Multinational evidence of the applicability and robustness of discrete choice modeling for deriving EQ-5D-5L health-state values

Krabbe, P. F. M., Devlin, N. J., Stolk, E. A., Shah, K. K., Oppe, M., van Hout, B., Quik, E. H., Pickard, A. S. & Xie, F., 10-Nov-2014, In : Medical Care. 52, 11, p. 935-943 9 p.

Research output: Contribution to journalArticleAcademicpeer-review

  • Paul F. M. Krabbe
  • Nancy J. Devlin
  • Elly A. Stolk
  • Koonal K. Shah
  • Mark Oppe
  • Ben van Hout
  • Elise H. Quik
  • A. Simon Pickard
  • Feng Xie

Aims: To investigate the feasibility of discrete choice experiments for valuing EQ-5D-5L states using computer-based data collection, the consistency of the estimated regression coefficients produced after modeling the preference data, and to examine the similarity of the values derived across countries.

Methods: Data were collected in Canada, England, The Netherlands, and the United States (US). Interactive software was developed to standardize the format of the choice tasks across countries, except for face-to-face interviewing in England. The choice task required respondents to choose between 2 suboptimal health states. A Bayesian design was used to generate 200 pairs of states that were randomly grouped into 20 blocks. Each respondent completed 1 block of 10 pairs. A main-effects probit model was used to estimate regression coefficients and to derive values.

Results: Approximately 400 respondents participated from each country. The mean time to perform 1 choice task was between 29.2 (US) and 45.2 (England) seconds. All regression coefficients were statistically significant, except level 2 for Usual Activities in The Netherlands (P=0.51). Predictions for the complete set of 3125 EQ-5D-5L health states were similar for the 4 countries. Intraclass correlation coefficients between the countries were high: from 0.80 (England vs. US) through 0.98 (Canada vs. US).

Conclusions: Derivation of value sets from the general population using computer-based choice tasks for the EQ-5D-5L is feasible. Parameter estimates were generally consistent and logical, and health-state values were similar across the 4 countries.

Original languageEnglish
Pages (from-to)935-943
Number of pages9
JournalMedical Care
Issue number11
Publication statusPublished - 10-Nov-2014


  • EQ-5D-5L, health states, choice model, values, discrete choice experiment, PREFERENCES, VALUATION, OUTCOMES

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