Valuation and modeling of EQ-5D-5L health states using a hybrid approach

Juan M Ramos-Goni, Jose L. Pinto-Prades, Mark Oppe, Juan M. Cabases, Pedro Serrano-Aguilar, Oliver Rivero-Arias

Research output: Contribution to journalArticlepeer-review

93 Citations (Scopus)
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Background: The EQ-5D instrument is the most widely used preference- based health-related quality of life questionnaire in cost-effectiveness analysis of health care technologies. Recently, a version called EQ-5D-5L with 5 levels on each dimension was developed. This manuscript explores the performance of a hybrid approach for the modeling of EQ-5D-5L valuation data.
Methods: Two elicitation techniques, the composite time trade-off, and discrete choice experiments, were applied to a sample of the Spanish population (n = 1000) using a computer-based questionnaire.
The sampling process consisted of 2 stages: stratified sampling of geographic area, followed by systematic sampling in each area. A hybrid regression model combining composite time trade-off and discrete choice data was used to estimate the potential value sets using main effects as starting point. The comparison between the models was performed using the criteria of logical
consistency, goodness of fit, and parsimony.
Results: Twenty-seven participants from the 1000 were removed following the exclusion criteria. The best-fitted model included 2 significant interaction terms but resulted in marginal improvements in model fit compared to the main effects model. We therefore selected the model results with main effects as a potential value set for this methodological study, based on the parsimony criteria. The
results showed that the main effects hybrid model was consistent, with a range of utility values between 1 and 0.224.
Conclusion: This paper shows the feasibility of using a hybrid approach to estimate a value set for EQ-5D-5L valuation data.
Original languageEnglish
Pages (from-to)e51-e58
Number of pages8
JournalMedical Care
Issue number7
Publication statusPublished - Jul 2017


  • Adolescent
  • Adult
  • Aged
  • Cost-Benefit Analysis
  • Female
  • Health Status
  • Hispanic Americans/psychology
  • Humans
  • Male
  • Middle Aged
  • Models, Statistical
  • Quality of Life/psychology
  • Surveys and Questionnaires/standards
  • Young Adult


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