The first series of studies estimating value sets for the five-level EuroQol-five dimensions (EQ-5D-5L) questionnaire in selected countries identified areas for improvement. A feedback module is now included after the composite time trade-off (C-TTO) tasks in a new wave of country-specific EQ-5D-5L value set studies. |
This study shows that using a feedback module to allow participants to identify and exclude incorrect C-TTO responses reduces the number of inconsistent responses and improves both the quality of the data and the estimation of an EQ-5D-5L value set. |
This study also reports an EQ-5D-5L value set for Hong Kong that can be used to measure the impact of interventions on health-related quality of life in economic evaluations for resource allocation in this jurisdiction. |
1 Introduction
2 Methods
2.1 The EQ-5D-5L Hong Kong Valuation Exercise
2.1.1 Sample and Data Collection
2.1.2 Methods to Elicit Preferences
2.1.3 Quality Control
2.1.4 Feedback Module (FM)
2.2 Statistical Analysis
2.3 Assessing the Impact of the FM on Modelling Results
2.4 Comparison with Other Asian Country-Specific EQ-5D-5L Value Sets
3 Results
3.1 Characteristics of Study Sample
Hong Kong populationb (%) | Study sample (n = 1014) | Participants not excluding states during FM (n = 674) | Participants excluding states during FM (n = 340) | |
---|---|---|---|---|
Female gender | 55.0 | 600 (59.0) | 405 (60.1) | 195 (57.4) |
Age group (years) | ||||
15/18–24c
| 12.1 | 166 (16.4) | 101 (15.0) | 65 (19.1) |
25–34 | 16.7 | 173 (17.1) | 100 (14.8) | 73 (21.8) |
35–44 | 17.5 | 173 (17.1) | 108 (16.0) | 65 (19.1) |
45–54 | 18.6 | 119 (11.7) | 86 (12.8) | 33 (9.7) |
55–64 | 17.2 | 223 (22.0) | 159 (23.6) | 64 (18.8) |
≥65 | 17.9 | 160 (15.8) | 120 (17.8) | 40 (11.5) |
Highest education attainment | ||||
Primary and below | 20.0 | 201 (19.8) | 150 (22.3) | 51 (15.0) |
Secondary/sub-degree | 57.8 | 615 (60.7) | 408 (60.5) | 207 (60.9) |
Post-secondary/degree | 22.2 | 198 (19.5) | 116 (17.2) | 82 (24.1) |
Marital status | ||||
Single | 30.1 | 322 (31.8) | 197 (29.2) | 125 (36.8) |
Married | 58.4 | 583 (57.5) | 402 (59.6) | 181 (53.2) |
Divorced/separated | 5.1 | 52 (5.1) | 33 (4.9) | 19 (5.6) |
Widow | 6.4 | 57 (5.6) | 42 (6.2) | 15 (4.4) |
Employment statusd
| ||||
Full-time student | 16.9 | 109 (10.7) | 65 (9.6) | 44 (12.9) |
Retired/homemaker/unemployed | 31.8 | 470 (46.3) | 328 (48.7) | 142 (41.8) |
Employer/full-time/part-time | 51.3 | 435 (42.9) | 281 (41.7) | 154 (45.3) |
Experience with serious illness | ||||
Personal | – | 262 (25.8) | 197 (29.2) | 65 (19.1) |
Relatives | – | 397 (39.2) | 253 (37.5) | 144 (42.4) |
Caring for others | – | 501 (49.4) | 325 (48.2) | 176 (51.8) |
Diagnosed with chronic condition | ||||
None | – | 707 (69.7) | 450 (66.8) | 257 (75.6) |
1 | – | 194 (19.1) | 137 (20.3) | 57 (16.8) |
2 | – | 80 (7.9) | 59 (8.8) | 21 (6.2) |
≥3 | – | 33 (3.3) | 28 (4.2) | 5 (1.5) |
3.2 Responses from the Composite Time Trade-Off and Discrete-Choice Experiment Data
3.3 Quality Control
3.4 FM
Number of inconsistent health states without FM | Number of states excluded during FM | Number of inconsistent health states with FM | |||
---|---|---|---|---|---|
None | 1 | 2 | >2 | ||
None | None |
534
| NA | NA | NA |
1 | 121 | NA | NA | NA | |
2 | 58 | NA | NA | NA | |
>2 | 14 | NA | NA | NA | |
1 | None | NA |
100
| NA | NA |
1 | 38 | 20 | NA | NA | |
2 | 7 | 5 | NA | NA | |
>2 | 7 | 0 | NA | NA | |
2 | None | NA | NA |
21
| NA |
1 | 7 | 8 | 6 | NA | |
2 | 11 | 1 | 0 | NA | |
>2 | 4 | 1 | 0 | NA | |
>2 | None | NA | NA | NA |
19
|
1 | 3 | 3 | 3 | 1 | |
2 | 6 | 5 | 0 | 0 | |
>2 | 9 | 2 | 0 | 0 |
3.5 The EQ-5D-5L Value Set in Hong Kong
Without feedback module | With feedback module | |||||||
---|---|---|---|---|---|---|---|---|
Tobit: c-TTO responses cLogit: DC responses | Tobit: c-TTO responses cLogit: DC responses (no constant) | Tobit: c-TTO responses cLogit: DC responses | Tobit: c-TTO responses cLogit: DC responses (no constant) | |||||
Coefficient (SE) |
p value | Coefficient (SE) |
p value | Coefficient (SE) |
p value | Coefficient (SE) |
p value | |
MO2 | 0.111 (0.009) | 0.000 | 0.111 (0.009) | 0.000 | 0.110 (0.01) | 0.000 | 0.109 (0.01) | 0.000 |
MO3 | 0.177 (0.012) | 0.000 | 0.177 (0.012) | 0.000 | 0.183 (0.013) | 0.000 | 0.182 (0.013) | 0.000 |
MO4 | 0.359 (0.015) | 0.000 | 0.359 (0.015) | 0.000 | 0.372 (0.016) | 0.000 | 0.371 (0.016) | 0.000 |
MO5 | 0.505 (0.018) | 0.000 | 0.505 (0.018) | 0.000 | 0.529 (0.019) | 0.000 | 0.529 (0.019) | 0.000 |
SC2 | 0.088 (0.009) | 0.000 | 0.089 (0.009) | 0.000 | 0.087 (0.009) | 0.000 | 0.087 (0.009) | 0.000 |
SC3 | 0.113 (0.012) | 0.000 | 0.113 (0.012) | 0.000 | 0.114 (0.012) | 0.000 | 0.113 (0.012) | 0.000 |
SC4 | 0.268 (0.015) | 0.000 | 0.268 (0.015) | 0.000 | 0.272 (0.016) | 0.000 | 0.271 (0.016) | 0.000 |
SC5 | 0.338 (0.016) | 0.000 | 0.338 (0.016) | 0.000 | 0.352 (0.017) | 0.000 | 0.352 (0.017) | 0.000 |
UA2 | 0.073 (0.009) | 0.000 | 0.074 (0.008) | 0.000 | 0.068 (0.008) | 0.000 | 0.067 (0.008) | 0.000 |
UA3 | 0.098 (0.012) | 0.000 | 0.098 (0.012) | 0.000 | 0.095 (0.013) | 0.000 | 0.094 (0.012) | 0.000 |
UA4 | 0.230 (0.012) | 0.000 | 0.230 (0.012) | 0.000 | 0.234 (0.013) | 0.000 | 0.234 (0.013) | 0.000 |
UA5 | 0.277 (0.013) | 0.000 | 0.277 (0.013) | 0.000 | 0.282 (0.014) | 0.000 | 0.282 (0.014) | 0.000 |
PD2 | 0.081 (0.008) | 0.000 | 0.081 (0.008) | 0.000 | 0.076 (0.008) | 0.000 | 0.076 (0.008) | 0.000 |
PD3 | 0.150 (0.012) | 0.000 | 0.150 (0.012) | 0.000 | 0.148 (0.013) | 0.000 | 0.147 (0.013) | 0.000 |
PD4 | 0.299 (0.015) | 0.000 | 0.299 (0.015) | 0.000 | 0.308 (0.015) | 0.000 | 0.307 (0.015) | 0.000 |
PD5 | 0.343 (0.016) | 0.000 | 0.343 (0.016) | 0.000 | 0.355 (0.017) | 0.000 | 0.354 (0.017) | 0.000 |
AD2 | 0.085 (0.009) | 0.000 | 0.086 (0.009) | 0.000 | 0.081 (0.009) | 0.000 | 0.080 (0.009) | 0.000 |
AD3 | 0.143 (0.013) | 0.000 | 0.144 (0.013) | 0.000 | 0.140 (0.013) | 0.000 | 0.140 (0.013) | 0.000 |
AD4 | 0.290 (0.015) | 0.000 | 0.290 (0.015) | 0.000 | 0.294 (0.015) | 0.000 | 0.293 (0.015) | 0.000 |
AD5 | 0.340 (0.016) | 0.000 | 0.340 (0.016) | 0.000 | 0.348 (0.016) | 0.000 | 0.348 (0.016) | 0.000 |
Const. | 0.001 (0.005) | 0.826 | – | – | −0.002 (0.005) | 0.739 | – | – |
nC-TTO | 8407 | 8407 | 7943 | 7943 | ||||
ncensoredC-TTO | 1583 | 1583 | 1532 | 1532 | ||||
nDC | 7098 | 7098 | 7098 | 7098 | ||||
AIC/n
| 1.543 | 1.543 | 1.504 | 1.504 | ||||
U(21111) | 0.8879 | 0.8886 | 0.8919 | 0.8906 | ||||
U(12111) | 0.9107 | 0.9114 | 0.9144 | 0.9133 | ||||
U(11211) | 0.9257 | 0.9264 | 0.9339 | 0.9328 | ||||
U(11121) | 0.9183 | 0.9189 | 0.9254 | 0.9244 | ||||
U(11112) | 0.9139 | 0.9145 | 0.9209 | 0.9199 | ||||
U(55555) | −0.8024 | −0.8028 | −0.8642 | −0.8637 |