Exploring Relative Weighting and Ranking of Potential Bolt-on Item for the Eq-5D-5L-Hk By Pairwise Comparison in Hong Kong Context

OBJECTIVES: EuroQol-5D (EQ-5D) is a popular instrument to illustrate users’ health-related quality of life (HRQoL) and various studies explored the addition of cultural or community-specific bolt-on items to enrich the current tool. With respect to EQ-5D’s multi-attributes utility system, this study aims to illustrate the relative weighting of the potential bolt-on items in Hong Kong context by pairwise comparison, a methodology utilised by Analytical Hierarchy Process in multi-criteria decisional analysis.

METHODS: An online cross-sectional survey was conducted in March to April 2022 and 414 participants were recruited by quota sampling based on gender and age mix in Hong Kong population. Respondents first compared the relative importance of the original five dimensions in a pairwise manner. Based on previous qualitative findings on potential bolt-on items specific to Hong Kong context, respondents further conducted pairwise comparisons of the five original dimensions against ‘Sleeping Quality’, ‘Satisfaction’ and ‘Interpersonal Relationship’ respectively. Respondents were also required to rank all the eight dimensions directly based on the perceived importance of the dimensions.

RESULTS: Among the original EQ-5D dimensions, results of the pairwise comparisons showed that participants valued ‘Usual Activities’ the most (0.267), followed by ‘Self-care (0.230), ‘Anxiety/Depression’ (0.173), ‘Mobility’ (0.169) and ‘Pain/Discomfort’(0.161). For new comparison matrixes with the introduction of one bolt-on item each, ‘Sleeping Quality’ ranked third (0.160) among the list of itself and original dimensions, while ‘Satisfaction’ (0.126) and ‘Interpersonal Relationship’ (0.116) weighted lowest in their respective matrixes. The direct ranking exercises elicited similar results as a majority of participants included ‘Sleeping Quality’ as top five but bottomed ‘Satisfaction’ and ‘Interpersonal Relationship’.

CONCLUSIONS: Participants considered 'Sleeping Quality' as most important among the three bolt-on items under study. With the aligned results between pairwise comparison and direct ranking, pairwise comparison or Analytical Hierarchy Process could be potential methods to validate bolt-on dimensions in the future.