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Differential item functioning in the EQ-5D: An exploratory analysis using anchoring vignettes

Listed author(s):
  • Knott, R.
  • Lorgelly, P.
  • Black, N.
  • Hollingsworth, B.

Inter-group comparisons using the EQ-5D, or any self-reported measure of health, rely on the measure being an accurate reflection of the true health of the groups or individuals concerned. However, responses to questions on subjective scales, such as those used in the EQ-5D, will be inaccurate if groups of individuals systematically differ in their use of the response categories, a phenomenon known as differential item functioning(DIF). This paper reports on an exploratory analysis involving the use of anchoring vignettes to identify differential item functioning (DIF) in the EQ-5D-5L. We demonstrate that using vignettes to appropriately identify DIF in EQ-5D reporting is possible, at least in certain age groups. We find that the EQ-5D is indeed subject to DIF, and that failure to account for DIF can lead to conclusions that are misleading when using the instrument to compare health or quality of life across heterogeneous groups. For instance, when adjusting for DIF in a sample aged 55-65 years, we found that differences between the highest and lowest education groups doubled in value afteradjusting for DIF, and increased from quantities that would not have had relevance in a clinical settings to ones that would (based on a suggested minimally important difference). Thus, our research provides evidence that the EQ-5D should be used with caution when comparing health or quality of life across heterogeneous groups. We also provide several important insights in terms of the identifying assumptions of response consistency and vignette equivalence.

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Paper provided by HEDG, c/o Department of Economics, University of York in its series Health, Econometrics and Data Group (HEDG) Working Papers with number 16/14.

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Date of creation: Aug 2016
Handle: RePEc:yor:hectdg:16/14
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Web page: https://www.york.ac.uk/economics/postgrad/herc/hedg/
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  1. Franco Peracchi & Claudio Rossetti, 2013. "The heterogeneous thresholds ordered response model: identification and inference," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 176(3), pages 703-722, 06.
  2. Arie Kapteyn & James P. Smith & Arthur van Soest, 2007. "Vignettes and Self-Reports of Work Disability in the United States and the Netherlands," American Economic Review, American Economic Association, vol. 97(1), pages 461-473, March.
  3. Arie Kapteyn & James P. Smith & Arthur Van Soest, 2013. "Are A mericans Really Less Happy with Their Incomes?," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 59(1), pages 44-65, 03.
  4. Nancy Devlin & Paul Krabbe, 2013. "The development of new research methods for the valuation of EQ-5D-5L," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(1), pages 1-3, July.
  5. Hendrik Jürges & Joachim Winter, 2013. "Are Anchoring Vignettes Ratings Sensitive To Vignette Age And Sex?," Health Economics, John Wiley & Sons, Ltd., vol. 22(1), pages 1-13, 01.
  6. Viola Angelini & Danilo Cavapozzi & Luca Corazzini & Omar Paccagnella, 2014. "Do Danes and Italians Rate Life Satisfaction in the Same Way? Using Vignettes to Correct for Individual-Specific Scale Biases," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 76(5), pages 643-666, October.
  7. Teresa Bago d’Uva & Maarten Lindeboom & Owen O’Donnell & Eddy van Doorslaer, 2011. "Slipping Anchor?: Testing the Vignettes Approach to Identification and Correction of Reporting Heterogeneity," Journal of Human Resources, University of Wisconsin Press, vol. 46(4), pages 875-906.
  8. Teresa Bago d'Uva & Eddy Van Doorslaer & Maarten Lindeboom & Owen O'Donnell, 2008. "Does reporting heterogeneity bias the measurement of health disparities?," Health Economics, John Wiley & Sons, Ltd., vol. 17(3), pages 351-375.
  9. Bertoni, Marco, 2015. "Hungry today, unhappy tomorrow? Childhood hunger and subjective wellbeing later in life," Journal of Health Economics, Elsevier, vol. 40(C), pages 40-53.
  10. Dolan, Paul & Kavetsos, Georgios & Tsuchiya, Aki, 2013. "Sick but satisfied: The impact of life and health satisfaction on choice between health scenarios," Journal of Health Economics, Elsevier, vol. 32(4), pages 708-714.
  11. Kristensen, Nicolai & Johansson, Edvard, 2008. "New evidence on cross-country differences in job satisfaction using anchoring vignettes," Labour Economics, Elsevier, vol. 15(1), pages 96-117, February.
  12. Jones, Andrew M. & Rice, Nigel & Robone, Silvana & Dias, Pedro Rosa, 2011. "Inequality and polarisation in health systems' responsiveness: A cross-country analysis," Journal of Health Economics, Elsevier, vol. 30(4), pages 616-625, July.
  13. Nancy J. Devlin & David Parkin & John Browne, 2010. "Patient‐reported outcome measures in the NHS: new methods for analysing and reporting EQ‐5D data," Health Economics, John Wiley & Sons, Ltd., vol. 19(8), pages 886-905, August.
  14. Richard Norman & Paula Cronin & Rosalie Viney, 2013. "A Pilot Discrete Choice Experiment to Explore Preferences for EQ-5D-5L Health States," Applied Health Economics and Health Policy, Springer, vol. 11(3), pages 287-298, June.
  15. Teresa Bago d'Uva & Maarten Lindeboom & Owen O'Donnell & Eddy van Doorslaer, 2011. "Education‐related inequity in healthcare with heterogeneous reporting of health," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 174(3), pages 639-664, 07.
  16. Van de Poel, Ellen & Van Doorslaer, Eddy & O’Donnell, Owen, 2012. "Measurement of inequity in health care with heterogeneous response of use to need," Journal of Health Economics, Elsevier, vol. 31(4), pages 676-689.
  17. Teresa Molina, 2016. "Reporting Heterogeneity and Health Disparities Across Gender and Education Levels: Evidence From Four Countries," Demography, Springer;Population Association of America (PAA), vol. 53(2), pages 295-323, April.
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