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How Do Respondents Interpret and View the EQ-VAS? A Qualitative Study of Three Asian Populations

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Abstract

Background

This study aimed to understand how respondents from three Asian countries interpret and perceive the EuroQol Visual Analogue Scale (EQ-VAS).

Method

Data were from a project that aimed to examine the cultural appropriateness of EQ-5D in Asia. Members of the general public from China, Japan, and Singapore were interviewed one-to-one in their preferred languages. Open-ended questions (e.g. What does “best imaginable health” mean to you?) were used to elicit participants’ interpretation of the labels of EQ-VAS. How the scale could be improved was also probed. Thematic and content analyses were performed separately for each country before pooling for comparison.

Results

Sixty Chinese, 24 Japanese, and 60 Singaporeans were interviewed. Interpretations of the label “Best Imaginable Health” varied among the participants. Interestingly, some participants indicated that “Best Imaginable Health” is unachievable. Interpretations for “Worst Imaginable Health” also varied, with participants referring primarily to one of three themes, namely, “death,” “disease,” and “disability.” There were different opinions as to what changes in health would correspond to a 5- to 10-point change on the EQ-VAS. While participants opined that EQ-VAS is easy to understand, some criticized it for being too granular and that scale labels are open to interpretation. Findings from the three countries were similar.

Conclusion

It appears that interpretations of the EQ-VAS vary across Asian respondents. Future studies should investigate whether the variations are associated with any respondent characteristics and whether the EQ-VAS could be modified to achieve better respondent acceptance.

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Authors and Affiliations

  1. Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University of Singapore, Block MD1, 12 Science Drive 2, Singapore, 117549, Singapore

    Rachel Lee-Yin Tan & Nan Luo

  2. Guizhou Medical University, Guiyang, Guizhou, China

    Zhihao Yang

  3. Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan

    Ataru Igarashi

  4. Office of Health Economics, 105 Victoria Street, London, SW1E 6QT, UK

    Michael Herdman

Authors
  1. Rachel Lee-Yin Tan
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  2. Zhihao Yang
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  3. Ataru Igarashi
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  4. Michael Herdman
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  5. Nan Luo
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Corresponding author

Correspondence to Nan Luo.

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Funding

This study was funded by the EuroQol Group (EQ Project 2016290) and the Humanities and Social Sciences (HSS) Seed Fund from the National University of Singapore (1/2019).

Conflict of interest

Nan Luo, Michael Herdman, Zhihao Yang and Ataru Igarshi are members of the Euroqol Group. Rachel Lee-Yin Tan declare no conflict of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (NUS-IRB Ref No.: S-19-129E and B-16-252) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Consent to participate

Informed consent was obtained from all individual participants included in the studies.

Consent for publication

As part of informed consent for the study, participants gave consent for publication of the data derived from their participation in the research study.

Availability of data and material

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code Availability

NA.

Author contributions

NL and MH contributed to the study conception and design. AI and ZY collected the data in Japan and China respectively. RL-YT consolidated and analyzed the data. The first draft of the manuscript was written by RL-YT. All authors read and approved the final manuscript.

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Tan, R.LY., Yang, Z., Igarashi, A. et al. How Do Respondents Interpret and View the EQ-VAS? A Qualitative Study of Three Asian Populations. Patient 14, 283–293 (2021). https://doi.org/10.1007/s40271-020-00452-5

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  • DOI: https://doi.org/10.1007/s40271-020-00452-5

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