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Comparing EQ-5D-3L and EQ-5D-5L performance in common cancers: suggestions for instrument choosing |
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| Authors: | Zhu Juan Yan Xin-Xin Liu Cheng-Cheng Wang Hong Wang Le Cao Su-Mei Liao Xian-Zhen Xi Yun-Feng Ji Yong Lei Lin Xiao Hai-Fan Guan Hai-Jing Wei Wen-Qiang Dai Min Chen Wanqing Shi Ju-Fang |
| Affiliation: | 1.Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer /Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan South Lane, Chaoyang District, Beijing, 100021, People’s Republic of China ;2.Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China ;3.Hunan Office for Cancer Control and Research, Hunan Cancer Hospital, Changsha, People’s Republic of China ;4.Inner Mongolia Center for Disease Control and Prevention, Hohhot, People’s Republic of China ;5.Cancer Hospital, Shenzhen Center, Chinese Academy of Medical Sciences, Shenzhen, People’s Republic of China ;6.Shenzhen Center for Chronic Disease Control, Shenzhen, People’s Republic of China ;7.China Center for Health Economic Research, Peking University, Beijing, People’s Republic of China ;8.Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China ; |
| Abstract: | Purpose To compare the performance of three-level EuroQol five-dimensions (EQ-5D-3L) and five-level EuroQol five-dimensions (EQ-5D-5L) among common cancer patients in urban China. MethodsA hospital-based cross-sectional survey was conducted in three provinces from 2016 to 2018 in urban China. Patients with breast cancer, colorectal cancer, or lung cancer were recruited to complete the EQ-5D-3L and EQ-5D-5L questionnaires. Response distribution, discriminatory power (indicator: Shannon index [H′] and Shannon evenness index [J′]), ceiling effect (the proportion of full health state), convergent validity, and health-related quality of life (HRQoL) were compared between the two instruments. ResultsA total of 1802 cancer patients (breast cancer: 601, colorectal cancer: 601, lung cancer: 600) were included, with the mean age of 55.6 years. The average inconsistency rate was 4.4%. Compared with EQ-5D-3L (average: H′?=?1.100, J′?=?0.696), an improved discriminatory power was observed in EQ-5D-5L (H′?=?1.473, J′?=?0.932), especially contributing to anxiety/depression dimensions. The ceiling effect was diminished in EQ-5D-5L (26.5%) in comparison with EQ-5D-3L (34.5%) (p?p?Conclusions With greater discriminatory power, convergent validity and lower ceiling, EQ-5D-5L may be preferable to EQ-5D-3L for the assessment of HRQoL among cancer patients. However, higher utility scores derived form EQ-5D-5L may also lead to lower QALY gains than those of 3L potentially in cost-utility studies and underestimation in the burden of disease. |
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