Skip to main content
Log in

Valuation of EuroQOL (EQ-5D) Health States in an Adult US Sample

  • Original Research Article
  • EQ-5D Valuations in a US Sample
  • Published:
PharmacoEconomics Aims and scope Submit manuscript

Summary

While the EuroQOL instrument (EQ-5D) is being considered and used in clinical trials in the United States and Canada, and in large international multicentre studies, population weights for the instrument have never been established in North America. The primary purpose of this investigation was to derive a set of US—based population weights for the standard set of health states described in the EQ-5D health questionnaire. Valuations for EQ-5D health states were obtained via a postal survey using the visual analogue scale (VAS) format. A sample of 3500 adults from the continental US were surveyed. A response rate of 25.8% was obtained. Mean and median valuations for 45 distinct health states, including dead and unconscious, were calculated. An ordinary least squares (OLS) regression— based weighting scheme was constructed to impute scores for states not directly valued in the questionnaire formats. Valuations for the standard EQ-5D health states displayed similar characteristics to VAS valuations obtained in previous investigations in European countries. The OLS model fit the observed data relatively well, achieving an adjusted R2 of 0.42. However, the diagnostic testing indicated that the initial model was misspecified. Subsequent alternative models alleviated some, but not all, of the problems of misspecification. The EQ-5D valuations from adult Americans in this sample appeared to behave in much the same fashion as in previous valuation studies. However, the generalisability of results to the entire adult American population may be limited. Violations of assumptions of the OLS regression model indicate the need for further investigation into the modelling technique used in deriving a single index score.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kind P. The EuroQoL instrument: an index of health—related quality of life. In: Spilker B, editor. Quality of life and pharmacoeconomics in clinical trials. 2nd edition. Philadelphia (PA): Lippincott—Raven Publishers, 1996: 191–201

    Google Scholar 

  2. Essink-Bot ML, Bonsel GJ, van der Maas PJ. Valuations of health states by the general public: feasibility of a standardized measurement procedure. Soc Sci Med 1990; 31: 1201–6

    Article  PubMed  CAS  Google Scholar 

  3. Brooks RG, Jendteg S, Lindgren B, et al. EuroQoL: health—related quality of life measurement: results of the Swedish questionnaire exercise. Health Policy 1991; 18: 25–36

    Article  Google Scholar 

  4. Nord E. EuroQoL: health—related quality of life measurement. Valuations of health states by the general public in Norway. Health Policy 1991; 18: 37–46

    Article  Google Scholar 

  5. Kind P. Measuring valuations for health states: a survey of patients in general practice. York: Centre for Health Economics, The University of York, 1990. Discussion paper no.: 76

    Google Scholar 

  6. Kind P, Gudex C, Dolan P, et al. Practical and methodological issues in the development of the EuroQol: the York experience. Adv Med Sociol 1994; 5: 219–53

    Google Scholar 

  7. Dolan P, Gudex C, Kind P, et al. A social tariff for EuroQol: results from a UK general population survey. York: Center for Health Economics, The University of York, 1995. Discussion paper no.: 138

    Google Scholar 

  8. Brazier J, Jones N, Kind P. Testing the validity of the EuroQol and comparing it with the SF−36 health survey questionnaire. Qual Life Res 1993; 2: 169–80

    Article  PubMed  CAS  Google Scholar 

  9. Nord E, Richardson J, Macarounas-Kirchman K. Social evaluation of health care versus personal evaluation of health states: evidence of the validity of four health—state scaling instrument using Norwegian and Australian surveys. Int J Technol Assess Health Care 1993; 9: 463–78

    Article  PubMed  CAS  Google Scholar 

  10. Essink-Bot ML, Stouthard MEA, Bonsel GJ. Generalizability of valuations on health states collected with the EuroQolquestionnaire. Health Econ 1993; 2: 237–46

    Article  PubMed  CAS  Google Scholar 

  11. van Agt HM, Essink-Bot ML, Krabbe PF, et al. Test—retest reliability of health state valuations collected with the EuroQol questionnaire. Soc Sci Med 1994; 39: 1537–44

    Article  PubMed  Google Scholar 

  12. Selai C, Rosser R. Eliciting EuroQol descriptive data and utility scale values from inpatients. Pharmacoeconomics 1995; 8: 147–58

    Article  PubMed  CAS  Google Scholar 

  13. Kaplan RM, Feeny D, Revicki DA. Methods for assessing relative importance in preference based outcome measures. Qual Life Res 1993; 2: 467–75

    Article  PubMed  CAS  Google Scholar 

  14. Dolan P, Kind P. Inconsistency and health state valuations. Soc Sci Med 1996; 42: 609–15

    Article  PubMed  CAS  Google Scholar 

  15. Hakim Z, Pathak DS, Kucukarisan S, et al. Comparing alternative methodologies for measuring health state preferences. MADI Qual Life Newslett 1995; 12: 2–6

    Google Scholar 

  16. Johnson JA, Coons SJ. Comparison of the EuroQol and SF−12 in an Adult US Sample. Qual Life Res. In press

  17. Torrance GW, Furlong W, Feeny D, et al. Multi—attribute preference functions: health utilities index. Pharmacoeconomics 1995; 7: 503–20

    Article  PubMed  CAS  Google Scholar 

  18. Aaronson NK, Acquadro C, Alonso J, et al. International Quality of Life Assessment (IQOLA) Project. Qual Life Res 1992; 1: 349–51

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jeffrey A. Johnson.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Johnson, J.A., Coons, S.J., Ergo, A. et al. Valuation of EuroQOL (EQ-5D) Health States in an Adult US Sample. Pharmacoeconomics 13, 421–433 (1998). https://doi.org/10.2165/00019053-199813040-00005

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00019053-199813040-00005

Keywords

Navigation