Open Access
Population norms for the EQ-5D-3L: a cross-country analysis of population surveys for 20 countries
(Springer, 2019) Janssen, Mathieu F.; Szende, Agota; Cabasés Hita, Juan Manuel; Ramos Goñi, Juan Manuel; Vilagut, G.; König, H. H.; Economía; Ekonomia
This study provides EQ-5D population norms for 20 countries (N = 163,838), which can be used to compare profiles for patients with specific conditions with data for the average person in the general population in a similar age and/or gender group. Descriptive EQ-5D data are provided for the total population, by gender and by seven age groups. Provided index values are based on European VAS for all countries, based on TTO for 11 countries and based on VAS for 10 countries. Important differences exist in EQ-5D reported health status across countries after standardizing for population structure. Self-reported health according to all five dimensions and EQ VAS generally decreased with increasing age and was lower for females. Mean self-rated EQ VAS scores varied from 70.4 to 83.3 in the total population by country. The prior living standards (GDP per capita) in the countries studied are correlated most with the EQ VAS scores (0.58), while unemployment appeared to be significantly correlated in people over the age of 45 only. A country's expenditure on health care correlated moderately with higher ratings on the EQ VAS (0.55). EQ-5D norms can be used as reference data to assess the burden of disease of patients with specific conditions. Such information, in turn, can inform policy-making and assist in setting priorities in health care.
Open Access
Valuation and modeling of EQ-5D-5L health states using a hybrid approach
(Wolters Kluwer Health, 2017) Ramos Goñi, Juan Manuel; Pinto Prades, José Luis; Oppe, Mark; Cabasés Hita, Juan Manuel; Serrano Aguilar, Pedro; Economía; Ekonomia
Background: The EQ-5D instrument is the most widely used preference-based health-related quality of life questionnaire in cost-effectiveness analysis of health care technologies. Recently, a version called EQ-5D-5L with 5 levels on each dimension was developed. This manuscript explores the performance of a hybrid approach for the modeling of EQ-5D-5L valuation data. Methods: Two elicitation techniques, the composite time trade-off, and discrete choice experiments, were applied to a sample of the Spanish population (n=1000) using a computer-based questionnaire. The sampling process consisted of 2 stages: stratified sampling of geographic area, followed by systematic sampling in each area. A hybrid regression model combining composite time trade-off and discrete choice data was used to estimate the potential value sets using main effects as starting point. The comparison between the models was performed using the criteria of logical consistency, goodness of fit, and parsimony. Results: Twenty-seven participants from the 1000 were removed following the exclusion criteria. The best-fitted model included 2 significant interaction terms but resulted in marginal improvements in model fit compared to the main effects model. We therefore selected the model results with main effects as a potential value set for this methodological study, based on the parsimony criteria. The results showed that the main effects hybrid model was consistent, with a range of utility values between 1 and −0.224. Conclusion: This paper shows the feasibility of using a hybrid approach to estimate a value set for EQ-5D-5L valuation data.
Open Access
Socio-demographic indicators of self-reported health based on EQ-5D-3L: a cross-country analysis of population surveys from 18 countries
(Frontiers Media, 2023) Szende, Agota; Janssen, Mathieu F.; Cabasés Hita, Juan Manuel; Ramos Goñi, Juan Manuel; Burström, Kristina; Economía; Ekonomia
Background: Generic health-related quality of life instruments, such as the EQ-5D, are increasingly used by countries to monitor population health via general population health surveys. Our aim was to demonstrate analytic options to measure socio-demographic dierences in self-reported health using the EuroQol Group’s archive of EQ-5D-3L population surveys that accumulated over the past two decades. Methods: Analyses captured self-reported EQ-5D-3L data on over 100,000 individuals from 18 countries with nationally representative population surveys. Socio-demographic indicators employed were age, sex, educational level and income. Logistic regression odds ratios and the health concentration index methodology were used in the socio-demographic analysis of EQ-5D-3L data. Results: Statistically significant socio-demographic dierences existed in all countries (p < 0.01) with the EQ VAS based health concentration index varying from 0.090 to 0.157 across countries. Age had generally the largest contributing share, while educational level also had a consistent role in explaining lower levels of self-reported health. Further analysis in a subset of 7 countries with income data showed that, beyond educational level, income itself had an additional significant impact on self-reported health. Among the 5 dimensions of the EQ-5D-3L descriptive system, problems with usual activities and pain/discomfort had the largest contribution to the concentration of overall self-assessed health measured on the EQ VAS in most countries. Conclusion: The EQ-5D-3L was shown to be a powerful multi-dimensional instrument in the analyses of socio-demographic dierences in self-reported health using various analytic methods. It oered a unique insight of inequalities by health dimensions

Cabasés Hita, Juan Manuel

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