Filling the psycho-social gap in the EQ-5D: the empirical support for four bolt-on dimensions

Gang Chen · Jan Abel Olsen

61 citations0/0 files storedQuality of Life Research

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Health Systems, Economic Evaluations, Quality of Life Economic and Environmental Valuation Delphi Technique in Research

Abstract

PURPOSE: The EQ-5D is the most widely applied generic preference-based measure (GPBM) of health-related quality of life (HRQoL). Much concern has been raised that its descriptive system is lacking psycho-social dimensions. A recent paper in this journal provided theoretical support for four dimensions to fill this gap. The current paper aims to provide empirical support for these suggested bolt-on dimensions to the EQ-5D. METHODS: We use data from the comprehensive Multi-Instrument-Comparison (MIC) study. The four proposed bolt-on dimensions (Vitality, Sleep, Social Relationships, and Community Connectedness) were selected from the Assessment of Quality of Life (AQoL)-8D. We investigate the relative importance of these four dimensions as compared to the five EQ-5D-5L dimensions on explaining HRQoL (measured by a visual analogue scale; N = 7846) or global life satisfaction (measured by the Satisfaction With Life Scale; N = 8005), using the Shorrocks-Shapely decomposition analysis. Robustness analyses on Vitality was conducted using data from the United States National Health Measurement Study (NHMS) (N = 3812). RESULTS: : 23.0%), followed by Usual Activities (15.1%). Self-Care was the least important dimension (relative contribution: 5.4%). As a comparison, when explaining global life satisfaction, Social Relationships was the most important dimension (relative contribution: 24.0%), followed by Anxiety/Depression (23.2%), while Self-Care remained the least important (relative contribution: 1.6%). The importance of the Vitality dimension in explaining HRQoL was supported in the robustness analysis using the NHMS data (relative contribution: 23.7%). CONCLUSIONS: We provide empirical support for complementing the current EQ-5D-5L descriptive system with a coherent set of four bolt-on dimensions that will fill its psycho-social gap. Such an extended health state classification system would in particular be relevant for programme evaluations within the expanding fields of mental health and community care.

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References

1985The Satisfaction With Life Scale 2011Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)1986Comparison of five rules for determining the number of components to retain.2002The estimation of a preference-based measure of health from the SF-36 1982Inequality Decomposition by Factor Components 1992Measuring Health. A Review of Quality of Life Measurement Scales.1982Factors Influencing Four Rules For Determining The Number Of Components To Retain 2014Use of generic and condition-specific measures of health-related quality of life in NICE decision-making: a systematic review, statistical modelling and survey

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2021Methods Used to Identify, Test, and Assess Impact on Preferences of Bolt-Ons: A Systematic Review

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