ArticleQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation2026
Testing culturally relevant EQ-5D-5L bolt-ons for the Chinese general population: first quantitative phase of a mixed methods study.
Article in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Validity and responsiveness of the EQ-5D-5L, EQ-HWB and EQ-HWB-9 to measure health and wellbeing impact of heatwaves among older adults.Health and quality of life outcomes · 2026Article
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6 authors.
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Abstract
objectiveAs part of a large mixed-methods study, we aim to develop culturally relevant additional dimensions (bolt-ons) for the EQ-5D-5L in China. In the qualitative phase, we developed seven candidate bolt-ons. In this first quantitative phase, we aimed to test the psychometric properties of these bolt-ons in the Chinese adult general population.
methodsAn online survey was conducted among a representative sample of the Chinese general population (n = 1,037) to collect data on the EQ-5D-5L + bolt-ons, SF-6Dv2, EQ-HWB-9, general health status, and socio-demographics. Psychometric analysis was performed to assess the EQ-5D-5L + bolt-ons, including ceiling, informativity, convergent and divergent validity, known-group validity and explanatory power.
resultsAdding bolt-ons reduced the ceiling of the EQ-5D-5L by 2.3%-points (adaptation to society) to 7.6%-points (tiredness/lack of strength). Tiredness/lack of strength had the highest relative informativity (Shannon's evenness index = 0.67). Appetite and social relationships showed the best divergent validity from the five core dimensions. Tiredness/lack of strength demonstrated strong or moderate correlations with SF-6Dv2 vitality (r = 0.648) and EQ-HWB-9 exhaustion (r = 0.541) dimensions. Adding tiredness/lack of strength, climate adaptation and emotional control improved the explanatory power for the EQ VAS score. Tiredness/lack of strength enhanced the known-groups validity for differentiating between respondents based on the presence of chronic diseases and in group comparisons by SF-6Dv2 level sum scores.
conclusionThe tiredness/lack of strength bolt-ons performed best, but the sleep problems and appetite bolt-ons also improved several psychometric properties of the EQ-5D-5L in the Chinese general population. Combined with patient evidence, these findings may inform evidence-based bolt-on selection in the Chinese context.
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