Abstract
Objectives: Existing measures for estimating quality-adjusted life-years are mostly limited to health-related quality of life. This article presents an overview of the development the EQ-HWB (EQ Health and Wellbeing), which is a measure that encompasses health and wellbeing. Methods: Stages: (1) Establishing domains through reviews of the qualitative literature informed by a conceptual framework. (2) Generation and selection of items to cover the domains. (3) Face validation of these items through qualitative interviews with 168 patients, social care users, general population, and carers across 6 countries (Argentina, Australia, China, Germany, United Kingdom, United States). (4) Extensive psychometric testing of candidate items (using classical, factor analysis, and item response theory methods) on > 4000 respondents in the 6 countries. Stakeholders were consulted throughout. Results: A total of 32 subdomains grouped into 7 high-level domains were identified from the qualitative literature and 97 items generated to cover them. Face validation eliminated 36 items, modified 14, and added 3. Psychometric testing of 64 items found little difference in missing data or problems with response distribution, the conceptual model was confirmed except in China, and most items performed well in the item response theory in all countries. Evidence was presented to stakeholders in 2 rounds of consultation to inform the final selection of items for the EQ-HWB (25-item) and the short version of EQ-HWB (9-items). Conclusions: EQ-HWB measures have been developed internationally for evaluating interventions in health, public health, and social care including the impact on patients, social care users, and carers.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 482-491 |
| Number of pages | 10 |
| Journal | Value in Health |
| Volume | 25 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 2022 |
Funding
The authors thank the National Institute for Health and Care Excellence for highlighting the methodological research need to the Medical Research Council that resulted in the funding call entitled “Beyond the QALY,” which led to this research being funded. The authors acknowledge the support of the National Institute for Health Research Yorkshire and Humber Applied Research Collaboration (formerly CLAHRC) and the National Institute for Health Research Clinical Research Network . The authors acknowledge the invaluable contributions of members of the project Steering Group, advisory group, and patient and public involvement and engagement groups and Julie Johnson for project administration. The authors also thank members of the EuroQol Group Association for their input at plenary and academy meetings and the EuroQol office for their support. Finally, the authors acknowledge the contribution of all the patients, social care users, and informal carers who took part in all the studies across the different countries. Conflict of Interest Disclosures: Drs Brazier, Peasgood, Carlton, Connell, Tsuchiya, Lovett, and Rowan reported receiving grants from the EuroQol Research Foundation and the UK Medical Research Council during the conduct of the study. Dr Brazier reported receiving grants and personal fees from the EuroQol Research Foundation outside the submitted work and reported having a patent for the SF-6D and SF-6Dv2 with royalties paid to The University of Sheffield. Drs Brazier, Mukuria, Gibbons, and Carlton reported serving as members of the EuroQol Research Foundation. Dr Mukuria reported receiving grants from the EuroQol Research Foundation during the conduct of the study and reported receiving grants from the EuroQol Research Foundation outside the submitted work. Mr Marten and Drs Kreimeier, Pickard, Greiner, and Ludwig reported receiving grants and nonfinancial support from the EuroQol Research Foundation during the conduct of the study and reported serving as members of the EuroQol Group. Dr Luo reported receiving grants and personal fees from the EuroQol Research Foundation during the conduct of the study and reported receiving grants and personal fees from the EuroQol Research Foundation outside the submitted work. Dr Luo is an editor for Value in Health and had no role in the peer-review process of this article. Dr Mulhern reported receiving grants from the EuroQol Research Foundation during the conduct of the study and reported serving as a member of the EuroQol Research Foundation. Dr Mulhern is an editor for Value in Health and had no role in the peer-review process of this article. Dr Engel reported receiving grants from EuroQol Research Foundation during the conduct of the study and reported serving as a member of the EuroQol Group. Drs Belizan and Yang and Miss Monteiro reported receiving grants from the EuroQol Research Foundation during the conduct of the study. Dr Kuharic reported receiving grants from the EuroQol Research Foundation during the conduct of the study and reported receiving fellowship support for graduate studies from Takeda Pharmaceuticals USA, Inc, during the conduct of this study. Dr Naidoo is employed by the National Institute for Health and Care Excellence. The views expressed in this article are those of the authors and not necessarily of our funders, the National Institute for Health and Care Excellence, the Department of Health and Social Care, or those acknowledged. No other disclosures were reported. Funding/Support: This study is an independent research funded by the UK Medical Research Council (grant number 170620 ) and the EuroQol Research Foundation . Funding/Support: This study is an independent research funded by the UK Medical Research Council (grant number 170620) and the EuroQol Research Foundation.The authors thank the National Institute for Health and Care Excellence for highlighting the methodological research need to the Medical Research Council that resulted in the funding call entitled ?Beyond the QALY,? which led to this research being funded. The authors acknowledge the support of the National Institute for Health Research Yorkshire and Humber Applied Research Collaboration (formerly CLAHRC) and the National Institute for Health Research Clinical Research Network. The authors acknowledge the invaluable contributions of members of the project Steering Group, advisory group, and patient and public involvement and engagement groups and Julie Johnson for project administration. The authors also thank members of the EuroQol Group Association for their input at plenary and academy meetings and the EuroQol office for their support. Finally, the authors acknowledge the contribution of all the patients, social care users, and informal carers who took part in all the studies across the different countries.
Keywords
- carer outcomes
- EQ-HWB
- health and wellbeing
- outcome measures
- preference-based measures
- quality-adjusted life-years
- social care outcomes
- utilities
ASJC Scopus subject areas
- Health Policy
- Public Health, Environmental and Occupational Health
