Dewilde Sarah, Tollenaar Nafthali Hananja, Phillips Glenn, Paci Sandra, Janssen Mathieu F
Services in Health Economics (SHE), Boulevard Lambermont 418, Brussels, 1030, Belgium.
argenx BV, Ghent, Belgium.
Arch Public Health. 2025 Jul 11;83(1):184. doi: 10.1186/s13690-025-01642-z.
BACKGROUND: This study aimed to estimate population norms in the US, Canada, UK, Italy, Spain, Germany, The Netherlands, and Belgium for the EQ-5D-5-L with six bolt-on dimensions (vision, breathing, tiredness, sleep, social relationships, self-confidence), and for the Health Utilities Index-Mark 3 (HUI-3). METHODS: A digital study was conducted among 9,000 general population participants, representative of age, sex, education, and region within each country. Data collection included demographics, health conditions, EQ-5D-5-L and bolt-ons, and the HUI-3. National population norms were calculated for each dimension and for utility values. Testing for differences between subgroups was performed with a Generalized Linear Model. RESULTS: The proportion of respondents reporting severe-to-extreme problems at dimension level was highest on the EQ-5D-5-L dimensions pain/discomfort (5.5%) and anxiety/depression (5.6%), and on the HUI-3 dimensions pain (5.7%), emotion (5.4%), and cognition (4.1%). Severe-to-extreme problems on the EQ-5D-5-L bolt-on dimensions were social relationships (8.0%), sleep (7.6%), tiredness (7.4%), self-confidence (5.1%), vision (3.7%), and breathing (2.0%). Mean EQ-5D-5-L utility values for all countries combined displayed a U-shape by age and ranged between 0.819 and 0.871, whereas HUI-3 utility values ranged between 0.717 and 0.768 without a clear pattern. The impact of age by sex on EQ-5D-5-L utility values was country-specific. HUI-3 utilities did not show a linear trend by age, and no difference was found by sex. Italy had the highest mean EQ-5D-5-L utility values, while the Netherlands and Spain had the highest values according to the HUI-3. The lowest utility values were observed in the UK, for both instruments. Utility values differed significantly by education, employment, place of residence, needing a caregiver, being on sick leave and having health conditions such as dementia, MS, depression, rheumatoid arthritis, systemic lupus erythematosus and heart failure. CONCLUSIONS: Important differences in reporting problems and in utility values were found between countries and subgroups, highlighting the need for country-specific population norms.
背景：本研究旨在估算美国、加拿大、英国、意大利、西班牙、德国、荷兰和比利时在EQ-5D-5-L（包含六个附加维度：视力、呼吸、疲倦、睡眠、社会关系、自信）以及健康效用指数-第三版（HUI-3）方面的人群常模。 方法：在9000名普通人群参与者中开展了一项数字研究，这些参与者在每个国家的年龄、性别、教育程度和地区方面具有代表性。数据收集包括人口统计学信息、健康状况、EQ-5D-5-L及附加维度，以及HUI-3。计算了每个维度和效用值的国家人群常模。使用广义线性模型对亚组间差异进行检验。 结果：在维度层面报告严重至极严重问题的受访者比例，在EQ-5D-5-L维度疼痛/不适（5.5%）和焦虑/抑郁（5.6%）方面，以及在HUI-3维度疼痛（5.7%）、情绪（5.4%）和认知（4.1%）方面最高。EQ-5D-5-L附加维度上严重至极严重问题的情况为：社会关系（8.0%）、睡眠（7.6%）、疲倦（7.4%）、自信（5.1%）、视力（3.7%）和呼吸（2.0%）。所有国家合并后的EQ-5D-5-L效用值按年龄呈U形分布，范围在0.819至0.871之间，而HUI-3效用值范围在0.717至0.768之间，无明显模式。年龄和性别的交互作用对EQ-5D-5-L效用值的影响因国家而异。HUI-3效用值未随年龄呈现线性趋势，且未发现性别差异。意大利的EQ-5D-5-L平均效用值最高，而根据HUI-3，荷兰和西班牙的效用值最高。两种工具在英国的效用值均最低。效用值在教育程度、就业情况、居住地点、是否需要护理人员、是否休病假以及是否患有痴呆、多发性硬化症、抑郁症、类风湿性关节炎、系统性红斑狼疮和心力衰竭等健康状况方面存在显著差异。 结论：在国家和亚组之间发现了报告问题和效用值方面的重要差异，突出了针对特定国家人群常模的必要性。
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