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.
Related Scores in Practice
In clinical practice, this assessment is frequently evaluated alongside other validated measures. Depending on the patient's presentation and specific diagnostic requirements, you may also need to utilize the Sf 36, Promis Global Health, Whoqol Bref, or the Euroqol Visual Analog Scale to formulate a comprehensive care plan.
Last Comprehensive Review: 2026