Testing four cognition bolt-on items to the EQ-5D in a general Chinese population

Meixia Liao (), Hongyan Wu (), Zhihao Yang (), Yan Huang (), Mathieu F. Janssen (), Gouke Bonsel () and Nan Luo ()
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Meixia Liao: National University of Singapore
Hongyan Wu: Guizhou Medical University
Zhihao Yang: Guizhou Medical University
Yan Huang: Nanming Center for Disease Control and Prevention
Mathieu F. Janssen: Erasmus MC
Gouke Bonsel: EuroQol Research Foundation
Nan Luo: National University of Singapore

The European Journal of Health Economics, 2025, vol. 26, issue 3, No 5, 403-411

Abstract: Abstract Objectives This study aimed to evaluate the psychometric properties of four candidate cognition bolt-on items and their combinations to the EQ-5D-5L. Methods Four cognition items (concentration, memory, calculation, and learning) were developed as separate questionnaire items, and were administered with the standard EQ-5D-5L to 640 individuals in a general population survey in China. From the 4 items, 11 compound items were constructed, and the ‘worse level counts’ rule was used to calculate a compound item score. Psychometric performance of the cognition bolt-ons was assessed in terms of informativity, convergent validity, explanatory power, and discriminatory power. Results The tested four cognition bolt-on items improved the informativity, convergent validity, explanatory power, and discriminatory power of EQ-5D-5L, with calculation and learning yielding better psychometric performance. The compound bolt-on items that coverd a range of cognitive functions demonstrated superior psychometric performance compared to single-aspect bolt-on items, with those items covering calculation and learning resulting in better psychometric performance. Conclusion This study confirmed the validity of the tested cognition bolt-ons in a general Chinese population. It supported the use of a compound bolt-on item covering a range of cognitive functions such as the ability to calculate and learn.

Keywords: EQ-5D-5L; Cognition; Bolt-on (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1007/s10198-024-01714-x

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