Comparing Psychometric Properties of Six 5-Level and 3-Level EQ-5D Bolt-Ons in a Large, Multinational, Longitudinal General Population Sample.

IF 6 2区医学 Q1 ECONOMICS

Value in Health Pub Date : 2025-09-24 DOI:10.1016/j.jval.2025.09.009

Sarah Dewilde, Mathieu F Janssen, Glenn Phillips, Brendan Mulhern, Fanni Rencz

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引用次数: 0

Abstract

Objective: This study systematically compared the psychometric properties of six 5-level and 3-level EQ-5D bolt-ons (vision, breathing, tiredness, sleep, social relationships, and self-confidence).

Methods: POPUP is a longitudinal survey collecting general population data from US, Canada, UK, Italy, Spain, Germany, Netherlands, and Belgium. Respondents entered demographics, health conditions data, and completed the EQ-5D-5L/3L with bolt-ons, MG-ADL, and HUI-3. Psychometric properties included ceiling/floor, informativity, divergent and convergent validity, reliability, known-groups validity, and responsiveness.

Results: 9,758 respondents completed the survey in 2021, and 4,839 respondents in 2023. The 5-level bolt-ons reduced ceiling effects by 35% and floor effects by 55% compared to 3-level, with the largest reductions for vision and sleep (42%/57%) and the smallest for breathing (29%/44%). Informativity was higher for the 5-level bolt-ons (3%-11%) than 3-level (2%-9%), except for breathing (-2%). Most bolt-ons showed weak to moderate correlations with EQ-5D dimensions, except for social relationships, which correlated strongly with anxiety/depression (r=0.61). Both measures showed strong convergent validity for breathing (5-level r=0.68; 3-level r=0.66) and lower for vision (5-level r=0.37; 3-level r=0.32). EQ-5D+5-level and EQ-5D-5L+3-level bolt-ons had excellent reliability (Intraclass Correlation Coefficients=0.92-0.97). Adding bolt-ons did not significantly improve known-groups validity, except for breathing (relative efficiency EQ-5D+5-level=1.12; EQ-5D-5L+3-level=1.10). The 5-level bolt-ons improved responsiveness, detecting 47.1% more improvements and 55.7% more worsening over time.

Conclusions: The six 5-level EQ-5D bolt-ons outperformed the 3-level bolt-ons by reducing ceiling and floor, enhancing informativity, demonstrating divergent validity, and improving responsiveness.

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比较6个5-Level和3-Level EQ-5D在大型跨国纵向一般人群样本中的心理测量特性。

目的：本研究系统比较了EQ-5D 6个5级和3级附加项（视力、呼吸、疲劳、睡眠、社会关系和自信）的心理测量特征。方法：POPUP是一项纵向调查，收集了美国、加拿大、英国、意大利、西班牙、德国、荷兰和比利时的一般人群数据。受访者输入人口统计数据、健康状况数据，并完成附有螺栓的EQ-5D-5L/3L、MG-ADL和HUI-3。心理测量特性包括天花板/下限、信息性、发散和收敛效度、信度、已知群体效度和反应性。结果：2021年9758名受访者完成了调查，2023年4839名受访者完成了调查。与3级相比，5级螺栓减少了35%的天花板效应和55%的地板效应，其中视力和睡眠的减少最大（42%/57%），呼吸的减少最小（29%/44%）。除了呼吸（-2%）外，5级栓接的信息性（3%-11%）高于3级栓接（2%-9%）。除了与焦虑/抑郁强烈相关的社会关系（r=0.61）外，大多数锚点与EQ-5D维度表现出弱至中度的相关性。两项测量均显示呼吸的趋同效度较强（5水平r=0.68； 3水平r=0.66），而视力的趋同效度较低（5水平r=0.37； 3水平r=0.32）。EQ-5D+5级和EQ-5D- 5l +3级螺栓具有良好的信度（类内相关系数=0.92 ~ 0.97）。除了呼吸外，添加附加项对已知组的效度没有显著提高（相对效率EQ-5D+5级=1.12；EQ-5D- 5l +3级=1.10）。5级栓接提高了反应能力，随着时间的推移，检测到47.1%的改善和55.7%的恶化。结论：6个5级EQ-5D锚定在降低上限和下限、增强信息性、显示发散效度和提高反应性方面优于3级锚定。

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.