School of Political Science and Public Administration, Wuhan University, Wuhan, Hubei, China.
School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.
J Glob Health. 2021 Feb 11;11:08001. doi: 10.7189/jogh.11.08001.
EQ-5D-3L is one of the most commonly used instruments for assessing health-related quality of life and cost-utility analyses, but it is not yet available in China. This study aims to develop population norms for the EQ-5D-3L in China in order to encourage appropriate use and interpretation of the EQ-5D-3L instrument.
Data were extracted from the 2013 National Health Services Survey on a nationally representative sample of 188 720 participants. The utility index based on the 2018 Chinese preference-based value sets were calculated for the participants with different demographic and socio-economic characteristics. Differences in reported problems and visual analogue scale (VAS) and utility index scores were tested using a logistic, linear and tobit regression model, respectively.
The Chinese respondents were less likely to report problems on the EQ-5D dimensions compared with most populations in other countries. Pain/discomfort was the most commonly reported problem (12.6%). This resulted in a high ceiling effect (84.19%) on the utility index and high mean scores for the utility index (0.985 ± 0.056) and VAS (80.91 ± 13.74) in the Chinese population. Those who were younger, better educated, employed, married, had no illness condition, lived in a more developed region and had a higher income obtained higher scores in both VAS and utility index. The VAS and utility index scores were also associated with gender, residency and lifestyles, but not always in a consistent way. Male and rural residents had a higher VAS score but not in the utility index compared with their female and urban counterparts.
This study provides national population norms for the EQ-5D-3L based on the 2018 Chinese preference-based value sets. The norms can be used as a reference for health evaluation studies. Cautions need to be taken for presenting and interpreting the utility index results given the high ceiling effect of the EQ-5D-3L instrument.
EQ-5D-3L 是评估健康相关生活质量和成本效用分析最常用的工具之一，但在中国尚未普及。本研究旨在制定 EQ-5D-3L 的中国人群常模，以鼓励对 EQ-5D-3L 工具的适当使用和解释。
从全国代表性样本中抽取了 188720 名参与者的 2013 年国家卫生服务调查数据。根据 2018 年中国偏好权重集计算了不同人口统计学和社会经济特征参与者的效用指数。使用逻辑回归、线性回归和截尾回归模型分别检验报告问题和视觉模拟量表（VAS）和效用指数得分的差异。
与其他国家的大多数人群相比，中国受访者在 EQ-5D 维度上报告问题的可能性较小。疼痛/不适是最常见的问题（12.6%）。这导致效用指数的高天花板效应（84.19%）和中国人群中效用指数（0.985±0.056）和 VAS（80.91±13.74）的高平均得分。年龄较小、受教育程度较高、就业、已婚、无疾病状况、生活在较发达地区、收入较高的人在 VAS 和效用指数上的得分都较高。VAS 和效用指数得分也与性别、居住地和生活方式有关，但并不总是以一致的方式。与女性和城市居民相比，男性和农村居民的 VAS 得分较高，但效用指数得分较低。
本研究基于 2018 年中国偏好权重集提供了 EQ-5D-3L 的全国人群常模。该常模可作为健康评估研究的参考。鉴于 EQ-5D-3L 工具的高天花板效应，在呈现和解释效用指数结果时需要谨慎。
