The Ceiling Effects of EQ-5D-3L and 5L in General Population Health Surveys: A Systematic Review and Meta-Analysis

IF 4.9 2区医学 Q1 ECONOMICS

Value in Health Pub Date : 2024-07-01 DOI:10.1016/j.jval.2024.02.018

Ling Jie Cheng MPH, RN , Tianxin Pan PhD , Le Ann Chen BSc , Jing Ying Cheng BSN (Hons), RN , Brendan Mulhern PhD , Nancy Devlin PhD , Nan Luo PhD

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引用次数: 0

Abstract

Objectives

This review aims to examine the ceiling effects of EQ-5D-3L (3L) and EQ-5D-5L (5L) in general adult populations and identify the factors influencing these effects.

Methods

We searched 8 databases for observational studies published in English from inception to 24 July 2023. Ceiling effects were calculated by dividing the number of participants reporting full health at dimension or profile level by the total sample size. Subgroup analysis and meta-regression using the metafor package in R software were performed.

Results

We identified 94 studies from 70 articles, including 4 543 647 adults across 37 countries. The global pooled proportion of individuals reporting full health (“11111”) was 56% (95% CI 51%-62%) for 3L and 49% (95% CI 44%-54%) for 5L. The self-care dimension showed the highest ceiling effects (3L: 97%; 5L: 94%), whereas pain/discomfort had the lowest (3L: 69%; 5L: 60%). The ceiling effects in East/South-East Asia were higher than in Europe by 25% (95% CI 18%-32%) in 3L and 9% (95% CI −2%-20%) in 5L. Adjusting for mean age and proportion of males, significant regional differences persisted in the overall profile level of 3L, in all 3L dimensions (except for self-care), and 5L dimensions (except for pain/discomfort and anxiety/depression).

Conclusions

This review highlights significant ceiling effects in the EQ-5D, especially in Asian populations. The 5L version exhibited fewer ceiling effects than the 3L, indicating its superiority for general population surveys. Further research is crucial to understand the disparities in self-reported health outcomes between Asians and other populations.

查看原文本刊更多论文

普通人群健康调查中 EQ-5D-3L 和 5L 的上限效应：系统回顾与元分析》。

目的：本综述旨在研究普通成年人群中 EQ-5D-3L (3L) 和 EQ-5D-5L (5L) 的上限效应，并确定影响这些效应的因素：本综述旨在研究 EQ-5D-3L (3L) 和 EQ-5D-5L (5L) 在普通成年人群中的上限效应，并确定影响这些效应的因素：我们在八个数据库中检索了从开始到 2023 年 7 月 24 日用英语发表的观察性研究。上限效应的计算方法是将在维度或特征水平上报告完全健康的参与者人数除以总样本量。使用 R 软件中的 metafor 软件包进行了分组分析和元回归：我们从 70 篇文章中确定了 94 项研究，涉及 37 个国家的 4543 647 名成年人。报告完全健康（"11111"）的全球汇总比例为：3L 56%（95% CI 51-62%），5L 49%（95% CI 44-54%）。自我保健维度的上限效应最高（3L：97%；5L：94%），而疼痛/不适的上限效应最低（3L：69%；5L：60%）。东亚/东南亚的上限效应高于欧洲，3L 为 25% (95% CI 18-32%)，5L 为 9% (95% CI -2-20%)。根据平均年龄和男性比例进行调整后，在 3L 的总体概况水平、所有 3L 维度（自我护理除外）和所有 5L 维度（疼痛/不适和焦虑/抑郁除外）方面仍存在显著的地区差异：本综述强调了 EQ-5D 的显著上限效应，尤其是在亚洲人群中。5L 版比 3L 版表现出更少的上限效应，表明其在普通人群调查中的优越性。要了解亚裔和其他人群在自我报告健康结果方面的差异，进一步的研究至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Value in Health 医学-卫生保健

CiteScore

6.90

自引率

6.70%

发文量

3064

审稿时长

3-8 weeks

期刊介绍： Value in Health contains original research articles for pharmacoeconomics, health economics, and outcomes research (clinical, economic, and patient-reported outcomes/preference-based research), as well as conceptual and health policy articles that provide valuable information for health care decision-makers as well as the research community. As the official journal of ISPOR, Value in Health provides a forum for researchers, as well as health care decision-makers to translate outcomes research into health care decisions.

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