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Euroqol (EQ-5D)
EuroQol, also referred to as EQ-5D, is one of the multi-attribute health status classification systems. It is a generic instrument for measuring the health-related quality of life. Along with other multi-attribute health status classification systems, such as Health Utilities Index (HUI) and Quality of Well-Being (QWB), EuroQol is used as an alternative to measure the utility or health preference. Measuring utilities or preferences can be a complex and time-consuming task. EuroQol is attractive due to its simplicity. Thus, it has been widely used throughout the world in both clinical investigations and health policy determinations.
The EuroQol questionnaire was developed by the EuroQol group, original members of which came from various research teams in Europe. The name EuroQol comes from European Quality of Life. There are three components within the EuroQol questionnaire. The first component, the most important one, comprises five dimensions (5D): mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.
EuroQol Questionnaire
The EuroQol group was established in 1987, with investigators coming from various countries in western Europe. The group has expanded into an organization with members from all over the world in 1994. The EuroQol questionnaire is designed for self-completion by the respondents, and it was initially developed to complement other health-related quality-of-life measures. The primary component of the EuroQol questionnaire originally had six dimensions: mobility, self-care, main activity, social relationships, pain, and mood. EuroQol has become a stand-alone questionnaire subsequently, and the primary component was revised to five dimensions, including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. It has been publicly available since 1990.
The EuroQol questionnaire has three components. The first component is the primary one that includes five dimensions. Each dimension is measured by a question that has three possible responses: no problem, some problem, or severe problem. A preference-based index score can be created based on the answers to these five dimensions. The second component of the EuroQol questionnaire is a visual analog scale, where respondents can indicate their current health status on a “thermometer” scaled from 0, the worst imaginable health state, to 100, the best imaginable health state. The third component of the EuroQol questionnaire is for respondents to answer their background information, including disease experience, age, gender, smoking status, education, and others. The first two components are the instruments to be used if the researchers are only interested in knowing the health-related quality of life from the respondents.
Preference-Based Scoring Algorithm
Since the first component of the EuroQol questionnaire has five dimensions, with each having three levels of answers, the combination of responses results in 243 (35) possible health states. Methods were developed to assign preference scores to each of the 243 health states that represent an average preference for one state versus another. By adding two additional health states, “unconscious” and “dead” for a total of 245 health states, this method was initially developed based on a random sample of about 3,000 adults in the United Kingdom. The scoring function was developed using econometric modeling based on the time trade-off technique. The final preference-based index scores were assessed on a scale where 0 represents a health state of being dead and 1 represents perfect health.
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