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01-10-2010 | Uitgave 8/2010

Quality of Life Research 8/2010

Preliminary findings of an investigation into the relationship between national culture and EQ-5D value sets

Quality of Life Research > Uitgave 8/2010
Henry Bailey, Paul Kind
Belangrijke opmerkingen
An earlier version of this work was presented at the EuroQol Plenary Meeting in Paris, September 2009.



Despite the growing importance of the EQ-5D descriptive system as a basis for the valuation of QALYs in cost-utility analysis, for most countries, there are no EQ-5D value sets. Researchers and policy makers wishing to use the EQ-5D descriptive system in a country for which there is no value set are advised to use one from a nearby or ‘similar’ population. Factors other than geographic proximity can affect the relative values of EQ-5D states.


This study explores the links between national culture and EQ-5D value sets.


Rank correlation analysis is used to explore relationships between the relative values of a set of EQ-5D states and dimensions of national culture. The latter are taken from Hofstede’s framework which operationalizes national culture in five dimensions.


For the data currently available (countries for which EQ-5D value sets and scores on dimensions of culture both exist), moderate and strong correlations were found between the culture dimension of power distance and individualism and the EQ-5D dimensions of pain/discomfort and anxiety/depression. Moderate correlations were also observed between the cultural dimension of masculinity and the EQ-5D dimensions of self care, usual activities and pain/discomfort. Uncertainty avoidance correlates with the EQ-5D dimension of anxiety/depression.


The correlation patterns observed are generally consistent with a priori expectations based on the nature of the dimensions of culture and the EQ-5D model. This analysis demonstrates the potential of national culture in providing insight into the drivers of the relative values of EQ-5D dimensions for different countries and in informing decisions about which EQ-5D value sets to use in situations where one does not exist.

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