The UK’s new valuation study for the EQ-5D-5L questionnaire, designed to understand how people prioritise different aspects of their quality of life, gets underway in October. The study is an important contribution to the evidence NICE uses to decide whether treatments offer good value.
The results of this study will allow better interpretation of the results of the EQ-5D-5L questionnaire, informed by up-to-date information about the public's preferences.
Why do we need this study?
Valuation studies gather the public’s views about which aspects of health matter the most to them. Those results create a ‘value set’ that converts people’s responses to quality of life questionnaires completed during clinical trials, into a number called a utility value. Utility values are used to inform many of NICE’s decisions about whether treatments provide good value for money.
NICE prefers to use utility values based on the EQ‑5D questionnaire developed by EuroQol, a registered non-profit foundation. The EQ-5D-5L is the latest version of the EQ-5D, with 5 response options. For example:
Please tick ONE box that best describes your health TODAY:
Pain/Discomfort
□ I have no pain or discomfort
□ I have slight pain or discomfort
□ I have moderate pain or discomfort
□ I have severe pain or discomfort
□ I have extreme pain or discomfort
Extract from EQ-5D-5L, © With permission of EuroQol Research Foundation.
Why don’t we have a value set for the EQ-5D-5L yet?
In 2018 researchers published an EQ-5D-5L value set for England after interviewing around 1000 members of the general public. But independent quality assurance raised concerns about the reliability of the data collected in the valuation study, and the methods used to model these data. The English study was one of the first to be carried out anywhere in the world, and since then the international standard valuation study protocol has been improved and additional quality control methods introduced. Accordingly, NICE chose not to use the existing EQ-5D-5L value set for England, and recommended a new valuation study. If companies, academic groups or others preparing evidence submissions for NICE have used the EQ-5D-5L questionnaire to measure health-related quality of life, our methods state that this data should be ‘mapped’ onto the EQ-5D-3L value set.
Most valuation studies involve face-to-face interviews so, like many research studies around the world, it wasn’t safe to start the new study during the COVID-19 pandemic. But work didn’t stop altogether – the study team continued to work on the methods for study, which have now been approved, meaning that data collection will start in October 2022.
What did the pandemic teach us about valuation studies?
Valuation studies are challenging. The tasks are difficult and involve emotive subject matter - people are asked to think about their own death. So it’s important to get a good rapport between interviewer and participant, to ensure that participants understand and are engaged in the exercise. The pandemic raised the questions of how feasible and acceptable it is to do valuation interviews over videoconferencing software (such as Zoom), and whether doing interviews remotely would compromise the quality and accuracy of the results.
In 2021 the research team ran a study to formally compare the feasibility, acceptability and equivalence of using videoconference versus the traditional face-to-face approach in a valuation study (Rowen et al. 2022). The results showed that both approaches are feasible and acceptable, and generated good-quality data. An interesting finding was that the characteristics of people who preferred video interviews differed significantly from those who preferred face-to-face interviews. Therefore, both modes will be used in the UK valuation study, with participants being able to choose their preferred interviewing method, to make the study more inclusive and ensure the sample is representative of the UK population.
Where can I find more information?
The new EQ-5D-5L valuation study is being funded by the EuroQol Research Foundation with ongoing advisory input from NICE, the Department of Health and Social Care, NHS England and NHS Improvement and academic experts. More detailed information about the study design and its governance can be found on the EuroQol website.
References
Rowen D, Mukuria C, Bray N et al. (2022) Assessing the comparative feasibility, acceptability and equivalence of videoconference interviews and face-to-face interviews using the time trade-off technique. Social Science and Medicine.
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