The Ceiling Effects of EQ-5D-3L and 5L in General Population Health Surveys: A Systematic Review and Meta-Analysis

Jul 1, 2024, 00:00 AM
10.1016/j.jval.2024.02.018
https://www.valueinhealthjournal.com/article/S1098-3015(24)00091-3/fulltext
Section Title : SYSTEMATIC LITERATURE REVIEW
Section Order : 986
First Page : 986

Objectives

This review aims to examine the ceiling effects of EQ-5D-3L (3L) and EQ-5D-5L (5L) in general adult populations and identify the factors influencing these effects.

Methods

We searched 8 databases for observational studies published in English from inception to 24 July 2023. Ceiling effects were calculated by dividing the number of participants reporting full health at dimension or profile level by the total sample size. Subgroup analysis and meta-regression using the metafor package in R software were performed.

Results

We identified 94 studies from 70 articles, including 4 543 647 adults across 37 countries. The global pooled proportion of individuals reporting full health (“11111”) was 56% (95% CI 51%-62%) for 3L and 49% (95% CI 44%-54%) for 5L. The self-care dimension showed the highest ceiling effects (3L: 97%; 5L: 94%), whereas pain/discomfort had the lowest (3L: 69%; 5L: 60%). The ceiling effects in East/South-East Asia were higher than in Europe by 25% (95% CI 18%-32%) in 3L and 9% (95% CI −2%-20%) in 5L. Adjusting for mean age and proportion of males, significant regional differences persisted in the overall profile level of 3L, in all 3L dimensions (except for self-care), and 5L dimensions (except for pain/discomfort and anxiety/depression).

Conclusions

This review highlights significant ceiling effects in the EQ-5D, especially in Asian populations. The 5L version exhibited fewer ceiling effects than the 3L, indicating its superiority for general population surveys. Further research is crucial to understand the disparities in self-reported health outcomes between Asians and other populations.

https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(24)00091-3&doi=10.1016/j.jval.2024.02.018
HEOR Topics :
  • Health State Utilities
  • Literature Review & Synthesis
  • Patient-Centered Research
  • Stated Preference & Patient Satisfaction
  • Study Approaches
Tags :
  • ceiling effects
  • EQ-5D
  • general population survey
  • meta-regression
  • systematic review
Regions :
  • Global