General population norms for the EQ-5D-3 L in Norway: comparison of postal and web surveys

Health Qual Life Outcomes. 2018 Oct 19;16(1):204. doi: 10.1186/s12955-018-1029-1.


Background: The EQ-5D-3 L instrument is a standardized questionnaire which was developed as a simple, generic measure of health for clinical and economic appraisal. To aid in the interpretation, scores are often compared with a normative group. The objectives of this study were 1) to provide population norms for the EQ-5D-3 L for Norway, and 2) to compare scores from postal and web surveys.

Methods: We conducted two surveys in samples that were aimed to be representative of the Norwegian general population: 1) a postal survey (n = 5000) and 2) a panel study with electronic data collection (n = 1936). For scoring the EQ-5D Index, we used the UK tariff. EQ-5D items were compared using multivariable ordinal logistic regression analysis and EQ-5D Index and EQ VAS scores using multivariable linear regression, adjusting for age, sex and education.

Results: In total 1131 (22.6%) responded to the postal survey and 977 (50.5%) to the web survey. The odds ratio (OR) for being in a higher score category on the Pain/Discomfort scale in the web survey was 1.25 (95%CI 1.04 to 1.50, p = 0.019) relative to the postal survey. The odds were similar in the other four dimensions. The EQ-5D Index and EQ VAS scores were similar in the postal and web surveys in the various strata according to age, sex and education, except for lower unadjusted and adjusted score for web respondents aged 41-50 years and for those with higher education (≥14 years) than postal respondents.

Conclusions: The distribution of scores for the EQ-5D descriptive system and its derived utility scores were rather similar in a postal survey and a panel web survey. Hence, these values were combined into a norm set for Norway.

Keywords: EQ VAS; EQ-5D; EQ-5D index; General population; Health-related quality of life; Population norms; Postal survey; Utility; Web survey.

MeSH terms

  • Adult
  • Aged
  • Female
  • Health Status
  • Health Surveys / methods*
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Norway
  • Pain Measurement
  • Quality of Life*
  • Reference Values
  • Young Adult