Skip to main content

Advertisement

SpringerLink
Log in

Do health preferences contradict ordering of EQ-5D labels?

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to test whether the ordering of item labels in EQ-5D instruments disagrees with the preferences of US adults.

Methods

A preference inversion occurs when “worse” health along a scale or score is preferred. As a sub-study of the 2013 United States Measurement and Valuation of Health Study, we tested for 33 EQ-5D preference inversions using paired comparisons with unique samples of 50 or more US adults, aged 18 or older. Specifically, we tested whether health preferences contradicted ordering of EQ-5D labels.

Results

The EQ-5D-3L and EQ-5D-Y item labels had no significant preference inversions. The EQ-5D-5L version had preference inversions between Levels 4 and 5. For example, 30 out of 59 respondents (51 %) preferred being “extremely” over “severely anxious or depressed,” contrary to the ordering of labels for that item.

Conclusions

Preference inversions between Levels 4 and 5 on the EQ-5D-5L were tested and confirmed; therefore, valuation studies may find that Levels 4 and 5 have the same value. To mitigate such inversions, labels could be revised or a 4-level version could be considered.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Feeny, D., Furlong, W., Torrance, G. W., Goldsmith, C. H., Zhu, Z. L., DePauw, S., et al. (2002). Multiattribute and single-attribute utility functions for the health utilities index mark 3 system. Medical Care, 40(2), 113–128.

    Article  PubMed  Google Scholar 

  2. 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(2), 271–292.

    Article  PubMed  Google Scholar 

  3. Craig, B. M., Pickard, A. S., Stolk, E., & Brazier, J. E. (2013). US valuation of the SF-6D. Medical Decision Making, 33(6), 793–803.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Craig, B. M., Pickard, A. S., & Lubetkin, E. I. (2014). Health problems are more common, but less severe when measured using newer EQ-5D versions. Journal of clinical epidemiology, 67(1), 93–99.

  5. Craig, B. M., & Busschbach, J. J. V. (2011). Toward a more universal approach in health valuation. Health Economics, 20(7), 864–875.

    Article  PubMed  Google Scholar 

  6. Xie, F., Pullenayegum, E., Bansback, N., Bryan, S., Ohinmaa, A., Poissant, L., & Johnson, J. A. (2013). The Canadian EQ-5D-5L valuation study: An exploratory analysis, Table 1.4, 30th Scientific Plenary Meeting of the EuroQol Group. Montreal: EuroQol Group.

    Google Scholar 

  7. Craig, B., & Reeve, B. (2012). Patient-reported outcomes and preference research: Igniting the candle at both ends and the middle. ISPOR Connections Uniting Research and Practice, 18(5), 24.

  8. Lipscomb, J., Drummond, M., Fryback, D., Gold, M., & Revicki, D. (2009). Retaining, and enhancing, the QALY. Value in Health, 12, S18–S26.

    Article  PubMed  Google Scholar 

  9. Pickard, A. S., Kohlmann, T., Janssen, M. F., Bonsel, G., Rosenbloom, S., & Cella, D. (2007). Evaluating equivalency between response systems: Application of the Rasch model to a 3-level and 5-level EQ-5D. Medical Care, 45(9), 812–819.

    Article  PubMed  Google Scholar 

  10. The EuroQol Group. (1990). EuroQol—A new facility for the measurement of health-related quality of life. Health Policy, 16(3), 199–208.

    Article  Google Scholar 

  11. Herdman, M., Gudex, C., Lloyd, A., Janssen, M. F., Kind, P., Parkin, D., et al. (2011). Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research, 20(10), 1727–1736.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  12. Janssen, M. F., Pickard, A. S., Golicki, D., Gudex, C., Niewada, M., Scalone, L., et al. (2013). Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups: A multi-country study. Quality of Life Research, 22(7), 1717–1727.

  13. Ravens-Sieberer, U., Wille, N., Badia, X., Bonsel, G., Burstrom, K., Cavrini, G., et al. (2010). Feasibility, reliability, and validity of the EQ-5D-Y: Results from a multinational study. Quality of Life Research, 19(6), 887–897.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Wille, N., Badia, X., Bonsel, G., Burstrom, K., Cavrini, G., Devlin, N., et al. (2010). Development of the EQ-5D-Y: A child-friendly version of the EQ-5D. Quality of Life Research, 19(6), 875–886.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Craig, B. M., Schell, M. J., Brown, P. M., Reeve, B. B., Cella, D., Hays, R. D., Lipscomb, J., Pickard, A. S., & Revicki, D. A. (2011). HRQoL values for cancer survivors: Enhancing PROMIS measures for CER (Vol. $3,978,708, p. 89). H. Lee Moffitt Cancer Center: NIH.

  16. Craig, B., & Reeve, B. (2012). Methods report on the PROMIS valuation study: Year 1. Moffitt Cancer Center. http://labpages.moffitt.org/craigb/Publications/Report120928.pdf.

  17. Craig, B. M., Pickard, A. S., & Lubetkin, E. I. (2014). Health problems are more common, but less severe when measured using newer EQ-5D versions. Journal of Clinical Epidemiology, 67(1), 93–99.

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank Michelle Owens, Shannon Runge, and Carol Templeton at Moffitt Cancer Center for their contributions to the research and creation of this paper. Financial support for this study was provided by a grant from the National Institutes of Health, Department of Health and Human Services, through the National Cancer Institute (1R01CA160104), the EuroQol Group (EQ Project 2013100) and Dr. Craig’s support account at Moffitt Cancer Center. The funding agreements ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report.

Conflict of interest

There are no conflicts of interest.

Author information

Authors and Affiliations

  1. Health Outcomes and Behavior, Moffitt Cancer Center, University of South Florida, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612-9416, USA

    Benjamin M. Craig

  2. Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA

    A. Simon Pickard

  3. Department of Health Management and Health Economics, University of Oslo, Oslo, Norway

    Kim Rand-Hendriksen

Authors
  1. Benjamin M. Craig
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Simon Pickard
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kim Rand-Hendriksen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Benjamin M. Craig.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Craig, B.M., Pickard, A.S. & Rand-Hendriksen, K. Do health preferences contradict ordering of EQ-5D labels?. Qual Life Res 24, 1759–1765 (2015). https://doi.org/10.1007/s11136-014-0897-z

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-014-0897-z

Keywords

Search

Navigation