Zakershahrak, M.Ribeiro Santiago, P.H.Sethi, S.Haag, D.Jamieson, L.Brennan, D.2022-03-022022-03-022022Current Medical Research and Opinion, 2022; 38(5):673-6850300-79951473-4877https://hdl.handle.net/2440/134493Published online: 06 Feb 2022.OBJECTIVE: 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.en© 2022 Informa UK Limited, trading as Taylor & Francis GroupHealth statusHealth-related quality of lifePsychometricsQuality-adjusted life-yearsJournal article10.1080/03007995.2022.20319412022-03-01599585Zakershahrak, M. [0000-0001-6101-0200]Ribeiro Santiago, P.H. [0000-0002-1267-8340]Sethi, S. [0000-0002-3571-5298]Haag, D. [0000-0001-6722-6635]Jamieson, L. [0000-0001-9839-9280]Brennan, D. [0000-0002-7888-0920]