Detecting Changes in Relative Weighting of EQ-5D Dimensions and Levels with Sequential Analytical Hierarchy Process in Hong Kong Sar, China

OBJECTIVES: Limited discussion was raised on the possible change in Health-related Quality of Life(HRQoL) perception across time, while such changes may impact the accuracy and timeliness of health utility values previously assigned to the EQ-5D-5L value sets. This study aimed to examine the possible HRQoL perception and preference changes across a certain time interval in Hong Kong SAR.

METHODS: This study utilized a paired sample with an interval of at least six months. Local residents aged ≥18 with Chinese literacy were eligible for the surveys. The first round(n=165) was conducted from April to June 2022 with a representative sample mix by age and gender. The second round was from November 2022 to March 2023 while the second round's composition was still close to the local demographic mix. By Analytical Hierarchy Process(AHP), relative weightings of the EQ-5D-5L five dimensions and five levels were computed by pairwise comparison and absolute scoring separately.

RESULTS: With 75.2% follow-up rate, 124 paired cases were analyzed. Among those who could recall the first round (n=107), 53.3% of participants self-reported change in HRQoL perception, or had experienced adverse health events by significant others or themselves within the period. The sequential changes in AHP relative weighting in Mobility(MO), Self-care(SC), Usual Activities(UA), Pain/Discomfort(PD) and Anxiety/Depression(AD) were +22.2%, +18.9%, -4.89%, -23.1% and -55.6% respectively, hinting a transitional emphasis in MO and SC from PD and AD within the study period. A similar pattern was observed in the five levels of each dimension, as the percentage changes in perceived health utility loss were +22.2%- +26.6%(MO), +17.2%- +26.5%(SC), -4.50%- -7.53%(UA), -17.9%- -29.2%(PD) and -42.3%- -62.6%(AD).

CONCLUSIONS: This study quantified the sequential changes in HRQoL perception with the EQ-5D-5L instrument but the factors influencing such change are yet to be explored. Further investigations should be conducted to explore and explain HRQoL changes on individual and population levels.