EQ-5D and the EuroQol Group: Past, Present and Future
OHE’s Professor Nancy Devlin and co-author Richard Brooks have published a new paper that provides an overview of the development of the EQ-5D; the current state of play; and what the future might hold for the further development and use…
OHE’s Professor Nancy Devlin and co-author Richard Brooks have published a new paper that provides an overview of the development of the EQ-5D; the current state of play; and what the future might hold for the further development and use of EQ-5D instruments in HTA and other applications.
The article, authored by OHE’s Professor Nancy Devlin in collaboration with Richard Brooks (both long standing members of the EuroQol Group), provides an overview of the development of the EQ-5D; the current state of play in the use of these questionnaires worldwide to measure patient reported health; and considers what the future might hold for their further development and use in health technology assessment (HTA) and other applications.
Over the period 1987–1991 an inter-disciplinary group developed the EuroQol instrument, the EQ-5D. The instrument allows patients to self-report their health in terms of five dimensions (mobility, usual activities, self care, pain/discomfort, and anxiety/depression) and three levels (no, some or extreme problems).
The EQ-5D was designed to measure health status in a generic way that was not specific to a particular disease or health problem. The generic nature of the EQ-5D meant it could be used to compare health across different disease areas, and could be used as a measure of health in the general population. This made it particularly useful for decisions that required comparisons of health and health improvement across disease areas – for example, in the assessment of the effectiveness and cost effectiveness of new health care technologies by organisations such as NICE and its equivalents world-wide.
The instrument was developed in new languages, raising translation and semantic issues along the way. Subsequently two further versions of the questionnaire were developed: the EQ-5D-5L (which expands the response options on each dimension from 3 to 5: no, mild, moderate, severe and extreme problems) and a version adapted for self-reporting health by children and young people, the EQ-5D-Y.
Devlin and Brooks outline the expanded usage of the EQ-5D across clinical programmes, disease and condition areas, population surveys, patient-reported outcomes, and value sets. They also explain the use of this generic measure in the economic appraisal of health programmes and their incorporation into HTA.
The future of the Group is considered in the context of: (1) its scientific strategy, (2) changes in the external environment affecting the demand for EQ-5D, and (3) a variety of issues it is facing in the context of the design of the instrument, its use in health technology assessment, and potential new uses for EQ-5D outside of clinical trials and technology appraisal.
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