Response-scale heterogeneity in the EQ-5D

Knott, Rachel J. and Black, Nicole and Hollingsworth, Bruce Philip and Lorgelly, Paula K. (2017) Response-scale heterogeneity in the EQ-5D. Health Economics, 26 (3). pp. 387-394. ISSN 1057-9230

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This paper discusses two types of response-scale heterogeneity, which may impact upon the EQ-5D. Response-scale heterogeneity in reporting occurs when individuals systematically differ in their use of response scales when responding to self-assessments. This type of heterogeneity is widely observed in relation to other self-assessed measures but is often overlooked with regard to the EQ-5D. Analogous to this, preference elicitation involving the EQ-5D could be subject to a similar type of heterogeneity, where variations across respondents may occur in the interpretations of the levels (response categories) being valued. This response-scale heterogeneity in preference elicitation may differ from variations in preferences for health states, which have been observed in the literature. This paper explores what these forms of response-scale heterogeneity may mean for the EQ-5D and the potential implications for researchers who rely on the instrument as a measure of health and quality of life. We identify situations where they are likely to be problematic and present potential avenues for overcoming these issues.

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Journal Article
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Health Economics
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This is the peer reviewed version of the following article: Knott, R. J., Black, N., Hollingsworth, B., and Lorgelly, P. K. (2017) Response-Scale Heterogeneity in the EQ-5D. Health Econ., 26: 387–394. doi: 10.1002/hec.3313 which has been published in final form at This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
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27 Apr 2016 08:08
Last Modified:
17 Sep 2023 01:49