Validity, Reliability, and Responsiveness of the EQ-5D in Hematological Cancers: A Systematic Review of Measurement Properties.

Objectives: This study aimed to conduct a systematic review of the published evidence regarding the measurement properties of the EuroQoL 5-Dimension (EQ-5D) (3 level [EQ-5D-3L] and 5 level [EQ-5D-5L]) in adult patients with hematological cancers.

Methods: A comprehensive literature search was carried out utilizing the MEDLINE, EMBASE, and Web of Science (up to October 2025). Full-text English articles focusing on original research concerning the measurement properties of the EQ-5D, including construct validity, test-retest reliability, or responsiveness, were included. Studies involving experimental versions of the EQ-5D were excluded. The quality assessment utilized the COSMIN Risk of Bias checklist, and data synthesis followed the COSMIN methodology.

Results: A total of 16 studies from 31 countries, presenting 996 individual tests (96% met results) of the EQ-5D measurement properties were included. Sufficient construct validity for EQ-5D-5L index, EQ-5D-5L dimensions, EQ-5D-3L index, EQ-5D-3L dimensions, and EQ visual analog scale (VAS) was supported by high certainty. Evidence regarding test-retest reliability was limited to EQ-5D-5L index and EQ VAS, had moderate and low certainty, and indicated sufficient overall rating of measurement properties. Responsiveness was assessed in 104 tests (100 for EQ-5D-5L index, 2 for EQ-5D-3L index, 2 for EQ VAS). Most tests demonstrated the expected directional change (97%; 101/104).

Conclusion: This systematic review provides an overview of the measurement properties of the EQ-5D as a health-related quality-of-life measure in hematological cancers. The available evidence suggests that both EQ-5D-3L and EQ-5D-5L have sufficient construct validity and may be used to assess health-related quality of life in this patient population. Evidence for reliability and responsiveness remains limited and warrants further investigation.