Exploring potential EQ-5D bolt-on dimensions with a qualitative approach: an interview study in Hong Kong SAR, China

• Published in: Health and quality of life outcomes 2024-05, Vol.22 (1), p.42-9, Article 42
• Main Authors: Cheuk Wai Ng, Clement, Wai Ling Cheung, Annie, Lai Yi Wong, Eliza
• Format: Article
• Language: English
• Subjects: Adult; Age groups; Aged; Bolt-on; Chronic illnesses; Data analysis; Data collection; EQ-5D; Evaluation; Female; Health aspects; Health Status; Health surveys; Health-related quality of life; Hong Kong; Humans; Interviews; Interviews as Topic; Male; Mental health; Middle Aged; Perception; Perceptions; Psychometrics; Qualitative Research; Quality of life; Quality of Life - psychology; Questionnaires; Surveys and Questionnaires; Young Adult
• ISSN: 1477-7525; 1477-7525
• DOI: 10.1186/s12955-024-02259-6

The introduction of bolt-on dimensions in EQ-5D instruments is growing common, but most bolt-on studies have targeted the diseased population and obtained bolt-on from other existing Health-related Quality of Life (HRQoL) instruments. As the qualitative approach offers important evidence to support the consistency and design of the potential bolt-on items, this paper studies the Hong Kong SAR community's perception of the current EQ-5D-5 L instrument and identifies potential bolt-on via a qualitative approach. A representative sample mix was recruited based on the age group, gender, and education level composition of the Hong Kong SAR community by quota sampling. Semi-structured interviews were conducted and the interviews were transcribed and coded to identify emergent and recurrent themes. Thirty interviews were conducted and the majority of the interviewees considered the EQ-5D-5 L insufficiently comprehensive to illustrate their HRQoL. While some key HRQoL aspects included in the EQ-5D matched with the community's HRQoL perception, respondents showed concern about the potential overlap of the existing HRQoL dimension, the optimal number or attributes, and the appropriateness of the EQ-VAS. Among the potential bolt-on dimensions that emerged, 'Sleep', 'Interpersonal Relationship', and 'Satisfaction' were the key potential bolt-on dimensions identified and emphasized in the interviews. The qualitative findings of the study illustrate the possible gap between EQ-5D-5 L measurements and community HRQoL perception, while the findings support the development of EQ-5D bolt-on dimensions in the target community with content and face validity.