Cross-cultural measurement equivalence of the EQ-5D-5L items for English-speaking Asians in Singapore

Abstract

The EQ-5D-5L items are likely to generate equivalent health outcomes between English-speaking Chinese and non-Chinese Singaporeans.

Less Is More: Cross-Validation Testing of Simplified Nonlinear Regression Model Specifications for EQ-5D-5L Health State Values

“…This indicates that, at least for the three data sets tested here, respondents appear to perceive the relative severity of the descriptive levels to be roughly the same across dimensions. This corresponds with previous studies in which general population respondents from several countries rated the descriptive levels using a numerical rating scale [19,20]. The improved performance associated with restricting the freedom of the 20-parameter model suggests that the number of parameters puts it at risk of overfitting to the observed data; modeling between-dimension variance in relative level distance did not improve predictions, suggesting that this is largely influenced by measurement error and random variance.…”

“…Through these studies, the final labels were selected from a larger initial pool of possible labels on the basis of several criteria, including approximate equidistance in severity rated by lay persons in a visual analogue scale task (medians close to 25th, 50th, and 75th percentile for level labels 2, 3, and 4), consistency in relative severity across dimensions, consistency in ranking, availability in colloquial language, and subjective reporting of how easy they were to understand [3]. Following the selection of labels, followup studies in English, Spanish, French, and Chinese indicate that the labels are perceived as describing relatively equal intervals across the five dimensions [18][19][20].…”

“…The question we ask in this study is whether the regression modeling of values for EQ-5D-5L health states could capitalize on the shared level and label structure across the five dimensions. If the general population perceives the five dimension scales to have close to proportional relative severity distances between levels, as indicated by the studies conducted to test the level labels [18][19][20], value algorithms could potentially be generated using substantially fewer parameters. In the simplest case, a single parameter per dimension, interpretable as the disutility of the dimension at level 5, could be multiplied by level parameters shared across all dimensions, for levels 2, 3, and 4 for a total of eight parameters.…”

Assessing the Content Validity of the EQ-5D Questionnaire Among Asians in Singapore: A Qualitative Study

“…The issue of respondents' failing to recognise the relative severity described by 'slight' and 'moderate' was reported in previous studies. 21,22 These issues suggest that interview-administration might be more appropriate when study samples comprise individuals with low literacy levels, such as old people.…”

An exploration of differences between Japan and two European countries in the self-reporting and valuation of pain and discomfort on the EQ-5D

“…For example, Luo et al found that the interpretation and use of EQ-5D-5L response labels (e.g., ‘slight’, ‘moderate’, and ‘severe’) varied across Chinese, Malay, and English speakers in Singapore [23], whereas the English version gave similar outcomes in Chinese and non-Chinese English speakers in the same country [24], suggesting that there was no effect of culture on responses. Although a strict protocol is followed in producing other language versions of EQ-5D [25], it may not always be possible to find identical terms in all languages.…”