EQ-5D-5L measurement properties are superior to EQ-5D-3L across the continuum of health using US value sets

Abstract

ObjectiveThe objective of this study was to compare the measurement properties of the US EQ-5D-3L, EQ-5D-5L, and -5L to -3L crosswalk value sets (3L; 5L; 5L > 3L) across the spectrum of health.MethodsThe three scoring approaches were compared in terms of range of scale, percent of worse-than-dead health states, and mean single-level transitions. Discriminative ability was compared by leveraging two cross-sectional datasets. A novel method was used to visualize and compare the responsiveness of 3L and 5L scoring approaches across EQ VAS values.ResultsThe US 5L value set had the broadest range of scale at 1.573 (vs. 1.109 for 3L and crosswalk). The crosswalk had the smallest mean single-level transition of 0.061 (vs. 0.078 for 5L and 0.111 for 3L). The 5L value set tended to be more discriminative/greater statistical efficiency than the crosswalk (F-statistic ratio: 1.111, 95% CI 0.989–1.240) and 3L (F-statistic ratio: 1.102 95% CI 0.861–1.383) across levels of general health. The 5L was the most responsive value set between EQ VAS values of 25 and 75.ConclusionThese results imply greater sensitivity of the 5L to health changes and potentially lower incremental cost-utility ratios compared to the 3L.