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      EQ-5D and the EuroQol Group: Past, Present and Future

      review-article
      1 , , 2
      Applied Health Economics and Health Policy
      Springer International Publishing

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          Abstract

          Over the period 1987–1991 an inter-disciplinary five-country group developed the EuroQol instrument, a five-dimensional three-level generic measure subsequently termed the ‘EQ-5D’. It was designed to measure and value health status. The salient features of its development and its consolidation and expansion are discussed. Initial expansion came, in particular, in the form of new language versions. Their development raised translation and semantic issues, experience with which helped feed into the design of two further instruments, the EQ-5D-5L and the youth version EQ-5D-Y. The expanded usage across clinical programmes, disease and condition areas, population surveys, patient-reported outcomes, and value sets is outlined. Valuation has been of continued relevance for the Group as this has allowed its instruments to be utilised as part of the economic appraisal of health programmes and their incorporation into health technology assessments. The future of the Group is considered in the context of: (1) its scientific strategy, (2) changes in the external environment affecting the demand for EQ-5D, and (3) a variety of issues it is facing in the context of the design of the instrument, its use in health technology assessment, and potential new uses for EQ-5D outside of clinical trials and technology appraisal.

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          The online version of this article (doi:10.1007/s40258-017-0310-5) contains supplementary material, which is available to authorized users.

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          A program of methodological research to arrive at the new international EQ-5D-5L valuation protocol.

          To describe the research that has been undertaken by the EuroQol Group to improve current methods for health state valuation, to summarize the results of an extensive international pilot program, and to outline the key elements of the five-level EuroQol five-dimensional (EQ-5D-5L) questionnaire valuation protocol, which is the culmination of that work.
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            Development of the EQ-5D-Y: a child-friendly version of the EQ-5D

            Purpose To develop a self-report version of the EQ-5D for younger respondents, named the EQ-5D-Y (Youth); to test its comprehensibility for children and adolescents and to compare results obtained using the standard adult EQ-5D and the EQ-5D-Y. Methods An international task force revised the content of EQ-5D and wording to ensure relevance and clarity for young respondents. Children’s and adolescents’ understanding of the EQ-5D-Y was tested in cognitive interviews after the instrument was translated into German, Italian, Spanish and Swedish. Differences between the EQ-5D and the EQ-5D-Y regarding frequencies of reported problems were investigated in Germany, Spain and South Africa. Results The content of the EQ-5D dimensions proved to be appropriate for the measurement of HRQOL in young respondents. The wording of the questionnaire had to be adapted which led to small changes in the meaning of some items and answer options. The adapted EQ-5D-Y was satisfactorily understood by children and adolescents in different countries. It was better accepted and proved more feasible than the EQ-5D. The administration of the EQ-5D and of the EQ-5D-Y causes differences in frequencies of reported problems. Conclusions The newly developed EQ-5D-Y is a useful tool to measure HRQOL in young people in an age-appropriate manner.
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              Feasibility, reliability, and validity of the EQ-5D-Y: results from a multinational study

              Purpose To examine the feasibility, reliability, and validity of the newly developed EQ-5D-Y. Methods The EQ-5D-Y was administered in population samples of children and adolescents in Germany, Italy, South Africa, Spain, and Sweden. Percentages of missing values and reported problems were calculated. Test–retest reliability was determined. Spearman’s rank correlation coefficients with other generic measures of HRQOL were calculated. Known groups’ validity was examined by comparing groups with a priori expected differences in HRQOL. Results Between 91 and 100% of the respondents provided valid scorings. Sweden had the lowest proportion of reported problems (1–24.9% across EQ-5D-Y dimensions), with the highest proportions in South Africa (2.8–47.3%) and Italy (4.3–39.0%). Percentages of agreement in test–retest reliability ranged between 69.8 and 99.7% in the EQ-5D-Y dimensions; Kappa coefficients were up to 0.67. Correlation coefficients with other measures of self-rated health indicated convergent validity (up to r = −0.56). Differences between groups classified according to presence of chronic conditions, self-rated overall health and psychological problems provided preliminary evidence of known groups’ validity. Conclusions Results provide preliminary evidence of the instrument’s feasibility, reliability and validity. Further study is required in clinical samples and for possible future applications in economic analyses.
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                Author and article information

                Contributors
                0207 747 8858 , 07 515 974 978 , ndevlin@ohe.org
                Journal
                Appl Health Econ Health Policy
                Appl Health Econ Health Policy
                Applied Health Economics and Health Policy
                Springer International Publishing (Cham )
                1175-5652
                1179-1896
                13 February 2017
                13 February 2017
                2017
                : 15
                : 2
                : 127-137
                Affiliations
                [1 ]Office of Health Economics, London, SW1 3QT UK
                [2 ]EuroQol Group, Rotterdam, The Netherlands
                Article
                310
                10.1007/s40258-017-0310-5
                5343080
                28194657
                630e220e-8e50-41ca-a558-3ff6a6941e5a
                © The Author(s) 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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                Review Article
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                © Springer International Publishing Switzerland 2017

                Economics of health & social care
                Economics of health & social care

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