Objectives. To evaluate the impact of adding a respiratory dimension (a bolt-on dimension) to the EQ-5D-5L health state valuations. Methods. Based on extensive regression and principal component analyses, 2 respiratory bolt-on candidates were formulated: R1, limitations in physical activities due to shortness of breath, and R2, breathing problems. Valuation interviews for the selected bolt-ons were performed with a representative sample from the Dutch general public using the standardized interview protocol and software of the EuroQol group. Hybrid models based on the combined time-tradeoff (TTO) and discrete choice experiment (DCE) data were estimated to assess whether the 5 levels of the respiratory bolt-on led to significant changes in utility values. Results. For each bolt-on candidate, slightly more than 200 valuation interviews were conducted. Mean TTO values and DCE choice probabilities for health states with a level 4 or 5 for the respiratory dimension were significantly lower compared with the same health states in the Dutch EQ-5D-5L valuation study without the respiratory dimension. Results of hybrid models showed that for the bolt-on ‘‘limitations in physical activities,’’ the utility decrements were significant for level 3 (–0.055), level 4 (–0.087), and level 5 (–0.135). For ‘‘breathing problems,’’ the utility decrements for the same levels were greater (–0.086, –0.219, and –0.327, respectively). Conclusions. The addition of each of the 2 respiratory bolt-ons to the EQ-5D-5L had a significant effect on the valuation of health states with severe levels for the bolt-on. The bolt-on dimension ‘‘breathing problems’’ showed the greatest utility decrements and therefore seems the most appropriate respiratory bolt-on dimension.

Additional Metadata
Keywords Q-5D, respiratory symptoms, bolt-on, valuation study, pilot
Persistent URL dx.doi.org/10.1177/0272989X19847983, hdl.handle.net/1765/122622
Journal Medical Decision Making: an international journal
Citation
Hoogendoorn, M., Oppe, M, Boland, M., Goossens, L.M.A, Stolk, E.A, & Rutten-van Mölken, M.P.M.H. (2019). Exploring the Impact of Adding a Respiratory Dimension to the EQ-5D-5L. Medical Decision Making: an international journal, 39(4), 393–404. doi:10.1177/0272989X19847983