A METHODOLOGICAL REVIEW OF VALUATION STUDIES FOR THE EQ-5D-5L: EVOLVING PRACTICES AND LESSONS FROM THE EQ-5D-3L
Author(s)
Annushiah Vasan Thakumar, BSc, PhD1, Xun Li, BSc, MSc2, Tessa Kennedy-Martin, MSc3, Xin Zhang, PhD4, Bernhard Slaap, PhD5, Michael Herdman, MSc6, Kristina Secnik Boye, MPH, MS, RPh, PhD7, Ling Jie Cheng, PhD, MPH, BSN (Hons), RN8.
1School of Pharmacy, Faculty of Health & Medical Sciences, Taylor's University, Subang Jaya, Malaysia, 2School of Engineering, Computing, and Mathematics, Oxford Brookes University, Oxford, United Kingdom, 3Kennedy Martin Health Outcomes, Hove, United Kingdom, 4Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore, 5Euroqol Research Foundation, Rotterdam, Netherlands, 6Saw Swee Hock School of Public Health, National University of Singapore, SIngapore, Singapore, 7Eli Lilly and Company, Greenwood, IN, USA, 8National Perinatal Epidemiology Unit, Nuffield Department of Women's & Reproductive Health,, University of Oxford, Oxford, United Kingdom.
1School of Pharmacy, Faculty of Health & Medical Sciences, Taylor's University, Subang Jaya, Malaysia, 2School of Engineering, Computing, and Mathematics, Oxford Brookes University, Oxford, United Kingdom, 3Kennedy Martin Health Outcomes, Hove, United Kingdom, 4Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore, 5Euroqol Research Foundation, Rotterdam, Netherlands, 6Saw Swee Hock School of Public Health, National University of Singapore, SIngapore, Singapore, 7Eli Lilly and Company, Greenwood, IN, USA, 8National Perinatal Epidemiology Unit, Nuffield Department of Women's & Reproductive Health,, University of Oxford, Oxford, United Kingdom.
OBJECTIVES: The introduction of EQ-5D-5L(5L) paved the way for innovative methods to generate value sets derived from the general public. As some health systems continue to rely on EQ-5D-3L(3L) values while others have adopted the 5L, it is important to understand what the transition from the 3L to 5L implies. This review aims to systematically map the approaches used to elicit preferences for the 3L and 5L, synthesising evidence to inform current practice and future research.
METHODS: We conducted a structured methodological review. Studies were identified through systematic searches of five medical databases from inception through August 2025 and the EuroQol Research Foundation value set repository (2009-2025). Eligible studies were national valuation studies for the 3L and 5L that employed hypothetical valuation health states to elicit preferences from the general public. Data were extracted on study design, elicitation technique, interview mode, modelling strategy, and value set outcomes.
RESULTS: The review synthesised evidence from 94 national valuation studies (3L: 49 studies; 5L: 45 studies) across 55 countries. Key findings include: 1) a substantial rise in the use of hybrid computer-assisted composite Time Trade-Off (cTTO) and Discrete Choice Experiment (DCE) tasks (3L:10.2%;5L:60.0%) in 5L valuation, marking a shift from the simpler TTO (3L:67.3%;5L:28.9%) and Visual Analogue Scale (3L:18.4%;5L:0%) approaches common in 3L valuation; 2) a notable shift in the modelled value for the worst health state (3L:-0.865 to 0.170;5L:-1.492 to -0.025); 3) increased use of web-based data collection (3L:4.3%;5L:17.8%); 4) greater implementation of quality control monitoring processes (3L:24.5%;5L:90.7%) alongside wider adoption of standardised valuation protocols (3L:83.7%;5L:97.7%).
CONCLUSIONS: This review synthesises the evolving methodological landscape of EQ-5D valuation and highlights marked improvements in data quality processes over earlier 3L practices. These findings underscore the importance of harnessing methodological learnings from existing studies to refine future valuation approaches and better understand how methodological heterogeneity influences resulting values.
METHODS: We conducted a structured methodological review. Studies were identified through systematic searches of five medical databases from inception through August 2025 and the EuroQol Research Foundation value set repository (2009-2025). Eligible studies were national valuation studies for the 3L and 5L that employed hypothetical valuation health states to elicit preferences from the general public. Data were extracted on study design, elicitation technique, interview mode, modelling strategy, and value set outcomes.
RESULTS: The review synthesised evidence from 94 national valuation studies (3L: 49 studies; 5L: 45 studies) across 55 countries. Key findings include: 1) a substantial rise in the use of hybrid computer-assisted composite Time Trade-Off (cTTO) and Discrete Choice Experiment (DCE) tasks (3L:10.2%;5L:60.0%) in 5L valuation, marking a shift from the simpler TTO (3L:67.3%;5L:28.9%) and Visual Analogue Scale (3L:18.4%;5L:0%) approaches common in 3L valuation; 2) a notable shift in the modelled value for the worst health state (3L:-0.865 to 0.170;5L:-1.492 to -0.025); 3) increased use of web-based data collection (3L:4.3%;5L:17.8%); 4) greater implementation of quality control monitoring processes (3L:24.5%;5L:90.7%) alongside wider adoption of standardised valuation protocols (3L:83.7%;5L:97.7%).
CONCLUSIONS: This review synthesises the evolving methodological landscape of EQ-5D valuation and highlights marked improvements in data quality processes over earlier 3L practices. These findings underscore the importance of harnessing methodological learnings from existing studies to refine future valuation approaches and better understand how methodological heterogeneity influences resulting values.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
MSR230
Topic
Methodological & Statistical Research
Topic Subcategory
PRO & Related Methods
Disease
No Additional Disease & Conditions/Specialized Treatment Areas