Skip to main content
Log in

Comparing the psychometric properties of the EQ-5D-3L and EQ-5D-5L in cancer patients in Korea

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

This study was conducted to assess the redistribution properties of the EQ-5D-3L when using the EQ-5D-5L and to compare the validity, informativity, and reliability of both EQ-5D-3L and EQ-5D-5L in Korean cancer patients.

Methods

Patients visiting one ambulatory cancer center self-administered the two versions of the EQ-5D and the EORTC QLQ-C30 questionnaire. Redistribution properties in each dimension of EQ-5D were analyzed between EQ-5D-3L and EQ-5D-5L. Informativity was evaluated using the Shannon entropy and ceiling effect. Convergent validity was evaluated by comparing the EQ-VAS, ECOG performance status, and EORTC QLQ-C30 subscales. Reliability was also evaluated in terms of test–retest reliability.

Results

All levels of the EQ-5D-3L substantially partitioned into associated levels of the EQ-5D-5L. The average inconsistency rate of the two versions was 3.5%. Absolute informativity was higher for the EQ-5D-5L than for the EQ-5D-3L, but their informative efficiency tended to be similar. The proportion of ‘perfect health’ (11111) decreased from 16.8% in the EQ-5D-3L to 9.7% in the EQ-5D-5L. EQ-5D-5L demonstrated similar or higher correlations with the EQ-VAS, ECOG performance status, and EORTC QLQ-C30, than the EQ-5D-3L. The intraclass correlation coefficient of the EQ-5D-5L index was 0.77.

Conclusions

The EQ-5D-5L had greater informativity and lower rate in the ceiling effect than those values of the EQ-5D-3L. The EQ-5D-5L showed good construct validity and reasonable reliability. Therefore, considering these findings, the EQ-5D-5L may be preferable to the EQ-5D-3L.

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

Abbreviations

ECOG:

Eastern Cancer Oncology Group

EQ-5D-3L:

3-level version of EQ-5D

EQ-5D-5L:

5-level version of EQ-5D

EORTC QLQ-C30:

European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30

EU ISPOR:

European Union International Society for Pharmacoeconomics and Outcomes Research

HRQoL:

Health-related quality of life

HUI2:

Health utility index mark 2

HUI3:

Health utility index mark 3

ICC:

Intraclass correlation coefficient

SF-6D:

Short form 6 dimension

VAS:

Visual analogue scale

References

  1. Park, S. S., Yoon, Y. S., & Oh, S. W. (2011). Health-related quality of life in metabolic syndrome: The Korea National Health and Nutrition Examination Survey 2005. Diabetes Research and Clinical Practice, 91(3), 381–388.

    Article  PubMed  Google Scholar 

  2. Lang, H. C., Chuang, L., Shun, S. C., Hsieh, C. L., & Lan, C. F. (2010). Validation of EQ-5D in patients with cervical cancer in Taiwan. Supportive Care in Cancer, 18(10), 1279–1286.

    Article  PubMed  Google Scholar 

  3. Hoi le, V., Chuc, N. T., & Lindholm, L. (2010). Health-related quality of life, and its determinants, among older people in rural Vietnam. BMC Public Health, 10, 549.

    Article  PubMed  CAS  Google Scholar 

  4. Kang, E. J., & Ko, S. K. (2009). A catalogue of EQ-5D utility weights for chronic diseases among noninstitutionalized community residents in Korea. Value Health, 12(Suppl 3), S114–S117.

    Article  PubMed  Google Scholar 

  5. Brooks, R., Rabin, R. E., & de Charro, F. (2003). The measurement and valuation of health status using EQ-5D: A European perspective. Dordrecht: Kluwer Academic Publishers.

    Google Scholar 

  6. Campbell, H., Rivero-Arias, O., Johnston, K., Gray, A., Fairbank, J., & Frost, H. (2006). Responsiveness of objective, disease-specific, and generic outcome measures in patients with chronic low back pain: an assessment for improving, stable, and deteriorating patients. Spine (Phila Pa 1976), 31(7), 815–822.

    Article  Google Scholar 

  7. Gusi, N., Tomas-Carus, P., Hakkinen, A., Hakkinen, K., & Ortega-Alonso, A. (2006). Exercise in waist-high warm water decreases pain and improves health-related quality of life and strength in the lower extremities in women with fibromyalgia. Arthritis and Rheumatism, 55(1), 66–73.

    Article  PubMed  CAS  Google Scholar 

  8. Petrou, S., & Hockley, C. (2005). An investigation into the empirical validity of the EQ-5D and SF-6D based on hypothetical preferences in a general population. Health Economics, 14, 1169–1189.

    Article  PubMed  Google Scholar 

  9. Petrou, S., Morrell, J., & Spiby, H. (2009). Assessing the empirical validity of alternative multi-attribute utility measures in the maternity context. Health Qual Life Outcomes, 7, 40.

    Article  PubMed  Google Scholar 

  10. Cunillera, O., Tresserras, R., Rajmil, L., Vilagut, G., Brugulat, P., Herdman, M., et al. (2010). Discriminative capacity of the EQ-5D, SF-6D, and SF-12 as measures of health status in population health survey. Quality of Life Research, 19(6), 853–864.

    Article  PubMed  Google Scholar 

  11. Janssen, M. F., Birnie, E., Haagsma, J. A., & Bonsel, G. J. (2008). Comparing the standard EQ-5D three-level system with a five-level version. Value in Health, 11(2), 275–284.

    Article  PubMed  Google Scholar 

  12. Bharmal, M., & Thomas, J., I. I. I. (2006). Comparing the EQ-5D and the SF-6D descriptive systems to assess their ceiling effects in the US general population. Value Health, 9, 262–271.

    Article  PubMed  Google Scholar 

  13. Pickard, A. S., De Leon, M. C., Kohlmann, T., Cella, D., & Rosenbloom, S. (2007). Psychometric comparison of the standard EQ-5D to a 5 level version in cancer patients. Medical Care, 45(3), 259–263.

    Article  PubMed  Google Scholar 

  14. Kim, M. H., Cho, Y. S., Uhm, W. S., Kim, S., & Bae, S. C. (2005). Cross-cultural adaptation and validation of the Korean version of the EQ-5D in patients with rheumatic diseases. Quality of Life Research, 14(5), 1401–1406.

    Article  PubMed  Google Scholar 

  15. Lee, Y. K., Nam, H. S., Chuang, L. H., et al. (2009). South Korean time trade-off values for EQ-5D health states: Modeling with observed values for 101 health states. Value in Health, 12(8), 1187–1193.

    Article  PubMed  Google Scholar 

  16. Aaronson, N. K., Cull, A. M., Kaasa, S., & Sprangers, M. A. (1996). The European organization for research and treatment of cancer modular approach to quality of life assessment in oncology: An update. In B. Spilker (Ed.), Quality of life and pharmacoeconomics in clinical trials (2nd ed., pp. 179–189). Philadelphia: Lippincott-Raven.

    Google Scholar 

  17. Shannon, C. E., & Weaver, W. (1948). A mathematical theory of communication. Bell System Technical Journal, 27, 379–423.

    Google Scholar 

  18. Dahl, F. A., & Østerås, N. (2010). Quantifying information content in survey data by entropy. Entropy, 12, 161–163.

    Article  Google Scholar 

  19. Kleinbaum, D. G., Kupper, L. L., Nizam, A., & Muller, K. E. (2008). Testing for the equality of two correlations. In C. Crockett (Ed.), Applied regression analysis and other multivariable methods (4th ed., pp. 103–104). Belmont, CA: Thomson Brooks/Cole.

    Google Scholar 

  20. Fleiss, J. L. (1981). Statistical methods for rates and proportions (2nd ed.). New York, NY: Wiley, John and Sons, Inc.

    Google Scholar 

  21. Brazier, J., Jones, N., & Kind, P. (1993). Testing the validity of the Euroqol and comparing it with the SF-36 health survey questionnaire. Quality of Life Research, 2(3), 169–180.

    Article  PubMed  CAS  Google Scholar 

  22. Johnson, J. A., & Coons, S. J. (1998). Comparison of the EQ-5D and SF-12 in an adult US sample. Quality of Life Research, 7(2), 155–166.

    Article  PubMed  CAS  Google Scholar 

  23. Gao, F., Ng, G. Y., Cheung, Y. B., et al. (2009). The Singaporean English and Chinese versions of the EQ-5D achieved measurement equivalence in cancer patients. Journal of Clinical Epidemiology, 62(2), 206–213.

    Article  PubMed  Google Scholar 

  24. Hughes, D. A. (2007). Feasibility, validity and reliability of the Welsh version of the EQ-5D health status questionnaire. Quality of Life Research, 16(8), 1419–1423.

    Article  PubMed  Google Scholar 

  25. Johnson, J. A., & Pickard, A. S. (2000). Comparison of the EQ-5D and SF-12 health surveys in a general population survey in Alberta, Canada. Medical Care, 38(1), 115–121.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Min-Woo Jo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, S.H., Kim, H.J., Lee, Si. et al. Comparing the psychometric properties of the EQ-5D-3L and EQ-5D-5L in cancer patients in Korea. Qual Life Res 21, 1065–1073 (2012). https://doi.org/10.1007/s11136-011-0018-1

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-011-0018-1

Keywords

Navigation