Psychometric properties of the EQ-5D-5L: a systematic review of the literature
Open accessAbstract
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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EQ-5D-5L has exhibited excellent psychometric properties across a broad range of populations, conditions, and settings.
“The EQ-5D-5L has exhibited excellent psychometric properties across a broad range of populations, conditions, and settings [67].”
The EQ-5D-5L has shown both validity and reliability.
“The scale has shown both of validity and reliability (Feng et al., 2021).”
From Feasibility of guided internet-based cognitive behavioral therapy for patients with anorexia nervosa (2022) · cites this paper as Feng et al., 2021
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The EQ-5D-5L is More Discriminative Than the EQ-5D-3L in Patients with Diabetes in Singapore
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Self-citationConvergent validation of EQ-5D-5L in patients with Parkinson's disease
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Translation, validity and reliability of the British Sign Language (BSL) version of the EQ-5D-5L
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What Determines the Shape of an EQ-5D Index Distribution?
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Marti-Pastor, M., Pont, À., Ávila, M., Garín, O., Vilagut, G., Forero, C. G., Pardo, Y., Tresserras, R., Medina-Bustos, A., Garcia-Codina, O., et al. (2018) · Population Health Metrics · doi:10.1186/s12963-018-0170-8 · Cited by 38 · see citing works
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Comparing the measurement equivalence of EQ-5D-5L across different modes of administration
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Validity of the EQ ‐5D in patients with pemphigus vulgaris and pemphigus foliaceus
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Can Multi-attribute Utility Instruments Adequately Account for Subjective Well-being?
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Comparison of EQ-5D-5L, VAS, and SF-6D in Thai Patients on Peritoneal Dialysis
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Does the choice of tariff matter?
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Generic Preference-based Measures for Low Back Pain
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“The validity of the EQ-5D-5L in measuring quality of life benefits of breast reconstruction”
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EQ-5D-5L is More Responsive than EQ-5D-3L to Treatment Benefit of Cataract Surgery
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Responsiveness of the Testing Morbidities Index in Colonoscopy
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Valuing health-related quality of life: systematic variation in health perception
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Health utility reporting in chronic rhinosinusitis patients
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Once Bitten Twice Shy: Thinking Carefully Before Adopting the EQ-5D-5L
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Japanese Population Norms for Preference-Based Measures: Eq-5d-3l, Eq-5d-5l, And Sf-6d
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Flagged first, then by citations
Research works printed but not linked: 3
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- [62]Chevalier J De Pouvourville G Testing a new 5 level version of the EQ-5D in France EuroQol Proceedings 2008 14 75 88
- 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
Cited by
Sorted by citations
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Hamatani, S., Matsumoto, K., Takahashi, J., Shiko, Y., Ozawa, Y., Niitsu, T., Hirano, Y., & Shimizu, E. (2022) · Internet Interventions · doi:10.1016/j.invent.2022.100504 · Cited by 12 · see citing works
“The scale has shown both of validity and reliability (Feng et al., 2021).”
BackgroundMeek, C., das Nair, R., Evangelou, N., Middleton, R., Tuite-Dalton, K., & Moghaddam, N. (2022) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2022.104154 · Cited by 12 · see citing works
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“The EQ-5D-5L has exhibited excellent psychometric properties across a broad range of populations, conditions, and settings [67].”
Background
- 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
- PMC
- PMC7952346
- 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
- hybrid
- doi.org
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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