DO WE NEED A SKIN IRRITATION BOLT-ON FOR THE EQ-5D-5L? A SYSTEMATIC REVIEW OF THE MEASUREMENT PROPERTIES OF THE EQ-5D-5L IN CONDITIONS WITH ITCH
Author(s)
Kimberly Teo, MSc1, Andrew Lloyd, DPhil1, Fanni Rencz, PhD2, Katy Gallop, MSc1.
1Acaster Lloyd, London, United Kingdom, 2Corvinus University of Budapest, Budapest, Hungary.
1Acaster Lloyd, London, United Kingdom, 2Corvinus University of Budapest, Budapest, Hungary.
OBJECTIVES: Itch is a burdensome symptom across dermatological and non-dermatological conditions, impacting health-related quality of life (HRQoL). This systematic literature review aimed to identify and summarise published evidence relating to the EQ-5D-5L’s measurement properties in conditions where itch is a key symptom for adults.
METHODS: A systematic literature search was conducted in Embase and MEDLINE in February 2025 (PROSPERO No.: CRD420250650978). Included articles underwent quality assessment using an adapted Grading of Recommendations Assessment, Development and Evaluation (GRADE) for quantitative studies and the Critical Appraisal Skills Programme (CASP) checklist for qualitative studies.
RESULTS: Overall 73 articles were eligible, assessing 17 dermatological (e.g. psoriasis) and 9 non-dermatological conditions (e.g. chronic kidney disease, CKD). Qualitative studies (n=5) reported the EQ-5D-5L comprehensible and relevant. Itch was reported missing in one study and was the most frequent spontaneously reported symptom in another. Ceiling effect ranged between 15% (hidradentis supprativa) and 55% (urticaria). Some evidence of known-groups validity was identified, however only one article (CKD) defined groups by itch severity, showing worse EQ-5D-5L values with more severe itch. There was mixed evidence for convergent validity between the EQ-5D-5L and disease-specific HRQoL measures, correlations ranged from weak (-0.10, actinic keratosis) to strong (-0.79, pemphigus). Of the conditions included, psoriasis and CKD had the most evidence supporting the EQ-5D-5L psychometric properties, however for both conditions there was only limited evidence of content validity, evidence of a ceiling effect and no evidence of test-retest reliability.
CONCLUSIONS: This systematic review found mixed evidence of the EQ-5D-5L’s psychometric properties in conditions where itch is a key symptom, predominantly in dermatological conditions. Overall, the findings suggest potential limitations in the EQ-5D-5L’s ability to fully capture the burden of itch. A bolt-on measuring skin irritation (itch) is available; research should explore the impact this has on the EQ-5D-5L’s psychometrics in these conditions.
METHODS: A systematic literature search was conducted in Embase and MEDLINE in February 2025 (PROSPERO No.: CRD420250650978). Included articles underwent quality assessment using an adapted Grading of Recommendations Assessment, Development and Evaluation (GRADE) for quantitative studies and the Critical Appraisal Skills Programme (CASP) checklist for qualitative studies.
RESULTS: Overall 73 articles were eligible, assessing 17 dermatological (e.g. psoriasis) and 9 non-dermatological conditions (e.g. chronic kidney disease, CKD). Qualitative studies (n=5) reported the EQ-5D-5L comprehensible and relevant. Itch was reported missing in one study and was the most frequent spontaneously reported symptom in another. Ceiling effect ranged between 15% (hidradentis supprativa) and 55% (urticaria). Some evidence of known-groups validity was identified, however only one article (CKD) defined groups by itch severity, showing worse EQ-5D-5L values with more severe itch. There was mixed evidence for convergent validity between the EQ-5D-5L and disease-specific HRQoL measures, correlations ranged from weak (-0.10, actinic keratosis) to strong (-0.79, pemphigus). Of the conditions included, psoriasis and CKD had the most evidence supporting the EQ-5D-5L psychometric properties, however for both conditions there was only limited evidence of content validity, evidence of a ceiling effect and no evidence of test-retest reliability.
CONCLUSIONS: This systematic review found mixed evidence of the EQ-5D-5L’s psychometric properties in conditions where itch is a key symptom, predominantly in dermatological conditions. Overall, the findings suggest potential limitations in the EQ-5D-5L’s ability to fully capture the burden of itch. A bolt-on measuring skin irritation (itch) is available; research should explore the impact this has on the EQ-5D-5L’s psychometrics in these conditions.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
P10
Topic
Patient-Centered Research
Topic Subcategory
Health State Utilities, Patient-reported Outcomes & Quality of Life Outcomes
Disease
Sensory System Disorders (Ear, Eye, Dental, Skin)