5LFive-Level EQ-5D Health State Assessment
Health Dimensions
Visual Analog Scale — Health Today
0 = worst health imaginable · 100 = best health imaginable
0100
100
Health Profile
Complete all five health dimensions and the visual analog scale to generate your EQ-5D assessment.
Guidelines & Evidence
Verified
Last Review: 2026
When to Use
What the EQ-5D Measures
The EQ-5D measures self-reported health status or health-related quality of life (HRQoL) across five dimensions: Mobility, Self-Care, Usual Activities, Pain/Discomfort, and Anxiety/Depression. It is a "generic" measure, meaning it can be compared across different types of patients, disease areas, treatments, and populations. The instrument generates three distinct types of data: (1) the EQ-5D profile (five-digit health state description), (2) the EQ Visual Analog Scale (EQ VAS, 0-100 overall health rating), and (3) EQ-5D index values (preference-weighted scores anchored at 1=full health, 0=dead, with negative values possible for states worse than dead).
Primary Clinical and Research Applications
Clinical trials – Primary or secondary endpoint to assess treatment impact on HRQoL; required by FDA/EMA for labeling claims of new drugs and devices
Economic evaluation (cost-utility analysis) – Calculation of quality-adjusted life years (QALYs) for cost-effectiveness analysis; preferred instrument by NICE (UK), ZIN (Netherlands), CADTH (Canada), and other HTA bodies
Population health surveys – Monitoring population health trends, health inequalities, and disease burden (e.g., National Health Interview Survey, Health Survey for England)
National quality registries – Comparing outcomes across providers; risk adjustment for case mix (e.g., Norwegian Rehabilitation Register, Swedish Quality Registers, English NHS PROMs program for hip/knee replacement)
Routine clinical practice – Individual patient monitoring of HRQoL over time; identifying problems in dimensions not otherwise captured (pain, anxiety, functional limitations)
Rehabilitation assessment – Measuring change from admission to discharge in inpatient and outpatient rehabilitation settings; validated across multiple diagnostic groups (stroke, brain injury, amputation, neurologic disorders, musculoskeletal conditions)
Resource allocation and priority setting – Informing coverage decisions, formulary placement, and disinvestment strategies
EQ-5D-3L vs EQ-5D-5L Comparison
| Feature | EQ-5D-3L | EQ-5D-5L | EQ-5D-Y (Youth) |
|---|---|---|---|
| Number of levels per dimension | 3 (no problems, some problems, extreme problems/unable to) | 5 (no, slight, moderate, severe, extreme/unable to) | 3 (similar to 3L, child-friendly wording) |
| Number of possible health states | 243 (3⁵) | 3,125 (5⁵) | 243 (3⁵) |
| Dimensions | Mobility, Self-care, Usual activities, Pain/discomfort, Anxiety/depression | Same 5 dimensions | Same 5 dimensions, adapted wording |
| Recall period | "Today" (descriptive system); no explicit recall for VAS | Same | Same |
| Age range | Adults (≥18 years) | Adults (≥18 years) | Children and youth (typically 8-15 years, but up to 18) |
| Value sets available | Multiple countries (UK, US, Germany, Japan, etc.) | Growing number of countries (UK, US, Netherlands, Canada, Japan, etc.); UK value set mapped from 3L | Limited number (e.g., England, Germany, Japan) |
| Psychometric advantages | Simpler, faster, less cognitive burden | Greater precision, fewer ceiling effects (better discrimination at "no problems" end), higher responsiveness | Child-appropriate language and examples; can be self- or proxy-reported |
| Year introduced | 1990 (original), revised 1997 | 2011 | 2010 |
EQ-5D-5L Rehabilitation Validation Study (Garratt et al. 2024) – Key Findings
Study: Multicenter observational study of 1,167 inpatients receiving specialized rehabilitation in Norway (5 facilities, stroke/brain injury 33%, neurologic/neuromuscular 26%, complex disorders 16%). Mean age: 56.1 years (range 18-91). Female: 43%. Key findings:
• Construct validity supported: As hypothesized, poorer scores were associated with more secondary diagnoses, admission from secondary care (vs home), and need for help completing the questionnaire.
• Responsiveness: Statistically significant improvements (P<.01) in all dimensions, EQ-5D-5L index (mean change 0.16, SD 0.26), and EQ VAS (mean change 11.73, SD 18.42) – exceeding minimal important difference estimates.
• Score distributions: At admission, rehabilitation patients had 550 different health states vs 156 in age/sex-matched general population; only 2.9% had full health (11111) vs 32.9% of general population.
• Help with completion: 44% of patients required assistance (explaining, reading, checking boxes), associated with poorer health on mobility, self-care, and usual activities – indicating trained staff appropriately identified patients needing support.
• Conclusion: EQ-5D-5L is valid and responsive in specialized rehabilitation settings; supports use in national quality registries.
Last Comprehensive Review: 2026