Measuring Outcomes for Loneliness Research: Examining the Appropriateness of the EQ-5D-5L and EQ-HWB
Author(s)
Ishani K. Majmudar, PhD.
Research Fellow, Deakin University, Melbourne, Australia.
Research Fellow, Deakin University, Melbourne, Australia.
OBJECTIVES: Loneliness is a global public health concern. This study aimed to (i) estimate utility values associated with different levels of loneliness using the EQ-5D-5L and EQ-HWB measures, (ii) evaluate their ability to differentiate between loneliness levels, and (iii) examine conceptual overlap between these measures and a validated loneliness scale.
METHODS: Data from an online survey comprising a nationally representative cross-sectional survey of Australian adults was used. The survey included information on demographics, the 20-item Revised UCLA Loneliness Scale (R-UCLA-LS), EQ-5D-5L, and EQ-HWB. The Kruskal-Wallis test was used to assess the statistical differences in utility scores from the EQ-5D-5L and EQ-HWB-Short, and also the EQ-HWB sum score, across three levels of loneliness (Low/Medium/High) as measured by the R-UCLA-LS. Exploratory factor analysis (EFA) was used to explore the conceptual overlap between the EQ-5D-5L and EQ-HWB with the R-UCLA-LS item measure. Additionally, ordinary least squares (OLS) regression was conducted to identify predictors of loneliness from the items that overlapped with the R-UCLA-LS.
RESULTS: 2072 respondents completed the survey. Both the EQ-5D-5L and EQ-HWB measures significantly differentiated between loneliness levels (p < 0.001). The mean EQ-5D-5L utility scores were 0.89 for low loneliness, 0.81 for moderate loneliness, and 0.72 for moderate to high loneliness. The EQ-HWB-S utility scores were 0.88, 0.75, and 0.58, respectively, showing greater sensitivity to the burden of loneliness. EFA revealed no overlap between EQ-5D-5L items and the R-UCLA-LS, while five EQ-HWB items overlapped with the R-UCLA-LS, including the “feel lonely” item, which is also part of the EQ-HWB-S. Regression analysis explained 53.58% of the variance in loneliness scores (F(10, 1463) = 168.87, p < 0.001), with “feeling lonely” and “feeling unsupported” contributing the most to predicting loneliness.
CONCLUSIONS: The EQ-HWB-S, in particular, shows promise as a brief yet sensitive tool for capturing loneliness-related burden and may be especially useful in interventions targeting loneliness.
METHODS: Data from an online survey comprising a nationally representative cross-sectional survey of Australian adults was used. The survey included information on demographics, the 20-item Revised UCLA Loneliness Scale (R-UCLA-LS), EQ-5D-5L, and EQ-HWB. The Kruskal-Wallis test was used to assess the statistical differences in utility scores from the EQ-5D-5L and EQ-HWB-Short, and also the EQ-HWB sum score, across three levels of loneliness (Low/Medium/High) as measured by the R-UCLA-LS. Exploratory factor analysis (EFA) was used to explore the conceptual overlap between the EQ-5D-5L and EQ-HWB with the R-UCLA-LS item measure. Additionally, ordinary least squares (OLS) regression was conducted to identify predictors of loneliness from the items that overlapped with the R-UCLA-LS.
RESULTS: 2072 respondents completed the survey. Both the EQ-5D-5L and EQ-HWB measures significantly differentiated between loneliness levels (p < 0.001). The mean EQ-5D-5L utility scores were 0.89 for low loneliness, 0.81 for moderate loneliness, and 0.72 for moderate to high loneliness. The EQ-HWB-S utility scores were 0.88, 0.75, and 0.58, respectively, showing greater sensitivity to the burden of loneliness. EFA revealed no overlap between EQ-5D-5L items and the R-UCLA-LS, while five EQ-HWB items overlapped with the R-UCLA-LS, including the “feel lonely” item, which is also part of the EQ-HWB-S. Regression analysis explained 53.58% of the variance in loneliness scores (F(10, 1463) = 168.87, p < 0.001), with “feeling lonely” and “feeling unsupported” contributing the most to predicting loneliness.
CONCLUSIONS: The EQ-HWB-S, in particular, shows promise as a brief yet sensitive tool for capturing loneliness-related burden and may be especially useful in interventions targeting loneliness.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
P45
Topic
Patient-Centered Research
Topic Subcategory
Instrument Development, Validation, & Translation, Patient-reported Outcomes & Quality of Life Outcomes
Disease
Mental Health (including addition)