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Comparison of the three-level and the five-level versions of the EQ-5D

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Abstract

EQ-5D is a generic instrument to measure health-related quality of life. In 2009, a new version, EQ-5D-5L, was introduced as an attempt to reduce ceiling effects and improve sensitivity to small changes over time. The objective of this study was to assess the measurement properties of the EQ-5D-5L instrument compared to the EQ-5D-3L instrument in an elderly general population with a moderate to a high degree of comorbidity. A subgroup of participants in a large clinical trial completed the EQ-5D-3L and the EQ-5D-5L questionnaires. Based on the collected data, we tested for feasibility and ceiling and floor effects. Furthermore, we assessed the redistribution properties of the responses and examined the level of inconsistency, informativity, and convergent validity. A total of 1002 persons diagnosed with hypertension, diabetes, heart failure, and/or previous stroke completed both the EQ-5D-3L and the EQ-5D-5L questionnaires. The overall ceiling effect decreased from 46% with the EQ-5D-3L to 30% with the EQ-5D-5L and absolute and relative informativity were higher for EQ-5D-5L, and there was a stronger correlation between EQ-5D-5L and EQ VAS. The EQ-5D-5L seemed to perform better than the EQ-5D-3L in terms of feasibility, ceiling effect, discriminatory power, and convergent validity. The overall ceiling effect was higher than that found in patient samples in previous studies but lower than the one found in population studies.

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Funding

Innovationsfonden (DK)—Grant Number: 12-135225; Hjerteforeningen (DK)—Grant Number: 11-04-R83-A3363-22625; Region Hovedstaden (DK); Aalborg Universitet (DK); Arvid Nilssons Fond (DK); Medtronic—No Grant Number

Author information

Authors and Affiliations

  1. Department of Business and Economics, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark

    Anne Simone Juhl Christiansen, Marie Louise Sletskov Møller & Christian Kronborg

  2. Department of Cardiology, Zealand University Hospital Roskilde, Sygehusvej 10, 4000, Roskilde, Denmark

    Ketil Jørgen Haugan

  3. Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Inge Lehmanns Vej 7, 2100, Copenhagen, Denmark

    Lars Køber, Søren Zöga Diederichsen & Jesper Hastrup Svendsen

  4. Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark

    Lars Køber & Jesper Hastrup Svendsen

  5. Department of Cardiology, Bispebjerg Hospital, Copenhagen University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark

    Søren Højberg

  6. Department of Cardiology, Odense University Hospital, J. B. Winsløws Vej 4, 5000, Odense, Denmark

    Axel Brandes

  7. Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Winsløwparken 19, 5000, Odense C, Denmark

    Axel Brandes

  8. Department of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7 D2, 9220, Aalborg, Denmark

    Claus Graff

  9. Laboratory for Molecular Cardiology, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Inge Lehmanns Vej 7, 2100, Copenhagen, Denmark

    Jonas Bille Nielsen, Anders Gaarsdal Holst & Jesper Hastrup Svendsen

  10. Department of Epidemiology Research, Statens Serum Institut, Artillerivej 5, 2300, Copenhagen, Denmark

    Jonas Bille Nielsen

  11. K.G. Jebsen Center for Genetic Epidemiology, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway

    Jonas Bille Nielsen

  12. University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zürich, Switzerland

    Derk Krieger

  13. Stroke Unit, Mediclinic City Hospital, Building 37 - 26th St, Dubai, UAE

    Derk Krieger

Authors
  1. Anne Simone Juhl Christiansen
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  2. Marie Louise Sletskov Møller
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  3. Christian Kronborg
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  4. Ketil Jørgen Haugan
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  5. Lars Køber
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  6. Søren Højberg
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  7. Axel Brandes
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  8. Claus Graff
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  9. Søren Zöga Diederichsen
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  10. Jonas Bille Nielsen
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  11. Derk Krieger
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  12. Anders Gaarsdal Holst
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  13. Jesper Hastrup Svendsen
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Corresponding author

Correspondence to Christian Kronborg.

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Christiansen, A.S.J., Møller, M.L.S., Kronborg, C. et al. Comparison of the three-level and the five-level versions of the EQ-5D. Eur J Health Econ 22, 621–628 (2021). https://doi.org/10.1007/s10198-021-01279-z

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  • DOI: https://doi.org/10.1007/s10198-021-01279-z

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