Psychometric properties of the EQ-5D-3L in South Australia: a multi-method non-preference-based validation study

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dc.contributor.authorZakershahrak, M.
dc.contributor.authorRibeiro Santiago, P.H.
dc.contributor.authorSethi, S.
dc.contributor.authorHaag, D.
dc.contributor.authorJamieson, L.
dc.contributor.authorBrennan, D.
dc.date.issued2022
dc.descriptionPublished online: 06 Feb 2022.
dc.description.abstractOBJECTIVE: Although HRQoL tools such as the EQ-5D-3L are significant in determining health status, these measures have not been validated in general populations in Australia. This study aims to psychometrically validate the EQ-5D-3L in a large population sample in Australia for the first time. METHODS: The EQ-5D-3L was included in the Dental Care and Oral Health study (DCOHS), conducted in a South Australian population sample. The participants were 23-91 years old, and 44.1% were male. The EQ-5D-3L was responded to on a three-point rating scale ("none"/"no", "some" and "extremely"/"unable"/"confined"). We employed the area under the receiver operating characteristic curve (AUROC) to evaluate whether the EQ-5D-3L total score could identify participants with diagnosed diseases and mental health disorders. Psychometric validation of the EQ-5D-3L investigated dimensionality with Exploratory Graph Analysis, model fit, floor/ceiling effects and criterion validity. RESULTS: The EQ-5D-3L comprised two dimensions, Activities and Symptoms. According to Root Mean Squared Error of Approximation (RMSEA) (<.05) and Comparative Fit Index (CFI) (>.950), the 2-dimensional structure showed excellent model fit with good reliability for the Activities subscale (Ωc = 0.80 - 95% CI [0.77, 0.83]), and poor reliability for the Symptom subscale (Ωc =0.56 - 95% CI [0.53, 0.58]). The EQ-5D-3L showed adequate reliability (Ωc= 0.70 - 95% CI [0.67, 0.72]). The EQ-5D-3L showed good discrimination for diagnosed diseases (ranging from 64.3% to 86.3%). Floor/ceiling effects were observed across all items. The EQ-5D-3L total score discriminated between respondents who were experiencing health conditions (e.g. cancer, cardiovascular disease, stroke) from healthy individuals. DISCUSSION: Despite the ceiling effects, the EQ-5D-3L displayed good psychometric properties as an HRQoL measure and discriminated between health states in the general South Australian population. Further research should investigate the psychometric properties of the EQ-5D-5L in South Australia and whether an increased number of response categories can mitigate the observed ceiling effects.
dc.description.statementofresponsibilityMehrsa Zakershahrak, Pedro Henrique Ribeiro Santiago, Sneha Sethi, Dandara Haag, Lisa Jamieson and David Brennan
dc.identifier.citationCurrent Medical Research and Opinion, 2022; 38(5):673-685
dc.identifier.doi10.1080/03007995.2022.2031941
dc.identifier.issn0300-7995
dc.identifier.issn1473-4877
dc.identifier.orcidZakershahrak, M. [0000-0001-6101-0200]
dc.identifier.orcidRibeiro Santiago, P.H. [0000-0002-1267-8340]
dc.identifier.orcidSethi, S. [0000-0002-3571-5298]
dc.identifier.orcidHaag, D. [0000-0001-6722-6635]
dc.identifier.orcidJamieson, L. [0000-0001-9839-9280]
dc.identifier.orcidBrennan, D. [0000-0002-7888-0920]
dc.identifier.urihttps://hdl.handle.net/2440/134493
dc.language.isoen
dc.publisherTaylor & Francis
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1031310
dc.rights© 2022 Informa UK Limited, trading as Taylor & Francis Group
dc.source.urihttps://doi.org/10.1080/03007995.2022.2031941
dc.subjectHealth status
dc.subjectHealth-related quality of life
dc.subjectPsychometrics
dc.subjectQuality-adjusted life-years
dc.titlePsychometric properties of the EQ-5D-3L in South Australia: a multi-method non-preference-based validation study
dc.typeJournal article
pubs.publication-statusPublished

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