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      The Indonesian EQ-5D-5L Value Set


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          The EQ-5D is one of the most used generic health-related quality-of-life (HRQOL) instruments worldwide. To make the EQ-5D suitable for use in economic evaluations, a societal-based value set is needed. Indonesia does not have such a value set.


          The aim of this study was to derive an EQ-5D-5L value set from the Indonesian general population.


          A representative sample aged 17 years and over was recruited from the Indonesian general population. A multi-stage stratified quota method with respect to residence, gender, age, level of education, religion and ethnicity was utilized. Two elicitation techniques, the composite time trade-off (C-TTO) and discrete choice experiments (DCE) were applied. Interviews were undertaken by trained interviewers using computer-assisted face-to-face interviews with the EuroQol Valuation Technology (EQ-VT) platform. To estimate the value set, a hybrid regression model combining C-TTO and DCE data was used.


          A total of 1054 respondents who completed the interview formed the sample for the analysis. Their characteristics were similar to those of the Indonesian population. Most self-reported health problems were observed in the pain/discomfort dimension (39.66%) and least in the self-care dimension (1.89%). In the value set, the maximum value was 1.000 for full health (health state ‘11111’) followed by the health state ‘11112’ with value 0.921. The minimum value was −0.865 for the worst state (‘55555’). Preference values were most affected by mobility and least by pain/discomfort.


          We now have a representative EQ-5D-5L value set for Indonesia. We expect our results will promote and facilitate health economic evaluations and HRQOL research in Indonesia.

          Electronic supplementary material

          The online version of this article (doi:10.1007/s40273-017-0538-9) contains supplementary material, which is available to authorized users.

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          Most cited references28

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          US valuation of the EQ-5D health states: development and testing of the D1 valuation model.

          The EQ-5D is a brief, multiattribute, preference-based health status measure. This article describes the development of a statistical model for generating US population-based EQ-5D preference weights. A multistage probability sample was selected from the US adult civilian noninstitutional population. Respondents valued 13 of 243 EQ-5D health states using the time trade-off (TTO) method. Data for 12 states were used in econometric modeling. The TTO valuations were linearly transformed to lie on the interval [-1, 1]. Methods were investigated to account for interaction effects caused by having problems in multiple EQ-5D dimensions. Several alternative model specifications (eg, pooled least squares, random effects) also were considered. A modified split-sample approach was used to evaluate the predictive accuracy of the models. All statistical analyses took into account the clustering and disproportionate selection probabilities inherent in our sampling design. Our D1 model for the EQ-5D included ordinal terms to capture the effect of departures from perfect health as well as interaction effects. A random effects specification of the D1 model yielded a good fit for the observed TTO data, with an overall R of 0.38, a mean absolute error of 0.025, and 7 prediction errors exceeding 0.05 in absolute magnitude. The D1 model best predicts the values for observed health states. The resulting preference weight estimates represent a significant enhancement of the EQ-5D's utility for health status assessment and economic analysis in the US.
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            Culture and social support.

            Social support is one of the most effective means by which people can cope with stressful events. Yet little research has examined whether there are cultural differences in how people utilize their social support networks. A review of studies on culture and social support presents evidence that Asians and Asian Americans are more reluctant to explicitly ask for support from close others than are European Americans because they are more concerned about the potentially negative relational consequences of such behaviors. Asians and Asian Americans are more likely to use and benefit from forms of support that do not involve explicit disclosure of personal stressful events and feelings of distress. Discussion centers on the potential implications of these findings for intercultural interactions and for the use of mental health services by Asians and Asian Americans.
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              A program of methodological research to arrive at the new international EQ-5D-5L valuation protocol.

              To describe the research that has been undertaken by the EuroQol Group to improve current methods for health state valuation, to summarize the results of an extensive international pilot program, and to outline the key elements of the five-level EuroQol five-dimensional (EQ-5D-5L) questionnaire valuation protocol, which is the culmination of that work.

                Author and article information

                +31107044789 , f.purba@erasmusmc.nl , fredrick.purba@unpad.ac.id
                Springer International Publishing (Cham )
                10 July 2017
                10 July 2017
                : 35
                : 11
                : 1153-1165
                [1 ]ISNI 000000040459992X, GRID grid.5645.2, Section Medical Psychology and Psychotherapy, Department of Psychiatry, , Erasmus MC University Medical Center, ; Wytemaweg 80, Room Na-2019, 3015 CN Rotterdam, The Netherlands
                [2 ]ISNI 0000 0004 1796 1481, GRID grid.11553.33, Department of Developmental Psychology, Faculty of Psychology, , Padjadjaran University, ; Jatinangor, Indonesia
                [3 ]ISNI 0000 0004 1796 1481, GRID grid.11553.33, Department of Clinical Psychology, Faculty of Psychology, , Padjadjaran University, ; Jatinangor, Indonesia
                [4 ]GRID grid.443430.4, Center of Applied Psychometrics, Faculty of Psychology, , YARSI University, ; Jakarta, Indonesia
                [5 ]ISNI 0000 0004 5906 3508, GRID grid.478988.2, Executive Office, , EuroQol Research Foundation, ; Rotterdam, The Netherlands
                [6 ]ISNI 0000 0004 1754 9227, GRID grid.12380.38, Department of Clinical, Neuro and Developmental Psychology, , VU University, ; Amsterdam, The Netherlands
                Author information
                © The Author(s) 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                Funded by: FundRef http://dx.doi.org/10.13039/501100006419, EuroQol Research Foundation;
                Award ID: 2013240
                Award Recipient :
                Funded by: Directorate General of Higher Education of Indonesia
                Award ID: 58.18/E4.412014
                Award Recipient :
                Original Research Article
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                © Springer International Publishing AG 2017

                Economics of health & social care
                Economics of health & social care


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