EQ-5D-3L | FAQs

General

For what period of time does EQ-5D-3L record health status?

Self-reported health status captured by EQ-5D-3L relates to the respondent’s situation at the time of completion. No attempt is made to summarize the recalled health status over the preceding days or weeks, although EQ-5D-3L has been tested in recall mode. An early decision taken by the EuroQol Group determined that health status measurement ought to apply to the respondent’s immediate situation – hence the focus on ‘your own health state today’.

Can I use only the EQ-5D-3L descriptive system or only the EQ VAS?

We cannot advise this. EQ-5D-3L is a two-part instrument. If you only use one part, you cannot claim to have used EQ-5D-3L in your publications.

How long should the EQ VAS be?

For paper versions, the EQ VAS scale should be 20 cm. All methodological and developmental work has been carried out on VAS of this length. To ensure that you print the correct length, set your paper size at A4 and make sure that the box in your printing instructions labelled ‘scale to paper size’ is set at ‘no scaling’.

Can I publish our study using EQ-5D?

Yes, you are free to publish your results. If you are reproducing the EQ-5D-3L, we request that you use the sample version of EQ-5D-3L. Also, please include the copyright statement located in the footer of each EQ-5D-3L language version.

How do I refer to the EQ-5D-3L instrument in publications?

When publishing results obtained with the EQ-5D-3L, the following references can be used:

  • The EuroQol Group (1990). EuroQol-a new facility for the measurement of health-related quality of life. Health Policy 16(3):199-208.
  • Brooks R (1996). EuroQol: the current state of play. Health Policy 37(1):53-72.

If you used a value set in your study you can also include a reference to the publication describing that value set. The appropriate references for the value sets can be found in the EQ-5D Value Sets Monograph and in the value set summary documents that can be ordered from the EuroQol Office.

What is the difference between the EQ-5D-3L descriptive system and the EQ VAS?

The descriptive system can be represented as a health state, e.g. health state 11212 represents a patient who indicates some problems on the usual activities and anxiety/depression dimensions. These health states can be converted into a single index value using (one of) the available EQ-5D-3L value sets. These value sets have been derived using VAS or TTO valuation techniques, and they reflect the opinion of the general population. In contrast, the EQ VAS scores are patient-based and are therefore not representative of the general population. The EQ VAS self-rating records the respondent’s own assessment of their health status. Furthermore, the EQ VAS scores are anchored on 100 = best imaginable health and 0 = worst imaginable health, whereas the value sets are anchored on 11111 = 1 and dead = 0 and can therefore be used in QALY calculations.

What is the difference between the TTO and VAS techniques?

The TTO and VAS value sets differ in the technique used to elicit the values for the models. In the TTO task, respondents are asked to imagine they live in a health state (e.g. 22222) for 10 years and then to specify the amount of time they are willing to give up to live in full health instead (i.e. 11111). For example, someone might consider that 8 years in 11111 is equivalent to 10 years in 22222. The VAS technique, on the other hand, asks people to indicate where they think a health state should be positioned on a vertical thermometer-like scale ranging from best imaginable health to worst imaginable health.

General population value sets vs patient population sets

To undertake a utility analysis, you will need to use a value set. Generally speaking, utility analysis requires a value set based on preferences from a general population (as opposed to a patient-based set). The rationale behind this is that the values are supposed to reflect the preferences of local taxpayers and potential receivers of healthcare. Additionally, patients tend to rate health states higher than the general population do because of coping strategies etc., thus underestimating the need for healthcare. The EQ-5D-3L value sets are therefore based on the values of the general population.

Multinational clinical trials

Data on EQ-5D health states gathered in the context of a multinational trial may be converted into a single summary index using one of the available EQ-5D-3L value sets. There are different options available to do this using appropriate value sets, however, the choice depends on the context in which researchers or decision makers will use the information. In cases where data from an multinational trial are to be used to inform decision makers in a specific country, it seems reasonable to expect decision makers to be interested primarily in value sets that reflect the values for EQ-5D-3L health states in that specific country. For example, if applications for reimbursement of a drug are rolled out from country to country, then country-specific value sets should be applied and reported in each pharmaco-economic report. This is no different from the requirement to use country-specific costs. In the absence of a country-specific value set, the researcher should select another set of values for a population that most closely approximates that country. Sometimes however, information about utilities is required to inform researchers or decision makers in an international context. In these instances, it is probably more appropriate to apply one value set over all the EQ-5D health state data. The decision about which value set to use will depend on whether the relevant decision making body in each country specifies any requirements or preferences in regard to the methodology used in different contexts (e.g. TTO, standard gamble (SG), VAS or discrete choice modelling (DCM)). These guidelines are the topic of an international ongoing debate, but the EuroQol Group website is planning to provide a summary of health-care decision-making bodies internationally, including their stated requirements regarding the valuation of health states. Detailed information regarding the EQ-5D valuation protocols, guidelines for choice of value set and tables of all available value sets have recently been published by Springer in: EuroQol Group Monograph series: Volume 2: EQ-5D value sets: inventory, comparative review and user guide’ (see section 8 for more information). Chapter 4 by Nancy Devlin and David Parkin will be of special interest to researchers pondering the issue of which value set to use.

Registration

How can I obtain the EQ-5D-3L instrument?

If you have already seen the EQ-5D-3L and/or have decided to go ahead and use it, please register your study/project/trial first, by completing the EQ-5D registration form. The EuroQol Office will then contact you by e-mail and inform you about the terms and conditions which apply to your use of the EQ-5D-3L, including licensing fees (if applicable). Please allow 5 working days to receive this reply.

I am not conducting a study but would like to use the EQ-5D to measure clinical outcomes. Do I still need to register?

Yes. You can only obtain EQ-5D versions by completing the EQ-5D Registration Form.

Licensing

Do I have to pay for using the EQ-5D-3L instrument?

Licensing fees are determined by the EuroQol Office on the basis of the user information provided in the registration form. The size of the payment depends on the type of study, funding source, sample size and number of requested languages. You are not obligated to purchase by registering.

Copyright

Is the EQ-5D-3L a copyrighted instrument?

Yes. Please note that without the prior written consent of the EuroQol Office, you are not permitted to use, reproduce, alter, amend, convert, translate, publish or make available in whatever way (digital, hard-copy etc.) the EQ-5D-3L and related proprietary materials.

The EuroQol Research Foundation stresses that any and all copyrights in the EQ-5D, its (digital) representations, and its translations are exclusively vested in the EuroQol Research Foundation. EQ-5D™ is a trade mark of the EuroQol Research Foundation.

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