The Measurement Properties of the EQ-HWB and the EQ-HWB-S in Italian Population: A Comparative Study With EQ-5D-5L

• Published in: Value in health 2024-07, Vol.27 (7), p.955-966
• Main Authors: Kuharić, Maja, Pickard, A. Simon, Mukuria, Clara, Finch, Aureliano Paolo
• Format: Article
• Language: English
• Subjects: EQ Health and well-being; EQ-5D-5L; EQ-HWB; Italy; psychometrics
• ISSN: 1098-3015; 1524-4733; 1524-4733
• DOI: 10.1016/j.jval.2024.03.002

The EQ Health and Well-being, EQ-HWB (25-item) and the EQ-HWB-S (9-item), are new generic measures of health and well-being. The purpose of this study was to examine the measurement properties of the EQ-HWB and EQ-HWB-S measures in relation to the EQ-5D-5L among the Italian general population. A cross-sectional survey was conducted from October 2020 to February 2021, followed by secondary analysis of collected data from Italian adults. This analysis included response pattern distributions, correlation strength, and known-group comparison. Known-group comparison was assessed using effect sizes (ES) across health conditions, caregiver status, and social care usage. The EQ-HWB-S index-based score was based on the UK pilot value set, whereas the Italian value set was used for scoring the EQ-5D-5L index. Out of the 1182 participants, 461 reported having a chronic condition, 185 identified as caregivers, and 42 were social care users. EQ-HWB items (7.5%) showed fewer ceiling effects than EQ-5D-5L items (34.7%). Strong correlations (rs > 0.5) were found between overlapping EQ-HWB and EQ-5D-5L items. EQ-HWB-S and EQ-5D-5L index scores demonstrated similar discrimination based on symptomatic chronic conditions (ES d = 0.68 vs d = 0.71), but EQ-HWB-S had slightly higher ES for social care users (ES d = 0.84 vs d = 0.74). Initial evidence supports the validity of EQ-HWB/EQ-HWB-S because outcome measures in the Italian population. EQ-HWB-S performed comparably to EQ-5D-5L among patients and was better in differentiating social care users. A slight decrease in discriminative properties for caregivers was observed when transitioning from EQ-HWB to EQ-HWB-S. •The EQ Health and Well-being, EQ-HWB (25-item) and EQ-HWB-S (9-item) were developed to meet the need for a single instrument applicable across different beneficiaries of health and social care services. The EQ-HWB is intended for use in clinical practice and population health surveys, whereas the EQ-HWB-S is designed for use in economic evaluations across health, social care, and public health.•This study aimed to assess the psychometric performance of the EQ-HWB/EQ-HWB-S in the general Italian population, including patients, caregivers, and social care users. It evaluated ceiling/floor effects, convergent validity, and discriminative ability against EQ-5D-5L.•Results support the validity of EQ-HWB/EQ-HWB-S as outcome measures in the Italian population. EQ-HWB-S performed comparably to EQ-5D-5L among patients and wa