EQ-5D-5L measurement properties are superior to EQ-5D-3L across the continuum of health using US value sets

Abstract

Objective The objective of this study was to compare the measurement properties of the US EQ-5D-3L, EQ-5D-5L, and -5L to -3L crosswalk value sets (3L; 5L; 5L > 3L) across the spectrum of health. Methods The three scoring approaches were compared in terms of range of scale, percent of worse-than-dead health states, and mean single-level transitions. Discriminative ability was compared by leveraging two cross-sectional datasets. A novel method was used to visualize and compare the responsiveness of 3L and 5L scoring approaches across EQ VAS values. Results The US 5L value set had the broadest range of scale at 1.573 (vs. 1.109 for 3L and crosswalk). The crosswalk had the smallest mean single-level transition of 0.061 (vs. 0.078 for 5L and 0.111 for 3L). The 5L value set tended to be more discriminative/greater statistical efficiency than the crosswalk (F-statistic ratio: 1.111, 95% CI 0.989–1.240) and 3L (F-statistic ratio: 1.102 95% CI 0.861–1.383) across levels of general health. The 5L was the most responsive value set between EQ VAS values of 25 and 75. Conclusion These results imply greater sensitivity of the 5L to health changes and potentially lower incremental cost-utility ratios compared to the 3L.

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“…However, we show the robustness of our results in the supporting information section ( Table 2 ) using a crosswalk mapping from the EQ-5D-3L value set from Chile. We use the value set from Uruguay for our main exercise because the EQ-5D-5L is superior to EQ-5D-3L and to crosswalk values in terms of its sensitivity and precision in health status measurement; it provides more precise utility measurements at individual and group levels [ 17 , 18 ].…”

“…measurement; it provides more precise utility measurements at individual and group levels [17,18]. In order to estimate the impacts on QALYs, we need to recover the trajectory of HRQoLs over time from the three point estimates discussed above.…”

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“…Generic health outcome questionnaires like the Short-Form 36 (SF-36) ( 30 ), Euro-QoL 5D (EQ-5D) ( 31 ) with their 3L and 5L scoring approaches ( 32 ), etc.…”