{"entity":{"id":"rejuv-measure-eq-5d","kind":"technology","name":"EQ-5D: health reduced to one number, and what that number is for","aka":[],"tldr":"Five questions and a thermometer-style scale from worst to best imaginable health. The five answers are converted into a single index value using a country-specific value set, and that index is what health systems use to decide whether a treatment is worth paying for.","summary":"The EQ-5D is the generic preference-based measure. The EuroQol Group describes the current five-level version as follows: \"The descriptive system comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression\", each with \"5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems\". \"The digits for the five dimensions can be combined into a 5-digit number that describes the patient's health state.\" Alongside it, \"the EQ VAS records the patient's self-rated health on a vertical visual analogue scale where the endpoints are labelled 'The best health you can imagine' and 'The worst health you can imagine'.\" The five-level version was introduced to reduce the ceiling effect of the earlier three-level version, which put too many people in the top category.\n\nWhat makes it different from the other instruments here is the value set. Each of the 3,125 possible health states is attached to a single number, anchored so that 1 is full health and 0 is a state as bad as being dead, with negative values for states valued as worse than dead. Those numbers are not derived from patients; they come from surveys of the general public in each country, who are asked to trade off time or risk against health states. This is deliberate and contested in equal measure: the argument for it is that public money should be allocated according to public values, and the argument against is that the general public systematically misjudges what it is like to live with a condition they have not had.\n\nWhy it appears in the recovery literature at all. The index value multiplied by time lived gives quality-adjusted life years, the currency in which the National Institute for Health and Care Excellence in England, the Institute for Quality and Efficiency in Health Care in Germany and most other appraisal bodies decide what a health service will fund. If a rehabilitation programme, a psychological therapy or a lymphoedema service is to be commissioned, somebody will need an EQ-5D. It was also the primary outcome of the first randomised trial of electronic symptom monitoring.\n\nWhat it misses. Five questions cannot capture fatigue, which is the commonest and most persistent complaint after cancer treatment and appears nowhere in the descriptive system except indirectly through usual activities. Nothing on cognition. Nothing on sexual function, body image, fertility or fear. Nothing on the social and financial consequences. For a drug that moves survival it is an adequate summary; for the things on this front it is a blunt instrument, and a recovery intervention can improve several outcomes that matter to a person without moving the EQ-5D index at all. In the UK, the Life After Prostate Cancer Diagnosis study used EQ-5D-5L alongside the disease-specific EPIC-26 in 35,823 men for exactly that reason.","status":"standard-of-care","asOf":"2026-10-02","wikipedia":"https://en.wikipedia.org/wiki/EQ-5D","links":[{"label":"Herdman et al., Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L) (Qual Life Res 2011)","url":"https://doi.org/10.1007/s11136-011-9903-x"},{"label":"EuroQol: EQ-5D-5L","url":"https://euroqol.org/information-and-support/euroqol-instruments/eq-5d-5l/"},{"label":"Basch et al., Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial (JCO 2016)","url":"https://doi.org/10.1200/JCO.2015.63.0830"},{"label":"Mason et al., Stability of health-related quality of life and morbidity burden from 18 months after diagnosis of prostate cancer: results of a UK-wide population-based outcome cohort (Support Care Cancer 2022)","url":"https://doi.org/10.1007/s00520-021-06650-7"}],"tags":["rejuvenation","survivorship","measurement","instruments"],"related":["rejuv-measure-epro-as-treatment","rejuv-access-survivorship-care-uk"],"cancers":["prostate","breast-hr-positive","colorectal","nsclc"],"sections":["rejuvenation","supportive-care"],"technologies":["rejuv-measure-patient-reported-outcomes","rejuv-measure-minimally-important-difference","rejuv-access-what-it-costs-uk","financial-navigation"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["quality-of-life","financial-toxicity"],"trials":[],"people":[],"bottlenecks":["b-patient-voice","b-drug-pricing","b-survivorship"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"principle":"A five-dimension, five-level descriptive system generates a health state; a country-specific value set derived from general population preference elicitation converts that state into a single cardinal index anchored at 1 for full health and 0 for dead, which multiplied by survival time yields quality-adjusted life years.","strengths":["One number, so treatments for different diseases can be compared and costed","The currency of health technology appraisal in most countries, so it decides what gets funded","Short, quick, and translated and valued in a large number of countries","Includes a direct self-rating on the visual analogue scale alongside the index"],"limitations":["No item captures fatigue, cognition, sexual function, fertility or fear of recurrence","Values come from the general public, not from people with the condition","Ceiling effects remain even in the five-level version","An intervention can help a survivor substantially without moving the index"],"since":1990},"route":"/technologies/rejuv-measure-eq-5d/","neighbours":{"technology":[{"id":"rejuv-access-survivorship-care-uk","kind":"technology","name":"After treatment in the UK: personalised care, and follow-up you lead yourself","route":"/technologies/rejuv-access-survivorship-care-uk/"},{"id":"rejuv-measure-epro-as-treatment","kind":"technology","name":"Asking people how they are, every week, as a treatment in its own right","route":"/technologies/rejuv-measure-epro-as-treatment/"},{"id":"financial-navigation","kind":"technology","name":"Financial toxicity and financial navigation","route":"/technologies/financial-navigation/"},{"id":"rejuv-measure-patient-reported-outcomes","kind":"technology","name":"How recovery is measured: the questionnaires behind the numbers","route":"/technologies/rejuv-measure-patient-reported-outcomes/"},{"id":"rejuv-measure-minimally-important-difference","kind":"technology","name":"What a difference has to be before a person would notice it","route":"/technologies/rejuv-measure-minimally-important-difference/"},{"id":"rejuv-access-what-it-costs-uk","kind":"technology","name":"What recovery costs in the UK, and what it does not","route":"/technologies/rejuv-access-what-it-costs-uk/"}],"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"section":[{"id":"rejuvenation","kind":"section","name":"Recovery & Rejuvenation","route":"/fronts/rejuvenation/"},{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"term":[{"id":"financial-toxicity","kind":"term","name":"Financial toxicity","route":"/terms/financial-toxicity/"},{"id":"quality-of-life","kind":"term","name":"Quality of life","route":"/terms/quality-of-life/"}],"bottleneck":[{"id":"b-patient-voice","kind":"bottleneck","name":"Patients lack understanding, navigation and agency","route":"/bottlenecks/b-patient-voice/"},{"id":"b-drug-pricing","kind":"bottleneck","name":"Prices and value","route":"/bottlenecks/b-drug-pricing/"},{"id":"b-survivorship","kind":"bottleneck","name":"Survivorship and late effects are neglected","route":"/bottlenecks/b-survivorship/"}]}}