OBJECTIVES:

The EQ Heath and well-being (EQ-HWB) and the short versions (EQ-HWB-S) are recently developed measures of health and well-being. Recent work showed face and content validity for the instruments in Italian population. This study aims to assess the measurement properties of the EQ-HWB and EQ-HWB-S in comparison to the EQ-5D-5L in Italy.

METHODS:

We conducted a secondary analysis of the data collected online between October 2020 and February 2021 from a sample representative of the Italian adult population. Responders completed the EQ-5D-5L, EQ-HWB, and a set of socioeconomic, chronic conditions and caregiver role questions. Measurement properties assessment was conducted at the item level, examining response pattern distributions, ceiling and floor effects, and correlation strength (Spearman's) between related items/constructs. Known group validity was based on effect sizes (ES) by health conditions, caregiver status, and social care users at the item level and index and level sum scores levels.

RESULTS:

The sample comprised 1,182 responders, of whom 461 reported one or more chronic conditions, 185 were caregivers and 42 were social care users. Most EQ-HWB items had slightly fewer ceiling and floor effects than the EQ-5D-5L items. Strong correlations were found between conceptually overlapping items, for example, EQ-5D Mobility and EQ-HWB Getting around inside and outside (rs=0.61), EQ-5D Usual Activities and EQ-HWB Day to day activities (rs=0.53), EQ-5D Self-care and EQ-HWB Personal Care (rs=0.51). The EQ-HWB-S and EQ-5D-5L index scores discriminated similarly based on having a symptomatic chronic condition (ES d=0.68, 95% Cl 0.54-0.81 vs. d=0.71, 95% Cl 0.60-0.80), while EQ-HWB-S outperformed EQ-5D based on social care (ES d=0.84, 95%Cl 0.40-1.30 vs. d=0.74, 95% CL 0.16-1.33).

CONCLUSIONS:

Initial evidence supports the validity of the EQ-HWB/EQ-HWB-S as an outcome measure in the Italian population. Results indicate a convergence between the measures, especially between overlapping dimensions, lending support to the validity of the EQ-HWB.