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Quality of Life Research
Published in: Quality of Life Research 3/2008

Open Access 01-04-2008

Quantification of the level descriptors for the standard EQ-5D three-level system and a five-level version according to two methods

Authors: M. F. Janssen, E. Birnie, G. J. Bonsel

Published in: Quality of Life Research | Issue 3/2008

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Abstract

Objectives

Our aim was to compare the quantitative position of the level descriptors of the standard EQ-5D three-level system (3L) and a newly developed, experimental five-level version (5L) using a direct and a vignette-based indirect method.

Methods

Eighty-two respondents took part in the study. The direct method represented a visual analog scale (VAS) rating of the nonextreme level descriptors for each dimension and each instrument separately. The indirect method required respondents to score 15 health scenarios with 3L, 5L and a VAS scale. Investigated were: (1) equidistance (Are 3L and 5L level descriptors distributed evenly over the VAS continuum?); (2) isoformity (Do the identical level descriptors on 3L and 5L yield similar results?); and (3) consistency between dimensions (Do the positions of similar level descriptors differ across dimensions within instruments?).

Results

Equidistance without transformation was rejected for all dimensions for both 3L and 5L but satisfied for 5L after transformation. Isoformity gave mixed results. Consistency between dimensions was satisfied for both instruments and both methods.

Discussion

The level descriptors have similar distributions across comparable dimensions within each system, but the pattern differs between 3L and 5L. This methodological study provides evidence of increased descriptive power and a broadened measurement continuum that encourages the further development of an official five-level EQ-5D.
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Literature
1.
Brooks, R., Rabin, R. E., & de Charro, F. Th. (2003). The measurement and valuation of health status using EQ-5D: A European perspective. Dordrecht: Kluwer academic publishers.
2.
Feeny, D., Furlong, W., & Torrance, G. (1999). The health utilities index: An update. Quality of Life Newsletter, 22, 8–9.
3.
Brazier, J., Deverill, M., Green, C., Harper, R., & Booth, A. (1999). A review of the use of health status measures in economic evaluation. Health Technology Assessment, 3, 1–164.
4.
Brazier, J., Roberts, J., & Deverill, M. (2002). The estimation of a preference-based measure of health from the SF-36. Journal of Health Economics, 21, 271–292.PubMedCrossRef
5.
Kopec, J. A., & Willison, K. D. (2003). A comparative review of four preference-weighted measures of health-related quality of life. Journal of Clinical Epidemiology, 56, 317–325.PubMedCrossRef
6.
Macran, S., Weatherly, H., & Kind, P. (2003). Measuring population health—a comparison of three generic health status measures. Medical Care, 41, 218–231.PubMedCrossRef
7.
Wu, A. W., Jacobson, K. L., Frick, K. D., Clark, R., Revicki, D. A., Freedberg, K. A., Scott-Lennox, J., & Feinberg, J. (2002). Validity and responsiveness of the EuroQol as a measure of health-related quality of life in people enrolled in an AIDS clinical trial. Quality of Life Research, 11, 273–282.PubMedCrossRef
8.
Myers, C., & Wilks, D. (1999). Comparison of Euroqol EQ-5D and SF-36 in patients with chronic fatigue syndrome. Quality of Life Research, 8, 9–16.PubMedCrossRef
9.
Willige van de, G., Wiersma, D., Nienhuis, F. J., & Jenner, J. A. (2005). Changes in quality of life in chronic psychiatric patients: a comparison between EuroQol (EQ-5D) and WHOQoL. Quality of Life Research, 14, 441–451.CrossRef
10.
Sullivan, P. W., Lawrence, W. F., & Ghushchyan, V. (2005). A national catalog of preference-based scores for chronic conditions in the United States. Medical Care, 43, 736–749.PubMedCrossRef
11.
Houle, C., Bertheloth, C. M., & Health Analysis, Modeling Group (2000). Head-to-head comparison of the health utilities index mark 3 and the EQ-5D for the population living in private households in Canada. Quality of Life Newsletter, 24, 5–6.
12.
Badia, X., Schiaffino, A., Alonso, J., & Herdman, M. (1998). Using the EuroQol 5-D in the Catalan general population: Feasibility and construct validity. Quality of Life Research, 7, 311–322.PubMedCrossRef
13.
Wang, H., Kindig, D. A., & Mullahy, J. (2005). Variation in Chinese population health related quality of life: Results from a EuroQol study in Beijing, China. Quality of Life Research, 14, 119–132.PubMedCrossRef
14.
Brazier, J., Roberts, J., Tsuchiya, A., & Busschbach, J. (2004). A comparison of the EQ-5D and SF-6D across seven patient groups. Health Economics, 13, 873–884.PubMedCrossRef
15.
Kaarlola, A., Pettila, V., & Kekki, P. (2004). Performance of two measures of general health-related quality of life, the EQ-5D and the RAND-36 among critically ill patients. Intensive Care Medicine, 30, 2245–2252.PubMedCrossRef
16.
Szabo, S. (1996). World Health Organization Quality of Life (WHOQOL) assessment instrument. In B. Spilker (Ed.), Quality of life and of life and pharmaeconomics in clinical trials (pp. 355–362). Philadelphia: Lippincott-Raven.
17.
Keller, S. D., Ware, J. E., Jr., Gandek, B., Aaronson, N. K., Alonso, J., Apolone, G., Bjorner, J. B., Brazier, J., Bullinger, M., Fukuhara, S., Kaasa, S., Leplege, A., Sanson-Fisher, R. W., Sullivan, M., & Wood-Dauphinee, S. (1998). Testing the equivalence of translations of widely used response choice labels: results from the IQOLA Project. International Quality of Life Assessment. Journal of Clinical Epidemiology, 51, 933–944.PubMedCrossRef
18.
19.
Pickard, A. S., De Leon, M. C., Kohlmann, T., Cella, D., & Rosenbloom, S. (2007). Psychometric comparison of the standard EQ-5D to a 5 level version in cancer patients. Medical Care, 45, 259–263.PubMedCrossRef
20.
Bonsel, G. J., & van Agt, H. M. E. (1993). The number of levels in the descriptive system. In J. J. van Busschbach, G. J. Bonsel, & F. Th. de Charro (Eds.), Book of EuroQol meeting proceedings (pp. 115–120). Rotterdam: Erasmus University Rotterdam.
21.
Lissitz, R. W., & Green, S. B. (1975). Effect of the number of scale points on reliability: A Monte Carlo approach. The Journal of Applied Psychology, 60, 10–13.CrossRef
22.
Nishisato, S., & Torii, Y. (1970). Effects of categorizing continuous normal variables on the product-moment correlation. The Japanese Psychological Research, 13, 45–49.
23.
Preston, C. C., & Colman, A. M. (2000). Optimal number of response categories in rating scales: reliability, validity, discriminating power, and respondent preferences. Acta Psychologica, 104, 1–15.PubMedCrossRef
24.
Miller, G. A. (1956). The magical number seven plus or minus two: some limits on our capacity for processing information. Psychological Review, 63, 81–97.PubMedCrossRef
25.
Streiner, D. L., & Norman, G. W. (2003). Health measurement scales: A practical guide to their development and use. Oxford: Oxford University Press.
26.
Cardinet, J., Tourneur, Y., & Allal, L. (1981). Extension of generalizability theory and its application in educational measurement. Journal of Educational Measurement, 4, 183–204.CrossRef
27.
Krabbe, P. F., Essink-Bot, M. L., & Bonsel, G. J. (1996). On the equivalence of collectively and individually collected responses: standard-gamble and time-tradeoff judgments of health states. Medical Decision Making, 16, 120–132.PubMedCrossRef
28.
Bass, B. M., Cascio, W. F., & O’Connor, E. J. (1974). Magnitude estimations of expressions of frequency and amount. The Journal of Applied Psychology, 59, 313–320.CrossRef
29.
Spector, P. E. (1976). Choosing response categories for summated rating scales. The Journal of Applied Psychology, 61, 374–375.CrossRef
30.
Pickard, A. S., Kohlmann, T., Cella, D., Rosenbloom, S., Bonsel, G. J., & Janssen, M. F. (2007). Come together: Use of IRT models to derive preference-based algorithms for a 5 level version of the EQ-5D. Medical Care, 45, 259–263.PubMedCrossRef
31.
Metadata
Title
Quantification of the level descriptors for the standard EQ-5D three-level system and a five-level version according to two methods
Authors
M. F. Janssen
E. Birnie
G. J. Bonsel
Publication date
01-04-2008
Publisher
Springer Netherlands
Published in
Quality of Life Research / Issue 3/2008
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-008-9318-5

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