COMPARING HEALTH, HEALTH AND WELLBEING (HWB), AND QUALITY OF LIFE (QOL) VISUAL ANALOGUE SCALE (VAS) CONSTRUCTS WITH THE EQ-HWB-9 IN THE UNITED STATES (US), UNITED KINGDOM (UK), AND GERMANY
Author(s)
Jonathan L. Nazari, PharmD1, Maja Kuharic, PhD2, Aaron N. Winn, MPP, PhD1, Ning Yan Gu, PhD3, Surrey M. Walton, PhD1, A Simon Pickard, PhD1;
1University of Illinois Chicago, Pharmacy Systems, Outcomes, and Policy, Chicago, IL, USA, 2Northwestern University Feinberg School of Medicine, CHICAGO, IL, USA, 3University of San Francisco & Exact Sciences, Santa Clarita, CA, USA
1University of Illinois Chicago, Pharmacy Systems, Outcomes, and Policy, Chicago, IL, USA, 2Northwestern University Feinberg School of Medicine, CHICAGO, IL, USA, 3University of San Francisco & Exact Sciences, Santa Clarita, CA, USA
OBJECTIVES: The EQ-HWB-9 was developed to support economic evaluation inclusive of health and social-care needs, thoughcurrently does not include a VAS. This study aimed to 1) compare VAS ratings across three specified constructs (Health, HWB, and QoL) to assess influence on ratings and agreement, 2) evaluate construct-specific sensitivity and convergent validity with the EQ-HWB-9 descriptive system and 3) estimate the extent that EQ-HWB-9 items or level sum scores (LSS) explain variance in VAS ratings.
METHODS: In online surveys, adults from the US, UK, and Germany completed the EQ-HWB-9 and three VAS versions (Health-VAS, HWB-VAS, QoL-VAS) in a randomized order. Agreement across VAS constructs was assessed using intraclass correlation coefficients (ICC). Convergent validity was examined through correlations with EQ-HWB-9 item scores and LSS. Multivariable linear regression models estimated variance in VAS ratings by EQ-HWB-9 items scores and LSS, adjusting for age, gender, caregiver and social-care status, and chronic condition burden.
RESULTS: In 916 respondents, mean (SD) ratings for Health-VAS, HWB-VAS, and QoL-VAS were 70.9 (19.5), 68.7 (20.2), 68.7 (20.6), respectively, with substantial agreement (ICC=0.771 [0.748-0.793]) and strong correlations (r=0.711- 0.846). Strong correlations between the LSS and Health-VAS (r=−0.562), HWB-VAS (r=−0.621) and QoL-VAS (r=−0.643) demonstrated convergent validity. In adjusted models, per level increase in item score, mean Health-VAS ratings were significantly reduced by: Pain (−4.12), Activities (−3.94), Exhausted (−3.25), and Sad/Depressed (−2.33); HWB-VAS by: Exhausted (−4.02), Activities (−3.61), Sad/Depressed (−3.27), Pain (−2.75), and Control (−1.53); and QoL-VAS by: Activities (−4.62), Sad/Depressed (−4.21), Control (−2.60), Exhausted (−2.27), Pain (−1.88), and Lonely (−1.55).
CONCLUSIONS: Construct specification showed small effects on VAS ratings, though the effects of item scores on VAS ratings differed by construct. QoL-VAS and HWB-VAS versions demonstrated stronger alignment with psychosocial domains, while Health-VAS aligned most with pain and functional limitations. These findings can inform construct choice when developing a VAS component for the EQ-HWB-9.
METHODS: In online surveys, adults from the US, UK, and Germany completed the EQ-HWB-9 and three VAS versions (Health-VAS, HWB-VAS, QoL-VAS) in a randomized order. Agreement across VAS constructs was assessed using intraclass correlation coefficients (ICC). Convergent validity was examined through correlations with EQ-HWB-9 item scores and LSS. Multivariable linear regression models estimated variance in VAS ratings by EQ-HWB-9 items scores and LSS, adjusting for age, gender, caregiver and social-care status, and chronic condition burden.
RESULTS: In 916 respondents, mean (SD) ratings for Health-VAS, HWB-VAS, and QoL-VAS were 70.9 (19.5), 68.7 (20.2), 68.7 (20.6), respectively, with substantial agreement (ICC=0.771 [0.748-0.793]) and strong correlations (r=0.711- 0.846). Strong correlations between the LSS and Health-VAS (r=−0.562), HWB-VAS (r=−0.621) and QoL-VAS (r=−0.643) demonstrated convergent validity. In adjusted models, per level increase in item score, mean Health-VAS ratings were significantly reduced by: Pain (−4.12), Activities (−3.94), Exhausted (−3.25), and Sad/Depressed (−2.33); HWB-VAS by: Exhausted (−4.02), Activities (−3.61), Sad/Depressed (−3.27), Pain (−2.75), and Control (−1.53); and QoL-VAS by: Activities (−4.62), Sad/Depressed (−4.21), Control (−2.60), Exhausted (−2.27), Pain (−1.88), and Lonely (−1.55).
CONCLUSIONS: Construct specification showed small effects on VAS ratings, though the effects of item scores on VAS ratings differed by construct. QoL-VAS and HWB-VAS versions demonstrated stronger alignment with psychosocial domains, while Health-VAS aligned most with pain and functional limitations. These findings can inform construct choice when developing a VAS component for the EQ-HWB-9.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
PCR203
Topic
Patient-Centered Research
Topic Subcategory
Instrument Development, Validation, & Translation, Patient-reported Outcomes & Quality of Life Outcomes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas