During the ISPOR Vienna Meeting, the EuroQol Research Foundation hosted an educational symposium on Monday 31 October 2016: INCREASING EUROQOL (EQ-5D) FROM 3 TO 5 LEVELS: IMPLICATIONS FOR USERS – DOES “NEW” MEAN “BETTER”?
Over the past 25 years EQ-5D has virtually become the de facto standard generic measure of health-related quality of life in clinical and economic evaluation of healthcare interventions. Its initial design was dictated by the need for instrument brevity and compactness. However, as a reaction to concerns about potential lack of sensitivity in the original 3L system, the number of response levels per EQ-5D dimension has been increased from 3 to 5, raising in turn the number of EQ-5D health states from 243 to 3,125. This change was expected to lead to improved performance in the new 5L version. Despite improvements in technical attributes in the 5L version, for example in ceiling effects, it cannot be assumed that these automatically lead to improved performance in its use as an HrQoL outcome measure, particularly when used in cost-effectiveness applications. There is no straightforward relationship between improved measurement properties and reduced ceiling effects and outcomes relevant for users such as discriminative power, responsiveness and impact on cost-effectiveness. Evidence is now emerging that reveals the consequences of moving from one version of EQ-5D to another. In this symposium, we examine the interplay between the level structure, value set characteristics, and population characteristics. Studies that employed both the 3 and 5 level versions will be used to illustrate the impact of using different versions of the EQ-5D on cost-effectiveness. The symposium will be structured around the key questions: What changes might result from any alterations in the value set for the original 3L version? What consequences occur when the 3L descriptive system is replaced by the 5L version? How does the use of a new 5L value set based on the revised descriptive system impact on cost-effectiveness evaluation? These topics are not specific to EQ-5D alone but are relevant when considering the possible substitution of any HrQoL measure with an alternative. They raise fundamental issues for instrument developers and end-users alike. In short – does “new” always mean “better”?
Moderator: Andrew Lloyd, DPhil
Director, Bladon Associates Ltd, Oxford, UK
Speaker: Paul Kind
Professor of Health Outcome Measurement, Academic Unit of Health Economics, Institute of Health Sciences, University of Leeds, Leeds, UK
Speaker: Bas Janssen, PhD
Senior Researcher, EuroQol Office, EuroQol Research Foundation, Rotterdam, The Netherlands
Speaker: Allan Wailoo, PhD
Professor of Health Economics, School of Health and Related Research, University of Sheffield, Sheffield, UK