Evidence map›Paper›PMID 30397508›Full record

ArticlePilot and feasibility studies2018

The feasibility of using the EQ-5D-3L with adults with mild to moderate learning disabilities within a randomized control trial: a qualitative evaluation.

A M Russell, J L O'Dwyer, L D Bryant, A O House, J C Birtwistle, S Meer, A Wright-Hughes, R E A Walwyn, E Graham, A J Farrin and 1 more

Open access · goldAbstract read
In one paragraph

Article in Pilot and feasibility studies, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.

  1. Pooled it
  2. Aphasia-specific or generic outcomes? a comparison of two health-related quality of life instruments for economic evaluations of aphasia treatments.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025
    Trial
  3. Comparing the measurement properties of the EQ-5D-Y-3L and EQ-5D-3L in a general population sample of adults.The European journal of health economics : HEPAC : health economics in prevention and care · 2026
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

A M Russell1Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
J L O'Dwyer1Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
L D Bryant1Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.ORCID 0000-0002-1972-7395
A O House1Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
J C Birtwistle1Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
S Meer1Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
A Wright-Hughes1Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
R E A Walwyn1Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
E Graham1Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
A J Farrin2Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.
C T Hulme1Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
University of Leeds · GB

Funding

Department of Health 10/102/03
6 · The paper itself

Abstract

backgroundIn trials incorporating a health economic evaluation component, reliable validated measures for health-related quality of life (HRQOL) are essential. The EQ-5D is the preferred measure for cost-effectiveness analysis in UK trials. This paper presents a qualitative evaluation of the use of the EQ-5D-3L in a feasibility randomised control trial with participants who had a mild- to  moderate learning disability and type 2 diabetes.

methodsResearchers administered the EQ-5D-3L to 82 participants at baseline and 77 at follow-up. After each interview, researchers rated the ease of administering the EQ-5D-3L and made free-text entries on the administration experience. For a subset of 16 interviews, researchers audio-recorded more detailed journal entries. Ease of administration data were analysed using descriptive statistics. Free-text responses were subject to a basic content analysis. The EQ-5D-3L-related journal entries were transcribed, coded and analysed thematically.

resultsOver half of participants were perceived to experience difficulty answering some or all of the items in the EQ-5D-3L (60% at baseline; 54% at follow-up). Analysis of the free-text entries and audio journals identified four themes that question the use of the EQ-5D-3L in this population. The first theme is related to observations of participant intellectual ability and difficulties, for example, in understanding the wording of the measure. Theme 2 is related to the normalisation of adjustments for impairments, which rendered the measure less sensitive in this population. Theme 3 is related to researcher adaptation and non-standard administration. An overarching fourth theme was identified in that people with learning disabilities were viewed as 'unreliable witnesses' by both researchers and supporters.

conclusionsIt is recommended that the EQ-5D-3L should not be used in isolation to assess health-related quality of life outcomes in trials research in adults with a learning disability. Further research is required to develop and evaluate a version of the EQ-5D appropriate for this population in trials research. It is unrealistic to expect that adjustments to the wording alone will deliver an appropriate measure: supporter or researcher involvement will almost always be required. This requirement needs to be factored into the development and administration guidelines of any new version of the EQ-5D for adults with a learning disability.

trial registrationCurrent Controlled Trials ISRCTN41897033 [registered 21 January 2013].

Indexed as

DiabetesEconomic evaluationEQ-5D-3LLearning disability

Identifiers

PMID30397508
PMCPMC6205783
OpenAlexW2898662076

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.