compared 3L and 5L in terms of their measurement properties and association with number of chronic conditions, including multimorbidity – the concurrent occurrence of two or more chronic conditions.MethodsData were available from two consecutive cycles of a cross-sectional telephone interview survey using 3L (2010 cycle) and 5L (2012 cycle), in the general population of adults (age ≥ 18 years) in Alberta, Canada. Measurement properties were compared by determining their feasibility, ceiling effect, and discriminatory power (Shannon indices) for 3L and 5L. Linear regression models were fitted to test the associations between multimorbidity and EQ-5D index score.ResultsData were available for 4946 (2010) and 4752 (2012) survey respondents with information on HRQL. Compared to 3L, 5L showed lower ceiling effect (32.3% versus 42.1%), higher absolute discriminatory power (Shannon index, mean 0.79 versus 0.52) and higher relative discriminatory power (Shannon Evenness index, mean 0.09 versus 0.06 for 3L). Despite these differences, similar relationships of lower HRQL with greater multimorbidity were observed for the 3L (ß = −0.13, 95% CI −0.15; −0.11) and 5L (ß = −0.12, 95% CI −0.13; −0.11).ConclusionsUsing a general population sample, the EQ-5D 5L showed better measurement properties than the EQ-5D 3L. Nonetheless, clinically important differences in HRQL associated with multimorbidity were similar in magnitude using both versions of EQ-5D.
Highlights
Studies comparing the measurement properties of EQ-5D 3L (3L) and EQ-5D 5L (5L) are limited to specific patient populations with small sample sizes
Previous research comparing the 3L and 5L versions of the EQ-5D indicate that additional levels of the 5L potentially increase discriminatory power and reduce ceiling effect among patients with chronic conditions, including chronic hepatic disease [8] or cancer patients
The survey comprised of a telephone-based questionnaire that was administered by Random-Digit Dialing (RDD)
Summary
Studies comparing the measurement properties of EQ-5D 3L (3L) and EQ-5D 5L (5L) are limited to specific patient populations with small sample sizes. Using a general population sample, we compared 3L and 5L in terms of their measurement properties and association with number of chronic conditions, including multimorbidity – the concurrent occurrence of two or more chronic conditions. Previous research comparing the 3L and 5L versions of the EQ-5D indicate that additional levels of the 5L potentially increase discriminatory power and reduce ceiling effect among patients with chronic conditions, including chronic hepatic disease [8] or cancer patients [9]. Few studies have compared 3L and 5L, most of them are based on patient populations or studies with relatively small sample sizes [6,7,8,9]. More research is needed to obtain a comparative assessment of both versions of the EQ-5D in a larger sample and their applicability in the general population
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