Introduction
Methods
Data
Measures
Analysis
Redistribution properties of the 3L to 5L extension
Discriminatory power
Convergent validity
Known-groups validity
Results
Country | Population |
N
| % female | Mean age (years) | Mean EQ-VAS (SD) |
---|---|---|---|---|---|
Denmark | Diabetes | 239 | 45 | 52.9 | 74 (19) |
Orthopedic accident | 94 | 34 | 37.8 | 79 (23) | |
Rheumatoid arthritis | 35 | 73 | 60.5 | 60 (25) | |
England | ADHD | 69 | 54 | 34.3 | 63 (21) |
Arthritis | 250 | 44 | 57.7 | 66 (20) | |
Back pain | 70 | 57 | 47.2 | 52 (19) | |
COPD | 125 | 37 | 60.8 | 57 (21) | |
Depression | 250 | 56 | 42.4 | 62 (21) | |
Diabetes | 45 | 58 | 50.8 | 69 (20) | |
Myocardial infarction | 75 | 27 | 56.7 | 63 (20) | |
Parkinson’s disease | 32 | 44 | 49.8 | 66 (22) | |
Stroke | 85 | 39 | 57.4 | 53 (24) | |
Italy | Liver disease | 645 | 35 | 56.7 | 70 (21) |
Netherlands | Kidney dialysis | 49 | 41 | 61.7 | 62 (21) |
Personality disorders | 384 | 67 | 31.7 | 59 (18) | |
Poland | Stroke | 529 | 49 | 69.9 | 52 (26) |
Student population | 443 | 79 | 22.1 | 79 (16) | |
Scotland | Asthma | 21 | 57 | 72.8 | 64 (18) |
Cardiovascular disease | 176 | 54 | 71.4 | 60 (21) | |
COPD | 196 | 62 | 70.1 | 58 (21) | |
Multiple sclerosis | 15 | 53 | 63.9 | 52 (21) | |
Parkinson’s disease | 5 | 60 | 63.0 | 41 (30) | |
Rheumatoid arthritis | 87 | 71 | 69.4 | 56 (22) | |
Total | 3,919 | 52 | 51.9 | 64 (23) |
3L | 5L | ||||
---|---|---|---|---|---|
Mobility | No problems | Slight problems | Moderate problems | Severe problems | Unable to |
No problems | 1,941 | 121 |
16
|
1
|
4
|
Some problems |
32
| 588 | 598 | 393 |
23
|
Confined to bed |
1
|
1
|
4
| 30 | 112 |
3L | 5L | ||||
---|---|---|---|---|---|
Self-Care | No problems | Slight problems | Moderate problems | Severe problems | Unable to |
No problems | 2,653 | 83 |
13
|
5
|
0
|
Some problems |
48
| 425 | 321 | 110 |
6
|
Unable to |
3
|
5
|
6
| 35 | 141 |
3L | 5L | ||||
---|---|---|---|---|---|
Usual Activities | No problems | Slight problems | Moderate problems | Severe problems | Unable to |
No problems | 1,527 | 167 |
22
|
9
|
0
|
Some problems |
49
| 686 | 676 | 277 |
16
|
Unable to |
5
|
7
|
24
| 140 | 242 |
3L | 5L | ||||
---|---|---|---|---|---|
Pain/Discomfort | None | Slight | Moderate | Severe | Extreme |
None | 1,251 | 211 |
21
|
6
|
2
|
Moderate |
67
| 895 | 869 | 244 |
9
|
Extreme |
1
|
5
|
19
| 160 | 83 |
3L | 5L | ||||
---|---|---|---|---|---|
Anxiety/Depression | None | Slight | Moderate | Severe | Extreme |
None | 1,466 | 220 |
31
|
10
|
3
|
Moderate |
46
| 890 | 731 | 165 |
7
|
Extreme |
1
|
4
|
17
| 163 | 94 |
Level | Mobility | Self-Care | Usual Activities | Pain/Discomfort | Anxiety/Depression | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
3L | 5L | 3L | 5L | 3L | 5L | 3L | 5L | 3L | 5L | ||||||||||||
N
| % |
N
| % |
N
| % |
N
| % |
N
| % |
N
| % |
N
| % |
N
| % |
N
| % |
N
| % | ||
Cardiovascular disease | 1 | 70 |
28
| 56 |
22
| 145 |
58
| 136 |
54
| 75 |
30
| 64 |
25
| 74 |
29
| 64 |
25
| 126 |
50
| 110 |
44
|
2 | 179 |
71
| 60 |
24
| 94 |
37
| 61 |
24
| 135 |
54
| 57 |
23
| 151 |
60
| 71 |
28
| 111 |
44
| 70 |
28
| |
3 | 2 |
1
| 74 |
29
| 12 |
5
| 35 |
14
| 41 |
16
| 67 |
27
| 26 |
10
| 61 |
24
| 14 |
6
| 51 |
20
| |
4 | – | – | 56 |
22
| – | – | 12 |
5
| – | – | 42 |
17
| – | – | 45 |
18
| – | – | 14 |
6
| |
5 | – | – | 5 |
2
| – | – | 7 |
3
| – | – | 21 |
8
| – | – | 10 |
4
| – | – | 6 |
2
| |
COPD/Asthma | 1 | 85 |
25
| 72 |
21
| 203 |
59
| 192 |
56
| 89 |
26
| 76 |
22
| 79 |
23
| 76 |
22
| 177 |
52
| 163 |
48
|
2 | 255 |
75
| 80 |
23
| 129 |
38
| 70 |
20
| 213 |
62
| 91 |
27
| 214 |
63
| 88 |
26
| 143 |
42
| 81 |
24
| |
3 | 2 |
1
| 94 |
27
| 10 |
3
| 52 |
15
| 40 |
12
| 87 |
25
| 49 |
14
| 105 |
31
| 22 |
6
| 74 |
22
| |
4 | – | – | 90 |
26
| – | – | 19 |
6
| – | – | 66 |
19
| – | – | 60 |
18
| – | – | 20 |
6
| |
5 | – | – | 6 |
2
| – | – | 9 |
3
| – | – | 22 |
6
| – | – | 13 |
4
| – | – | 4 |
1
| |
Depression | 1 | 165 |
66
| 154 |
62
| 205 |
82
| 204 |
82
| 119 |
48
| 113 |
45
| 107 |
43
| 82 |
33
| 46 |
18
| 33 |
13
|
2 | 84 |
34
| 54 |
22
| 44 |
18
| 21 |
8
| 118 |
47
| 72 |
29
| 121 |
48
| 88 |
35
| 175 |
70
| 89 |
36
| |
3 | 1 |
0
| 24 |
10
| 1 |
0
| 21 |
8
| 13 |
5
| 37 |
15
| 22 |
9
| 48 |
19
| 29 |
12
| 80 |
32
| |
4 | – | – | 17 |
7
| – | – | 4 |
2
| – | – | 25 |
10
| – | – | 24 |
10
| – | – | 32 |
13
| |
5 | – | – | 1 |
0
| – | – | 0 |
0
| – | – | 3 |
1
| – | – | 8 |
3
| – | – | 16 |
6
| |
Diabetes | 1 | 189 |
68
| 179 |
64
| 232 |
83
| 231 |
83
| 172 |
61
| 162 |
58
| 129 |
47
| 115 |
42
| 189 |
68
| 173 |
62
|
2 | 89 |
32
| 53 |
19
| 47 |
17
| 36 |
13
| 95 |
34
| 69 |
25
| 135 |
49
| 93 |
34
| 87 |
31
| 71 |
26
| |
3 | 0 |
0
| 26 |
9
| 0 |
0
| 8 |
3
| 13 |
5
| 28 |
10
| 13 |
5
| 41 |
15
| 3 |
1
| 25 |
9
| |
4 | – | – | 21 |
8
| – | – | 4 |
1
| – | – | 13 |
5
| – | – | 23 |
8
| – | – | 7 |
3
| |
5 | – | – | 0 |
0
| – | – | 0 |
0
| – | – | 6 |
2
| – | – | 5 |
2
| – | – | 1 |
0
| |
Liver disease | 1 | 457 |
74
| 465 |
73
| 542 |
88
| 568 |
89
| 425 |
68
| 428 |
68
| 367 |
60
| 365 |
58
| 346 |
56
| 347 |
55
|
2 | 163 |
26
| 103 |
16
| 73 |
12
| 42 |
7
| 183 |
29
| 106 |
17
| 233 |
38
| 151 |
24
| 249 |
40
| 166 |
26
| |
3 | 1 |
0
| 53 |
8
| 3 |
0
| 21 |
3
| 14 |
2
| 69 |
11
| 15 |
2
| 94 |
15
| 22 |
4
| 97 |
15
| |
4 | – | – | 17 |
3
| – | – | 4 |
1
| – | – | 22 |
3
| – | – | 19 |
3
| – | – | 19 |
3
| |
5 | – | – | 1 |
0
| – | – | 2 |
0
| – | – | 6 |
1
| – | – | 3 |
0
| – | – | 5 |
1
| |
Personality disorder | 1 | 324 |
85
| 320 |
84
| 357 |
94
| 357 |
93
| 120 |
31
| 98 |
26
| 168 |
44
| 137 |
36
| 64 |
17
| 51 |
13
|
2 | 58 |
15
| 39 |
10
| 24 |
6
| 21 |
5
| 228 |
60
| 85 |
22
| 197 |
52
| 132 |
34
| 217 |
57
| 82 |
21
| |
3 | 1 |
0
| 21 |
5
| 0 |
0
| 3 |
1
| 33 |
9
| 119 |
31
| 17 |
4
| 85 |
22
| 100 |
26
| 119 |
31
| |
4 | – | – | 2 |
1
| – | – | 1 |
0
| – | – | 70 |
18
| – | – | 26 |
7
| – | – | 105 |
27
| |
5 | – | – | 1 |
0
| – | – | 0 |
0
| – | – | 10 |
3
| – | – | 3 |
1
| – | – | 25 |
7
| |
RA/Arthritis | 1 | 106 |
29
| 83 |
22
| 235 |
64
| 223 |
60
| 106 |
29
| 81 |
22
| 45 |
12
| 26 |
7
| 222 |
60
| 190 |
51
|
2 | 263 |
71
| 115 |
31
| 132 |
36
| 84 |
23
| 232 |
63
| 131 |
36
| 282 |
76
| 123 |
33
| 134 |
36
| 100 |
27
| |
3 | 0 |
0
| 101 |
27
| 3 |
1
| 43 |
12
| 32 |
9
| 94 |
25
| 43 |
12
| 135 |
37
| 14 |
4
| 54 |
15
| |
4 | – | – | 67 |
18
| – | – | 17 |
5
| – | – | 46 |
12
| – | – | 73 |
20
| – | – | 18 |
5
| |
5 | – | – | 3 |
1
| – | – | 2 |
1
| – | – | 17 |
5
| – | – | 12 |
3
| – | – | 7 |
2
| |
Stroke | 1 | 133 |
22
| 121 |
20
| 201 |
33
| 190 |
31
| 118 |
20
| 108 |
18
| 122 |
20
| 117 |
19
| 141 |
23
| 122 |
20
|
2 | 359 |
59
| 117 |
19
| 263 |
44
| 122 |
20
| 309 |
51
| 127 |
21
| 428 |
71
| 148 |
25
| 416 |
69
| 213 |
35
| |
3 | 115 |
19
| 160 |
26
| 139 |
23
| 117 |
19
| 176 |
29
| 141 |
23
| 50 |
8
| 212 |
35
| 46 |
8
| 169 |
28
| |
4 | – | – | 113 |
19
| – | – | 60 |
10
| – | – | 95 |
16
| – | – | 100 |
17
| – | – | 79 |
13
| |
5 | – | – | 99 |
16
| – | – | 118 |
19
| – | – | 133 |
22
| – | – | 26 |
4
| – | – | 22 |
4
| |
Students | 1 | 434 |
98
| 428 |
97
| 442 |
100
| 442 | 442 | 398 |
90
| 376 |
85
| 297 |
67
| 268 |
60
| 246 |
56
| 190 |
43
|
2 | 9 |
2
| 12 |
3
| 1 |
0
| 0 | 1 | 44 |
10
| 48 |
11
| 145 |
33
| 143 |
32
| 192 |
43
| 173 |
39
| |
3 | 0 |
0
| 2 |
0
| 0 |
0
| 1 |
0
| 1 |
0
| 15 |
3
| 1 |
0
| 29 |
7
| 5 |
1
| 55 |
12
| |
4 | – | – | 1 |
0
| – | – | 0 |
0
| – | – | 3 |
1
| – | – | 3 |
1
| – | – | 21 |
5
| |
5 | – | – | 0 |
0
| – | – | 0 |
0
| – | – | 1 |
0
| – | – | 0 |
0
| – | – | 4 |
1
|
Dimension | 3L |
n
| % by dimension | 5L |
n
| % by level | Rating scale meana
|
---|---|---|---|---|---|---|---|
Mobility | 1 | 2,083 | 53.9 | 1 | 1,941 | 94.1 | 96.8 |
2 | 121 | 5.9 | 84.5 | ||||
2 | 1,634 | 42.3 | 2 | 588 | 37.2 | 70.0 | |
3 | 598 | 37.9 | 52.4 | ||||
4 | 393 | 24.9 | 32.1 | ||||
3 | 148 | 3.8 | 4 | 30 | 21.1 | 16.6 | |
5 | 112 | 78.9 | 3.1 | ||||
Self-Care | 1 | 2,754 | 71.5 | 1 | 2,653 | 97.0 | 98.0 |
2 | 83 | 3.0 | 81.6 | ||||
2 | 910 | 23.6 | 2 | 425 | 49.6 | 68.6 | |
3 | 321 | 37.5 | 49.4 | ||||
4 | 110 | 12.9 | 32.9 | ||||
3 | 190 | 4.9 | 4 | 35 | 19.9 | 18.2 | |
5 | 141 | 80.1 | 6.1 | ||||
Usual Activities | 1 | 1,725 | 44.8 | 1 | 1,527 | 90.1 | 96.7 |
2 | 167 | 9.9 | 86.8 | ||||
2 | 1,704 | 44.3 | 2 | 686 | 41.9 | 72.4 | |
3 | 676 | 41.2 | 53.1 | ||||
4 | 277 | 16.9 | 36.9 | ||||
3 | 418 | 10.9 | 4 | 140 | 36.6 | 20.1 | |
5 | 242 | 63.4 | 8.8 | ||||
Pain/Discomfort | 1 | 1,491 | 38.8 | 1 | 1,251 | 85.6 | 95.7 |
2 | 211 | 14.4 | 84.4 | ||||
2 | 2,084 | 54.2 | 2 | 895 | 44.6 | 72.5 | |
3 | 869 | 43.3 | 54.5 | ||||
4 | 244 | 12.2 | 37.2 | ||||
3 | 268 | 7.0 | 4 | 160 | 65.8 | 21.8 | |
5 | 83 | 34.2 | 13.0 | ||||
Anxiety/Depression | 1 | 1,730 | 45.0 | 1 | 1,466 | 87.0 | 97.2 |
2 | 220 | 13.0 | 84.6 | ||||
2 | 1,839 | 47.8 | 2 | 890 | 49.8 | 66.4 | |
3 | 731 | 40.9 | 50.0 | ||||
4 | 165 | 9.2 | 38.3 | ||||
3 | 279 | 7.3 | 4 | 163 | 63.4 | 28.5 | |
5 | 94 | 36.6 | 13.1 |
Ceiling 3L (% 11111) | Ceiling 5L (% 11111) | Absolute reduction (%) | Percentage reduction (%) | |
---|---|---|---|---|
Subgroup
| ||||
Cardiovascular disease | 13.1 | 8.0 | 5.2 | 39.4 |
COPD/Asthma | 8.5 | 7.0 | 1.5 | 17.2 |
Depression | 12.0 | 6.4 | 5.6 | 46.7 |
Diabetes | 33.9 | 28.3 | 5.7 | 16.7 |
Liver disease | 38.5 | 35.7 | 2.8 | 7.2 |
Personality disorder | 7.7 | 3.9 | 3.8 | 48.8 |
RA/Arthritis | 6.5 | 1.9 | 4.6 | 70.8 |
Stroke | 7.1 | 6.0 | 1.1 | 15.0 |
Students | 47.0 | 34.3 | 12.6 | 26.9 |
Country
| ||||
Denmark | 32.8 | 30.4 | 2.3 | 7.1 |
England | 10.0 | 5.7 | 4.3 | 43.0 |
Italya
| 38.5 | 35.7 | 2.8 | 7.2 |
Netherlands | 7.8 | 4.0 | 3.8 | 49.0 |
Poland | 23.6 | 17.6 | 6.0 | 25.4 |
Scotland | 9.6 | 6.0 | 3.6 | 37.5 |
Total | 20.2 | 16.0 | 4.2 | 20.8 |
WHO-5 | Good spirits | Relaxed | Energy | Fresh and rested | Interested in things | |||||
---|---|---|---|---|---|---|---|---|---|---|
EQ-5D | 3L | 5L | 3L | 5L | 3L | 5L | 3L | 5L | 3L | 5L |
Mobility | 0.27 | 0.39 | 0.24 | 0.34 | 0.43 | 0.54 | 0.30 | 0.33 | 0.27 | 0.39 |
Self-Care | 0.39 | 0.44 | 0.37 | 0.39 | 0.51 | 0.53 | 0.37 | 0.39 | 0.40 | 0.39 |
Usual Activities | 0.40 | 0.40 | 0.36 | 0.34 | 0.54 | 0.59 | 0.36 | 0.40 | 0.39 | 0.41 |
Pain/Discomfort | 0.35 | 0.37 | 0.32 | 0.35 | 0.41 | 0.47 | 0.36 | 0.41 | 0.29 | 0.29 |
Anxiety/Depression | 0.55 | 0.57 | 0.61 | 0.61 | 0.39 | 0.40 | 0.43 | 0.43 | 0.42 | 0.42 |
Average | 0.39 | 0.43 | 0.38 | 0.41 | 0.46 | 0.51 | 0.36 | 0.39 | 0.35 | 0.38 |
Demographic variable | Age-groups (Spearman’s rho) | Education (Spearman’s rho) | Smokingb (p value) | |||
---|---|---|---|---|---|---|
3L | 5L | 3L | 5L | 3L | 5L | |
Mobility | 0.44** | 0.45** | −0.16** | −0.20** | <.001 | <.001 |
Self-Care | 0.32** | 0.33** | −0.13** | −0.13** | <.001 | <.001 |
Usual Activities | 0.28** | 0.27** | −0.15** | −0.17** | <.001 | <.001 |
Pain/Discomfort | 0.23** | 0.24** | −0.15** | −0.14** | 0.068 | <.001 |
Anxiety/Depression | −0.04* | −0.06** | −0.04 | −0.04 | <.001 | <.001 |