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      Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)


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          This article introduces the new 5-level EQ-5D (EQ-5D-5L) health status measure.


          EQ-5D currently measures health using three levels of severity in five dimensions. A EuroQol Group task force was established to find ways of improving the instrument’s sensitivity and reducing ceiling effects by increasing the number of severity levels. The study was performed in the United Kingdom and Spain. Severity labels for 5 levels in each dimension were identified using response scaling. Focus groups were used to investigate the face and content validity of the new versions, including hypothetical health states generated from those versions.


          Selecting labels at approximately the 25th, 50th, and 75th centiles produced two alternative 5-level versions. Focus group work showed a slight preference for the wording ‘slight-moderate-severe’ problems, with anchors of ‘no problems’ and ‘unable to do’ in the EQ-5D functional dimensions. Similar wording was used in the Pain/Discomfort and Anxiety/Depression dimensions. Hypothetical health states were well understood though participants stressed the need for the internal coherence of health states.


          A 5-level version of the EQ-5D has been developed by the EuroQol Group. Further testing is required to determine whether the new version improves sensitivity and reduces ceiling effects.

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          Most cited references27

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          EuroQol: the current state of play.

          R. Brooks (1996)
          The EuroQol Group first met in 1987 to test the feasibility of jointly developing a standardised non-disease-specific instrument for describing and valuing health-related quality of life. From the outset the Group has been multi-country, multi-centre, and multi-disciplinary. The EuroQol instrument is intended to complement other forms of quality of life measures, and it has been purposefully developed to generate a cardinal index of health, thus giving it considerable potential for use in economic evaluation. Considerable effort has been invested by the Group in the development and valuation aspects of health status measurement. Earlier work was reported upon in 1990; this paper is a second 'corporate' effort detailing subsequent developments. The concepts underlying the EuroQol framework are explored with particular reference to the generic nature of the instrument. The valuation task is reviewed and some evidence on the methodological requirements for measurement is presented. A number of special issues of considerable interest and concern to the Group are discussed: the modelling of data, the duration of health states and the problems surrounding the state 'dead'. An outline of some of the applications of the EuroQol instrument is presented and a brief commentary on the Group's ongoing programme of work concludes the paper.
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            EuroQol: the current state of play

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              EQ-SD: a measure of health status from the EuroQol Group


                Author and article information

                +34-936-035135 , +34-936-035135 , michael.herdman@insightcr.com
                Qual Life Res
                Quality of Life Research
                Springer Netherlands (Dordrecht )
                9 April 2011
                9 April 2011
                December 2011
                : 20
                : 10
                : 1727-1736
                [1 ]Insight Consulting and Research, Cami Ral 266 2º 7ª, 08301 Mataró, Spain
                [2 ]CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
                [3 ]Health Services Research Unit, Institut Municipal d’Investigació Mèdica (IMIM-Hospital del Mar), Barcelona, Spain
                [4 ]Department of Endocrinology, Odense University Hospital, Odense, Denmark
                [5 ]Oxford Outcomes, Oxford, United Kingdom
                [6 ]EuroQol Group Executive Office, Rotterdam, The Netherlands
                [7 ]Centre for Health Economics, University of York, York, United Kingdom
                [8 ]NHS South East Coast, Horley, United Kingdom
                [9 ]Perinatal Care and Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
                [10 ]Health Economics and Outcomes Research, IMS Health S.A, Barcelona, Spain
                © The Author(s) 2011
                : 24 March 2011
                Custom metadata
                © Springer Science+Business Media B.V. 2011

                Public health
                eq-5d,5 level,health-related quality of life,development
                Public health
                eq-5d, 5 level, health-related quality of life, development


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