Population norms
Population reference data, sometimes called population norm data or simply population norms, provide baseline or reference scores for a specific country or international region, based on representative samples. EQ-5D population norms can be used to to benchmark the outcomes of specific individuals or groups (e.g. patients) against the health of the general population, which also helps to identity the burden of the disease of patients or patient groups. Additionally, population norms can facilitate the calculation of quality-adjusted life years (QALYs) and may be instrumental for health care decision-making in the economic evaluation of medical interventions and health technologies.
Population norms, including reported problems by the five EQ-5D dimensions, self-reported EQ VAS ratings, and EQ-5D values have been published by age and gender for the EQ-5D-5L and the EQ-5D-3L in a large number of countries or regions. Apart from norms for general populations, there are also several population norms available for specific population groups, such as patient groups and the elderly.
| Instrument | Country | Reference | Type |
|---|---|---|---|
| EQ-5D-5L | France | Population norms in France with EQ‑5D‑5L: health states, value indexes, and VAS. Gautier L, Azzi J, Saba G, Bonnelye G, De Pouvourville G. Eur J Health Econ (2023). | |
| EQ-5D-5L | England | Quality-Adjusted Life Expectancy Norms for the English Population McNamara S, Schneider PP, Love-Koh J, Doran T, Gutacker N. | |
| EQ-5D-5L | Australia | Health-related quality of life measured using the EQ-5D-5L: South Australian population norms. McCaffrey N, Kaambwa B, Currow DC, Ratcliffe J. Health Qual Life Outcomes. 2016 Sep 20;14(1):133. doi: 10.1186/s12955-016-0537-0. | |
| EQ-5D-5L | Barbados & Jamaica | EQ-5D self-reported health in Barbados and Jamaica with EQ-5D-5L population norms for the English-speaking Caribbean. Bailey H, Janssen MF, La Foucade A, Boodraj G, Wharton M, Castillo P. Health Qual Life Outcomes. 2021 Mar 19;19(1):97. doi: 10.1186/s12955-021-01734-8. | |
| EQ-5D-5L | Belgium | Belgian population norms for the EQ-5D-5L,  2018. Van Wilder L, Charafeddine R, Beutels P, Bruyndonckx R, Cleemput I, Demarest S, De Smedt D, Hens N, Scohy A, Speybroeck N, Van der Heyden J, Yokota RTC, Van Oyen H, Bilcke J, Devleesschauwer B. Qual Life Res. 2021 Aug 18. doi: 10.1007/s11136-021-02971-6. Online ahead of print. | |
| EQ-5D-5L | Belize | Health-Related Quality of Life Population Norms for Belize Using EQ-5D-5L. Bailey H, Janssen MF, La Foucade A, Castillo P, Boodraj G. Value Health Reg Issues. 2021 Nov 18;29:45-52. doi: 10.1016/j.vhri.2021.09.005. Online ahead of print. | |
| EQ-5D-5L | Bulgaria | EQ-5D-5L Bulgarian population norms. Encheva M, Djambazov S, Vekov T, Golicki D. Eur J Health Econ. 2020 Nov;21(8):1169-1178. doi: 10.1007/s10198-020-01225-5. Epub 2020 Aug 19. | |
| EQ-5D-5L | Canada (Alberta) | Alberta population norms for EQ-5D-5L. The APERSU Team (2018). | |
| EQ-5D-5L | Canada (Quebec) | Quebec Health-Related Quality-of-Life Population Norms Using the EQ-5D-5L: Decomposition by Sociodemographic Data and Health Problems.  Poder TG, Carrier N, Kouakou CRC. Value Health. 2020 Feb;23(2):251-259. doi: 10.1016/j.jval.2019.08.008. Epub 2019 Oct 3. | |
| EQ-5D-5L | China | EQ-5D-5L norms for the urban Chinese population in China.  Yang Z, Busschbach J, Liu G, Luo N. Health Qual Life Outcomes. 2018 Nov 8;16(1):210. doi: 10.1186/s12955-018-1036-2. | |
| EQ-5D-5L | China (Hong Kong) | Normative Profile of Health-Related Quality of Life for Hong Kong General Population Using Preference-Based Instrument EQ-5D-5L . Wong EL, Cheung AW, Wong AY, Xu RH, Ramos-Goñi JM, Rivero-Arias O. Value Health. 2019 Aug;22(8):916-924. doi: 10.1016/j.jval.2019.02.014. Epub 2019 Jul 27. | |
| EQ-5D-5L | Colombia | EQ-5D-5L Population Norms and Health Inequality in Colombia . Bailey HH, Janssen MF, Varela RO, Moreno JA. Value Health Reg Issues. 2021 Dec;26:24-32. doi: 10.1016/j.vhri.2020.12.002. Epub 2021 Mar 25. | |
| EQ-5D-5L | Denmark | Danish population health measured by the EQ-5D-5L . Jensen MB, Jensen CE, Gudex C, Pedersen KM, Sørensen SS, Ehlers LH. Scand J Public Health. 2021 Nov 30:14034948211058060. doi: 10.1177/14034948211058060. Online ahead of print. | |
| EQ-5D-5L | Germany | Health-related quality of life measured with the EQ-5D-5L: estimation of normative index values based on a representative German population sample and value set.  Grochtdreis T, Dams J, König HH, Konnopka A. Eur J Health Econ. 2019 Aug;20(6):933-944. doi: 10.1007/s10198-019-01054-1. Epub 2019 Apr 27. | |
| EQ-5D-5L | Germany | Health-Related Quality of Life of the General German Population in 2015: Results from the EQ-5D-5L.   Huber, M. B., Felix, J., Vogelmann, M., & Leidl, R. (2017). Int J Environ Res Public Health, 14(4). | |
| EQ-5D-5L | Germany | EQ-5D-5L in the General German Population: Comparison and Evaluation of Three Yearly Cross-Section Surveys.   Huber, M. B., Reitmeir, P., Vogelmann, M., & Leidl, R. (2016). Int J Environ Res Public Health, 13(3). | |
| EQ-5D-5L | Germany | The quality of life questionnaire EQ-5D-5L: psychometric properties and normative values for the general German population.  Hinz A, Kohlmann T, Stöbel-Richter Y, Zenger M, Brähler E. Qual Life Res. 2014 Mar;23(2):443-7. doi: 10.1007/s11136-013-0498-2. Epub 2013 Aug 7. | |
| EQ-5D-5L | Germany (Elderly) | EQ-5D-5L reference values for the German general elderly population.  Marten O, Greiner W. Health Qual Life Outcomes. 2021 Mar 6;19(1):76. doi: 10.1186/s12955-021-01719-7. | |
| EQ-5D-5L | Indonesia | Quality of life of the Indonesian general population: Test-retest reliability and population norms of the EQ-5D-5L and WHOQOL-BREF . Purba FD, Hunfeld JAM, Iskandarsyah A, Fitriana TS, Sadarjoen SS, Passchier J, Busschbach JJV. PLoS One. 2018 May 11;13(5):e0197098. doi: 10.1371/journal.pone.0197098. eCollection 2018. | |
| EQ-5D-5L | Iran | Health-related quality of life measured using the EQ-5D-5 L: population norms for the capital of Iran. Emrani Z, Akbari Sari A, Zeraati H, Olyaeemanesh A, Daroudi R. Health Qual Life Outcomes.  2020 Apr 25;18(1):108. doi: 10.1186/s12955-020-01365-5 Hobbins A, Barry L, Kelleher D, O'Neill C. | |
| EQ-5D-5L | Ireland | The health of the residents of Ireland: Population norms for Ireland based on the EQ-5D-5L descriptive system - a cross sectional study . Hobbins A, Barry L, Kelleher D, O'Neill C. HRB Open Res. 2018 Sep 4;1:22. doi: 10.12688/hrbopenres.12848.1. eCollection 2018. | |
| EQ-5D-5L | Japan | Japanese Population Norms of EQ-5D-5L and Health Utilities Index Mark 3: Disutility Catalog by Disease and Symptom in Community Settings . Shiroiwa T, Noto S, Fukuda T. Value Health. 2021 Aug;24(8):1193-1202. doi: 10.1016/j.jval.2021.03.010. Epub 2021 Apr 22. | |
| EQ-5D-5L | Japan | Japanese population norms for preference-based measures: EQ-5D-3L, EQ-5D-5L, and SF-6D . Shiroiwa T, Fukuda T, Ikeda S, Igarashi A, Noto S, Saito S, Shimozuma K. Qual Life Res. 2016 Mar;25(3):707-19. doi: 10.1007/s11136-015-1108-2. Epub 2015 Aug 25. | |
| EQ-5D-5L | New Zealand | New Zealand Population Norms for the EQ-5D-5L Constructed From the Personal Value Sets of Participants in a National Survey . Sullivan T, Turner RM, Derrett S, Hansen P. Value Health. 2021 Sep;24(9):1308-1318. doi: 10.1016/j.jval.2021.04.1280. Epub 2021 Jun 26. | |
| EQ-5D-5L | Norway | Norwegian population norms for the EQ-5D-5L: results from a general population survey . Garratt AM, Hansen TM, Augestad LA, Rand K, Stavem K. Qual Life Res. 2021 Jul 16:1-10. doi: 10.1007/s11136-021-02938-7. Online ahead of print. | |
| EQ-5D-5L | Poland | EQ-5D-5L Polish population norms . Golicki D, Niewada M. Arch Med Sci. 2017 Feb 1;13(1):191-200. doi: 10.5114/aoms.2015.52126. Epub 2015 Jun 9. | |
| EQ-5D-5L | Poland (diabetes patients) | EQ-5D-5L-based quality of life normative data for patients with self-reported diabetes in Poland.  Jankowska A, Golicki D. PLoS One. 2021 Sep 29;16(9):e0257998. doi: 10.1371/journal.pone.0257998. eCollection 2021. | |
| EQ-5D-5L | Russia | Population norms of health-related quality of life in Moscow, Russia: the EQ-5D-5L-based survey.  Hołownia-Voloskova M, Tarbastaev A, Golicki D. Qual Life Res. 2021 Mar;30(3):831-840. doi: 10.1007/s11136-020-02705-0. Epub 2020 Nov 25. | |
| EQ-5D-5L | Slovenia | EQ-5D-5L Slovenian population norms . Prevolnik Rupel V, Ogorevc M. Health Qual Life Outcomes. 2020 Oct 7;18(1):333. doi: 10.1186/s12955-020-01584-w. | |
| EQ-5D-5L | Spain | Validity of the EQ-5D-5L and reference norms for the Spanish population . Hernandez G, Garin O, Pardo Y, Vilagut G, Pont À, Suárez M, Neira M, Rajmil L, Gorostiza I, Ramallo-Fariña Y, Cabases J, Alonso J, Ferrer M. Qual Life Res. 2018 Sep;27(9):2337-2348. doi: 10.1007/s11136-018-1877-5. Epub 2018 May 16. | |
| EQ-5D-5L | Spain | Normative values of EQ-5D-5L: in a Spanish representative population sample from Spanish Health Survey, 2011.  Garcia-Gordillo MA, Adsuar JC, Olivares PR. Qual Life Res. 2016 May;25(5):1313-21. doi: 10.1007/s11136-015-1164-7. Epub 2015 Oct 19. | |
| EQ-5D-5L | Spain (diabetes patients) | Normative Values of Eq-5d-5l for Diabetes Patients from Spain.   Collado Mateo, D., Garcia Gordillo, M. A., Olivares, P. R., & Adsuar, J. C. (2015). Nutr Hosp, 32(4), 1595-1602. | |
| EQ-5D-5L | Sweden | Inequality and heterogeneity in health-related quality of life: findings based on a large sample of cross-sectional EQ-5D-5L data from the Swedish general population . Teni FS, Gerdtham UG, Leidl R, Henriksson M, Åström M, Sun S, Burström K. Qual Life Res. 2021 Oct 10. doi: 10.1007/s11136-021-02982-3. | |
| EQ-5D-5L | Trinidad & Tobago | EQ-5D-5L population norms and health inequalities for Trinidad and Tobago . Bailey H, Janssen MF, La Foucade A, Kind P. PLoS One. 2019 Apr 29;14(4):e0214283. doi: 10.1371/journal.pone.0214283. eCollection 2019. | |
| EQ-5D-5L | United States | US population norms for the EQ-5D-5L and comparison of norms from face-to-face and online samples.  Jiang R, Janssen MFB, Pickard AS. Qual Life Res. 2021 Mar;30(3):803-816. doi: 10.1007/s11136-020-02650-y. Epub 2020 Oct 6. | |
| EQ-5D-5L | Vietnam (hypertension patients) | Reference data among general population and known-groups validity among hypertensive population of the EQ-5D-5L in Vietnam . Mai VQ, Giang KB, Minh HV, Lindholm L, Sun S, Sahlen KG. Qual Life Res. 2021 Aug 9. doi: 10.1007/s11136-021-02959-2. Online ahead of print. | |
| EQ-5D-5L | Vietnam | Quality of life profile of general Vietnamese population using EQ-5D-5L . Nguyen LH, Tran BX, Hoang Le QN, Tran TT, Latkin CA. Health Qual Life Outcomes. 2017 Oct 11;15(1):199. doi: 10.1186/s12955-017-0771-0. | |
| EQ-5D-3L | 6 European countries (Belgium, France, Germany, Italy, the Netherlands, and Spain) | Comparison of population health status in six european countries: results of a representative survey using the EQ-5D questionnaire. König HH, Bernert S, Angermeyer MC, Matschinger H, Martinez M, Vilagut G, Haro JM, de Girolamo G, de Graaf R, Kovess V, Alonso J; ESEMeD/MHEDEA 2000 Investigators. Med Care. 2009 Feb;47(2):255-61. (Data also presented in: Szende A, Janssen B, Cabases J, editors. Self-Reported Population Health: An International Perspective based on EQ-5D. Dordrecht (NL): Springer; 2014.) | Multiple |
| EQ-5D-3L | EQ-5D population norms for 20 countries | Population norms for the EQ-5D-3L: a cross-country analysis of population surveys for 20 countries. Janssen MF, Szende A, Cabases J, Ramos-Goñi JM, Vilagut G, König HH. Eur J Health Econ. 2019 Mar;20(2):205-216. | Multiple |
| EQ-5D-3L | EQ-5D population norms for 20 countries | Population norms for the EQ-5D-3L: a cross-country analysis of population surveys for 20 countries. Janssen MF, Szende A, Cabases J, Ramos-Goñi JM, Vilagut G, König HH. Eur J Health Econ. 2019 Mar;20(2):205-216. | Multiple |
| EQ-5D-3L | 5 European countries (France, Germany, Italy, Spain, United Kingdom) | General population normative data for the EQ-5D-3L in the five largest European economies. Janssen MF, Pickard AS, Shaw JW. Eur J Health Econ. 2021 Dec;22(9):1467-1475. | Multiple |
| EQ-5D-3L | Central-Eastern Europe | Towards a Central-Eastern European EQ-5D-3L population norm: comparing data from Hungarian, Polish and Slovenian population studies. Zrubka Z, Golicki D, Prevolnik-Rupel V, Baji P, Rencz F, Brodszky V, Gulácsi L, Péntek M. Eur J Health Econ. 2019 Jun;20(Suppl 1):141-154. | Multiple |
| EQ-5D-3L | Armenia | Social inequalities in self-reported health: is Armenia different from Slovenia? Gharagebakyan G, Ghukasyan H, Williams A, Szende A (2003) In: Rupel VP (ed) 20th plenary meeting of the EuroQol Group. Discussion papers. Republic of Slovenia, Ministry of Health, pp 79–87. | Individual |
| EQ-5D-3L | Australia | A comparison of EQ-5D-3L population norms in Queensland, Australia, estimated using utility value sets from Australia, the UK and USA. Clemens S, Begum N, Harper C, Whitty JA, Scuffham PA. Qual Life Res. 2014 Oct;23(8):2375-81. | Individual |
| EQ-5D-3L | Brazil | EQ-5D Brazilian population norms. Santos M, Monteiro AL, Santos B. Health Qual Life Outcomes. 2021 Jun 10;19(1):162. | Individual |
| EQ-5D-3L | Canada (Alberta) | Comparison of the EQ-5D and SF-12 health surveys in a general population survey in Alberta, Canada. Johnson JA, Pickard AS. Med Care. 2000 Jan;38(1):115-21. | Individual |
| EQ-5D-3L | China | Population norms for the EQ-5D-3L in China derived from the 2013 National Health Services Survey. Yao Q, Liu C, Zhang Y, Xu L. J Glob Health. 2021 Feb 11;11:08001. | Individual |
| EQ-5D-3L | China (Heilongjiang) | Assessing Health-Related Quality of Life of Chinese Adults in Heilongjiang Using EQ-5D-3L. Huang W, Yu H, Liu C, Liu G, Wu Q, Zhou J, Zhang X, Zhao X, Shi L, Xu X. Int J Environ Res Public Health. 2017 Feb 23;14(3):224. | Individual |
| EQ-5D-3L | China | Population health status in China: EQ-5D results, by age, sex and socio-economic status, from the National Health Services Survey 2008. Sun S, Chen J, Johannesson M, Kind P, Xu L, Zhang Y, Burström K. Qual Life Res. 2011 Apr;20(3):309-20. (Data also presented in: Szende A, Janssen B, Cabases J, editors. Self-Reported Population Health: An International Perspective based on EQ-5D. Dordrecht (NL): Springer; 2014 .) | Individual |
| EQ-5D-3L | Denmark | Danish EQ-5D population norms. Sørensen J, Davidsen M, Gudex C, Pedersen KM, Brønnum-Hansen H. Scand J Public Health. 2009 Jul;37(5):467-74. (Data also presented in: Szende A, Janssen B, Cabases J, editors. Self-Reported Population Health: An International Perspective based on EQ-5D. Dordrecht (NL): Springer; 2014.) | Individual |
| EQ-5D-3L | Greece | Quality of life measurment and health production in Greece. Yfantopoulos Y (1999) In: Greiner W, Schulenburg J-M. Graf v.d., Piercy J (eds) (EuroQol) Plenary meeting. Discussion papers. Uni-Verlag Witte, Hannover, pp 100–114 | Individual |
| EQ-5D-3L | Hungary | Health-related quality of life of the Hungarian population Szende A, Németh R. A agyar lakosság egészségi állapothoz kapcsolódó életminósége. Orv Hetil. 2003 Aug 24;144(34):1667-74. Hungarian. (Data also presented in: Szende A, Janssen B, Cabases J, editors. Self-Reported Population Health: An International Perspective based on EQ-5D. Dordrecht (NL): Springer; 2014 .) | Individual |
| EQ-5D-3L | Japan | Japanese population norms for preference-based measures: EQ-5D-3L, EQ-5D-5L, and SF-6D. Shiroiwa T, Fukuda T, Ikeda S, Igarashi A, Noto S, Saito S, Shimozuma K. Qual Life Res. 2016 Mar;25(3):707-19. | Individual |
| EQ-5D-3L | Norway | General population norms for the EQ-5D-3 L in Norway: comparison of postal and web surveys. Stavem K, Augestad LA, Kristiansen IS, Rand K. Health Qual Life Outcomes. 2018 Oct 19;16(1):204. | Individual |
| EQ-5D-3L | Poland | General population reference values for 3-level EQ-5D (EQ-5D-3L) questionnaire in Poland. Golicki D, Niewada M. Pol Arch Med Wewn. 2015;125(1-2):18-26. | Individual |
| EQ-5D-3L | Portugal | EQ-5D Portuguese population norms. Ferreira LN, Ferreira PL, Pereira LN, Oppe M. Qual Life Res. 2014 Mar;23(2):425-30. | Individual |
| EQ-5D-3L | Singapore | Measuring health-related quality of life among adults in Singapore: population norms for the EQ-5D. Abdin E, Subramaniam M, Vaingankar JA, Luo N, Chong SA. Qual Life Res. 2013 Dec;22(10):2983-91. | Individual |
| EQ-5D-3L | Sri Lanka | EQ-5D-3L derived population norms for health related quality of life in Sri Lanka. Kularatna S, Whitty JA, Johnson NW, Jayasinghe R, Scuffham PA. PLoS One. 2014 Nov 3;9(11):e108434. | Individual |
| EQ-5D-3L | Sweden | Health-related quality of life (EQ-5D) among homeless persons compared to a general population sample in Stockholm County, 2006. Sun S, Irestig R, Burström B, Beijer U, Burström K. Scand J Public Health. 2012 Mar;40(2):115-25. (Data also presented in: Szende A, Janssen B, Cabases J, editors. Self-Reported Population Health: An International Perspective based on EQ-5D. Dordrecht (NL): Springer; 2014.) | Individual |
| EQ-5D-3L | Switzerland (French speaking) | General population reference values for the French version of the EuroQol EQ-5D health utility instrument. Perneger TV, Combescure C, Courvoisier DS. Value Health. 2010 Aug;13(5):631-5. | Individual |
| EQ-5D-3L | United Kingdom | Variations in population health status: results from a United Kingdom national questionnaire survey. Kind P, Dolan P, Gudex C, Williams A. BMJ. 1998 Mar 7;316(7133):736-41. (Data also presented in: Szende A, Janssen B, Cabases J, editors. Self-Reported Population Health: An International Perspective based on EQ-5D. Dordrecht (NL): Springer; 2014.) | Individual |
| EQ-5D-3L | Portugal | EQ-5D Portuguese population norms. Ferreira LN, Ferreira PL, Pereira LN, Oppe M. Qual Life Res. 2014 Mar;23(2):425-30. | Individual |
| EQ-5D-3L | Singapore | Measuring health-related quality of life among adults in Singapore: population norms for the EQ-5D. Abdin E, Subramaniam M, Vaingankar JA, Luo N, Chong SA. Qual Life Res. 2013 Dec;22(10):2983-91. | Individual |
| EQ-5D-3L | Sri Lanka | EQ-5D-3L derived population norms for health related quality of life in Sri Lanka. Kularatna S, Whitty JA, Johnson NW, Jayasinghe R, Scuffham PA. PLoS One. 2014 Nov 3;9(11):e108434. | Individual |
| EQ-5D-3L | Sweden | Health-related quality of life (EQ-5D) among homeless persons compared to a general population sample in Stockholm County, 2006. Sun S, Irestig R, Burström B, Beijer U, Burström K. Scand J Public Health. 2012 Mar;40(2):115-25. (Data also presented in: Szende A, Janssen B, Cabases J, editors. Self-Reported Population Health: An International Perspective based on EQ-5D. Dordrecht (NL): Springer; 2014.) | Individual |
| EQ-5D-3L | Switzerland (French speaking) | General population reference values for the French version of the EuroQol EQ-5D health utility instrument. Perneger TV, Combescure C, Courvoisier DS. Value Health. 2010 Aug;13(5):631-5. | Individual |
| EQ-5D-3L | United Kingdom | Variations in population health status: results from a United Kingdom national questionnaire survey. Kind P, Dolan P, Gudex C, Williams A. BMJ. 1998 Mar 7;316(7133):736-41. (Data also presented in: Szende A, Janssen B, Cabases J, editors. Self-Reported Population Health: An International Perspective based on EQ-5D. Dordrecht (NL): Springer; 2014.) | Individual |