A COMPARISON OF EQ-5D-5L AND SF-6DV2 HEALTH UTILITIESAMONGPEOPLE LIVING WITH HIV IN CHINA:A MULTI-REGION STUDY...
Author(s)
Qing He, PhD candidate1, JIA YIN, PhD1, Qiang Sun, PhD2.
1Shandong University, Jinan, China, 2Shandong University, Beijing, China.
1Shandong University, Jinan, China, 2Shandong University, Beijing, China.
OBJECTIVES: To evaluate and compare the measurement properties of the EQ-5D-5L and SF-6Dv2 among people living with HIV (PLHIV) in China, and to identify the determinants of their health utility values.
METHODS: A multicenter survey was conducted among PLHIV in Shandong (SD), Guangdong (GD), and Sichuan (SC) provinces of China in 2025. Health utility values were calculated by Chinese value sets for EQ-5D-5L and SF-6Dv2. Ceiling and floor effects were evaluated. Convergent validity and agreement were assessed using Spearman's rank correlation, intraclass correlation coefficients (ICC), and Bland-Altman (B-A) plots. Known-groups validity and sensitivity were compared using effect sizes and relative efficiency. Tobit regression models identified factors associated with utilities.
RESULTS: Among 705 respondents, the mean (SD) utility was 0.93 (0.15) for EQ-5D-5L and 0.80 (0.17) for SF-6Dv2. A higher ceiling effect was observed in EQ-5D-5L than in SF-6Dv2 (48.2% vs. 14.3%). The Spearman's rank correlation (0.719) indicated good convergent validity between the two instruments. The ICC was 0.729; however, B-A plots showed the 95% limits of agreement span (0.48) substantially exceeded the minimal clinically important difference (0.06). Both instruments showed good discriminative capacities. EQ-5D-5L was more efficient at distinguishing clinical characteristics, including chronic disease status, CD4+ T-cell counts, and prior HIV self-testing experience, while SF-6Dv2 was more efficient for duration of ART, economic burden, and self-rated health. Tobit regression indicated comorbid chronic disease, lack of prior HIV self-testing experience, and heavy economic burden were associated with reduced utilities.
CONCLUSIONS: Both EQ-5D-5L and SF-6Dv2 showed comparable validity and sensitivity in Chinese PLHIV. However, systematic differences in utility values prohibit their interchangeable use, highlighting the need for objective-driven instrument selection. These utility estimates inform future cost-utility analyses. Additionally, addressing the identified factors associated with reduced utilities supports the UNAIDS "fourth 90" goal, facilitating targeted, patient-centered care.
METHODS: A multicenter survey was conducted among PLHIV in Shandong (SD), Guangdong (GD), and Sichuan (SC) provinces of China in 2025. Health utility values were calculated by Chinese value sets for EQ-5D-5L and SF-6Dv2. Ceiling and floor effects were evaluated. Convergent validity and agreement were assessed using Spearman's rank correlation, intraclass correlation coefficients (ICC), and Bland-Altman (B-A) plots. Known-groups validity and sensitivity were compared using effect sizes and relative efficiency. Tobit regression models identified factors associated with utilities.
RESULTS: Among 705 respondents, the mean (SD) utility was 0.93 (0.15) for EQ-5D-5L and 0.80 (0.17) for SF-6Dv2. A higher ceiling effect was observed in EQ-5D-5L than in SF-6Dv2 (48.2% vs. 14.3%). The Spearman's rank correlation (0.719) indicated good convergent validity between the two instruments. The ICC was 0.729; however, B-A plots showed the 95% limits of agreement span (0.48) substantially exceeded the minimal clinically important difference (0.06). Both instruments showed good discriminative capacities. EQ-5D-5L was more efficient at distinguishing clinical characteristics, including chronic disease status, CD4+ T-cell counts, and prior HIV self-testing experience, while SF-6Dv2 was more efficient for duration of ART, economic burden, and self-rated health. Tobit regression indicated comorbid chronic disease, lack of prior HIV self-testing experience, and heavy economic burden were associated with reduced utilities.
CONCLUSIONS: Both EQ-5D-5L and SF-6Dv2 showed comparable validity and sensitivity in Chinese PLHIV. However, systematic differences in utility values prohibit their interchangeable use, highlighting the need for objective-driven instrument selection. These utility estimates inform future cost-utility analyses. Additionally, addressing the identified factors associated with reduced utilities supports the UNAIDS "fourth 90" goal, facilitating targeted, patient-centered care.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
PCR15
Topic
Patient-Centered Research
Topic Subcategory
Health State Utilities
Disease
SDC: Infectious Disease (non-vaccine)