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Do health preferences contradict ordering of EQ-5D labels?
Benjamin M Craig1, A Simon Pickard, Kim Rand-Hendriksen
1Health Outcomes and Behavior, Moffitt Cancer Center, University of South Florida, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612-9416, USA, benjamin.craig@moffitt.org.
Purpose:
The aim of this study was to test whether the ordering of item labels in EQ-5D instruments disagrees with the preferences of US adults.
Methods:
A preference inversion occurs when "worse" health along a scale or score is preferred. As a sub-study of the 2013 United States Measurement and Valuation of Health Study, we tested for 33 EQ-5D preference inversions using paired comparisons with unique samples of 50 or more US adults, aged 18 or older. Specifically, we tested whether health preferences contradicted ordering of EQ-5D labels.
Results:
The EQ-5D-3L and EQ-5D-Y item labels had no significant preference inversions. The EQ-5D-5L version had preference inversions between Levels 4 and 5. For example, 30 out of 59 respondents (51 %) preferred being "extremely" over "severely anxious or depressed," contrary to the ordering of labels for that item.
Conclusions:
Preference inversions between Levels 4 and 5 on the EQ-5D-5L were tested and confirmed; therefore, valuation studies may find that Levels 4 and 5 have the same value. To mitigate such inversions, labels could be revised or a 4-level version could be considered.
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