Objectives

The EQ Health and Wellbeing (EQ-HWB) is a new generic measure that captures constructs beyond health-related quality of life, with a 25-item long form and a shorter 9-item version (EQ-HWB-S). This study aimed to assess the psychometric performance of both versions in breast cancer, which is the most prevalent cancer worldwide, and compare them with other instruments.

Methods

A longitudinal survey in Indonesia (2023-2024) with 300 female patients used the EQ-HWB, 5-level EQ-5D (EQ-5D-5L), Functional Assessment of Cancer Therapy – General (from which Functional Assessment of Cancer Therapy Eight Dimension [FACT-8D] was derived), and Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS, from which the Short WEMWBS was derived). Distributional characteristics, convergent validity, known-group validity (Student’s t test or analysis of variance), test-retest reliability, and responsiveness were assessed.

Results

All patients reported problems in at least 1 EQ-HWB item. The EQ-HWB-S index (11%) had a lower ceiling than the EQ-5D-5L (35%) and the Short WEMWBS (15.3%), but not the FACT-8D (5%). EQ-HWB-S index values correlated strongly with EQ-5D-5L (r = 0.73) and FACT-8D index values (r = 0.70), whereas EQ-HWB level sum scores correlated strongly with Functional Assessment of Cancer Therapy – General (r = 0.69) and moderately with WEMWBS (r = 0.49). The EQ-HWB and EQ-HWB-S discriminated across known groups comparably with the EQ-5D-5L and FACT-8D with large effect sizes according to EuroQol visual analog scale groups, number of symptoms, and general health and exhibited excellent instrument-level test-retest reliability (intraclass correlations, 0.79-0.83) and acceptable responsiveness (standardized response means, |0.24| to |0.97|).

Conclusions

This study represents one of the first validations of the EQ-HWB and EQ-HWB-S in any clinical population. Both instrument versions demonstrate robust psychometric performance. The EQ-HWB-S can be recommended to inform resource allocation decisions of breast cancer treatments.

The EQ Health and Wellbeing (EQ-HWB) and its shorter version (EQ-HWB-S) are recently developed experimental instruments designed to measure health-related quality of life and broader aspects. This study assesses the measurement properties of both versions in patients with breast cancer—the most common cancer worldwide—and compares them with other standardized instruments, including the EQ-5D-5L, FACT-8D, and SWEMWBS.

Based on survey data from 300 female patients with breast cancer, results showed that all patients reported problems on at least one EQ-HWB(-S) item. Findings suggest that items such as exhaustion, pain, and sleep disturbances are particularly relevant for patients with breast cancer. The EQ-HWB and EQ-HWB-S corresponded well with the other instruments, indicating that they effectively capture comparable areas of health outcomes. Both the EQ-HWB and EQ-HWB-S produced consistent results over time, distinguished between groups of patients based on their health conditions, and detected changes in patients' health over time.

In summary, both EQ-HWB and EQ-HWB-S demonstrate robust psychometric performance and can be recommended for use in breast cancer populations.

^{Note: This content was created with assistance from artificial intelligence (AI) and has been reviewed and edited by ISPOR staff. For more information or for inquiries on ISPOR’s AI policy, click here or contact us at info@ispor.org.}