UK survey respondents identified several important aspects of health not covered by the EQ-5D descriptive system, with sensory deprivation and mental health mentioned most often. Responses were coded into themes and related to sensory deprivation, various aspects of mental health, absence of illness, communication, relationships, lifestyle and fitness. Further quantitative research is needed to establish the relative importance of the identified themes and what people would be willing to trade off between health dimensions.

1. IMPORTANT ASPECTS OF HEALTH
NOT CAPTURED BY EQ-5D
Koonal Shah (Office of Health Economics, UK); Brendan Mulhern (University of Technology Sydney, AUS);
Louise Longworth (Brunel University London, UK); MF (Bas) Janssen (EuroQol Research Foundation, NL)
For further information, contact Koonal Shah – kshah@ohe.org
METHODS
• Data were collected from 456 members of the UK general public
via face-to-face interviews.
• After completing a computer-based health state valuation
questionnaire [1], respondents were asked the following question
(as part of a follow-up paper questionnaire):
Are there aspects of health that are not included above
that you consider to be important? If yes, what are they?
Acknowledgements
This study was funded by the EuroQol Research Foundation, and all authors are
EuroQol members. However, the views expressed do not necessarily reflect the
views of the EuroQol Research Foundation.
References
1. Shah et al. Value in Health 2016; 19: 53-59.
2. Yang et al. Value in Health 2015; 18: 52-60.
3. Krabbe et al. Journal of Clinical Epidemiology 1999; 52: 293-301.
DATA ANALYSIS
Responses were analysed using a conventional content analysis framework with analyst triangulation.
I. All members of the study team read each response individually, with a view to identifying general themes in the responses.
II.Themes were proposed by one member of the study team (LL) and modified following discussion with the rest of the team.
III.Responses were coded according to their themes by two team members independently (task 1: BM & LL; task 4: MFJ & LL).
IV.Disagreements were resolved through discussion by the relevant team members.
V. Any remaining disagreements were resolved by a third team member (KS).
DISCUSSION AND CONCLUSIONS
• Findings of this study broadly support the choice of areas in which developmental bolt-on work has been conducted to date,
namely sensory deprivation [2] and mental health/cognition [3].
• Other aspects of health mentioned by respondents may inform the agenda for future bolt-on research.
• Further quantitative research can establish how important the identified themes are relative to the EQ-5D dimensions; and
whether and what people would be willing to trade for improvements in the dimensions not currently included in the EQ-5D.
BACKGROUND
• The EQ-5D is able to assess health status validly in
many disease areas, but its five dimensions may
not capture the impacts of some conditions.
• Attempts to improve the sensitivity of EQ-5D
include the development of ‘bolt-on’ dimensions.
• However, it is unclear which aspects of health
should be considered for further bolt-on research.
• Study objective: to understand what important
aspects of health are not captured by the five EQ-
5D dimensions, according to the general public.
SUMMARY
• UK survey respondents identified several aspects of health that they considered to be important but were not covered by the
EQ-5D descriptive system, with those relating to sensory deprivation and mental health mentioned most often.
RESULTS
• Text responses were provided by 179 respondents (remaining respondents answered ‘No’ to the initial question).
• Responses were coded into themes by MFJ and LL, who reached agreement about 156 of the 179 responses (87.2%).
• Some responses were assigned to multiple themes.
• Decisions about the remaining 16 responses were made by KS, with the agreement of the rest of the team.
Other themes mentioned: balance; cancer; cardiovascular disease; dexterity; gastroenterological & urological; immune; independence; infertility; non-
health outcomes; respiratory illness; sexual function; skin; spirituality; tiredness
Mobility – Ability to walk about
Self-care – Ability to wash or dress yourself
Usual Activities – Ability to do usual activities
Pain or discomfort – Level of pain or discomfort
Anxiety or depression – Level of anxiety or depression
Theme name Description No. responses Examples
Sensory Reference to sensory deprivation 50 “Vision, hearing” “Loss of any senses”
Mental health
a) General / unspecified
b) Happiness, wellbeing, emotional
health
c) Specific mental health conditions
Reference to:
a) Mental health generally
b) Happiness, wellbeing and/or emotional health
c) Specific mental health conditions and/or disorders
affecting mental or cognitive functioning
29
15
28
“Mental health”
“Self-esteem”
“Stress” “Autism”
Absence of illness or unspecified
other illnesses
General references absence or presence of other
illness, or needing medical attention
21 “Chronic illness”
“Disease”
Communication Reference to communication 15 “Speech” “Ability to communicate”
Relationships Reference to relationships, loneliness and sociability 15 “Personal relationships, family and
friends” “Feeling part of society”
Lifestyle and fitness Reference to lifestyle and fitness issues 13 “Weight and fitness” “Diet. Exercise.”
Table 1: Most frequently mentioned themes used for coding of open-ended text responses