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Title: Comparing the performance of the EQ-5D-3L and the EQ-5D-5L in young Portuguese adults
Authors: Ferreira, Lara N. 
Ferreira, Pedro Lopes 
Ribeiro, Filipa P.
Pereira, Luís Nobre 
Keywords: Ceiling effect; EQ-5D-3L; EQ-5D-5L; Explorative qualitative interviews; Health-related quality of life; Young individuals
Issue Date: 8-Jun-2016
Publisher: Springer Nature
Project: UID/Multi/04066/2013 
Serial title, monograph or event: Health and Quality of Life Outcomes
Volume: 14
Issue: 1
Abstract: Background: Some studies have reported a ceiling effect in EQ-5D-3L, especially in healthy and/or young individuals. Recently, two further levels have been included in its measurement model (EQ-5D-5L). The purposes of this study were (1) to assess the properties of the EQ-5D-5L in comparison with the standard EQ-5D-3L in a sample of young adults, (2) to foreground the importance of collecting qualitative data to confirm, validate or refine the EQ-5D questionnaire items and (3) to raise questions pertaining to the wording in these questionnaire items. Methods: The data used came from a sample of respondents aged 30 or under (n = 624). They completed both versions of the EQ-5D, which were compared in terms of feasibility, level of inconsistency and ceiling effect. Agreement between the instruments was assessed using correlation coefficients and Bland-Altman plots. Known-groups validity of the EQ-5D-5L was also assessed using non-parametric tests. The discriminative properties were compared using receiver operating characteristic curves. Finally, four interviews were conducted for retrospective reports to elicit respondents’ understanding and perceptions of the format, instructions, items, and responses. Results: Quantitative results show a ceiling effect reduction of 25.3 % and a high level agreement between both indices. Known-groups validity was confirmed for the EQ-5D-5L. Explorative interviews indicated ambiguity and low degree of certainty in regards to conceptualizing differences between levels moderate-slight across three dimensions. Conclusions: The EQ-5D-5L performed better than the EQ-5D-3L. However, the explorative interviews demonstrated several limitations in the EQ-5D questionnaire wording and high context-dependent answers point to lack of illnesses’ experience amongst young adults.
ISSN: 1477-7525
DOI: 10.1186/s12955-016-0491-x
Rights: openAccess
Appears in Collections:I&D CEISUC - Artigos em Revistas Internacionais
FEUC- Artigos em Revistas Internacionais

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