Cited by 917Health Systems, Economic Evaluations, Quality of LifeEconomic and Environmental ValuationMusculoskeletal pain and rehabilitation

Psychometric properties of the EQ-5D-5L: a systematic review of the literature

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Feng, You-Shan, Kohlmann, Thomas, Janssen, Mathieu F., Buchholz, Ines·2021·Quality of Life Research

Abstract

Purpose: Although the EQ-5D has a long history of use in a wide range of populations, the newer five-level version (EQ-5D-5L) has not yet had such extensive experience. This systematic review summarizes the available published scientific evidence on the psychometric properties of the EQ-5D-5L. Methods: Pre-determined key words and exclusion criteria were used to systematically search publications from 2011 to 2019. Information on study characteristics and psychometric properties were extracted: specifically, EQ-5D-5L distribution (including ceiling and floor), missing values, reliability (test–retest), validity (convergent, known-groups, discriminate) and responsiveness (distribution, anchor-based). EQ-5D-5L index value means, ceiling and correlation coefficients (convergent validity) were pooled across the studies using random-effects models. Results: Of the 889 identified publications, 99 were included for review, representing 32 countries. Musculoskeletal/orthopedic problems and cancer ( n = 8 each) were most often studied. Most papers found missing values (17 of 17 papers) and floor effects (43 of 48 papers) to be unproblematic. While the index was found to be reliable (9 of 9 papers), individual dimensions exhibited instability over time. Index values and dimensions demonstrated moderate to strong correlations with global health measures, other multi-attribute utility instruments, physical/functional health, pain, activities of daily living, and clinical/biological measures. The instrument was not correlated with life satisfaction and cognition/communication measures. Responsiveness was addressed by 15 studies, finding moderate effect sizes when confined to studied subgroups with improvements in health. Conclusions: The EQ-5D-5L exhibits excellent psychometric properties across a broad range of populations, conditions and settings. Rigorous exploration of its responsiveness is needed.

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Research works printed but not linked: 3

  1. [56]Luo N Li M Liu G Investigation of Labels for a 5-level EQ-5D descriptive system in Chinese EuroQol Proceedings 2009 26 77 102
  2. [62]Chevalier J De Pouvourville G Testing a new 5 level version of the EQ-5D in France EuroQol Proceedings 2008 14 75 88
  3. Scalone L Comparing the standard EQ-5D-3L versus 5L version for the assessment of health of patients with live diseases EuroQol Proceedings 2011 16 213 239

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Authors
Feng, Y.-S., Kohlmann, T., Janssen, M. F., & Buchholz, I.
Affiliations
  • Universitätsmedizin Greifswald (DE)
  • Erasmus MC (NL)
Corresponding author
Feng, You-Shan
Venue
Quality of Life Research
Published
2020-12-07
Volume
30
Issue
3
Pages
647-673
ISSN
  • 0962-9343 (ISSN-L)
  • 1573-2649
OpenAlex
W3111512677
Cited by
917
References
164
Citations by year
2026: 183 · 2025: 242 · 2024: 236 · 2023: 148 · 2022: 81 · 2021: 27
FWCI
10.35
Type
journal article
Language
en
Open access
Locations
  • Quality of Life Research (publishedVersion, cc-by)
  • Informationszentrum Lebenswissenschaften (ZB MED) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, cc-by)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, cc-by)
  • RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
Funders
  • EuroQol Research Foundation (EQ Project 2016170)
  • Universitätsklinikum Tübingen
Topics
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Economic and Environmental Valuation
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Keywords
EQ-5D-5L, EQ-5D, health-related quality of life, psychometric properties, reliability statistics, validity, responsiveness, floor effect, missing data, known-groups validity, convergent validity, musculoskeletal disorders, cancer
MeSH terms
Activities of Daily Living, Female, Humans, Male, Psychometrics, Surveys and Questionnaires, Reproducibility of Results

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