Evidence map›Paper›PMID 34236579›Full record

ArticleQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation2022

Combining EQ-5D-5L items into a level summary score: demonstrating feasibility using non-parametric item response theory using an international dataset.

You-Shan Feng, Ruixuan Jiang, A Simon Pickard, Thomas Kohlmann

Abstract read
In one paragraph

Article in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed
–field-weighted citation impact
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

28 citing papers in PubMed.

  1. Efficacy of a brief psychological intervention for adolescents with recent suicide attempt: A randomized clinical trial.European psychiatry : the journal of the Association of European Psychiatrists · 2025
    Trial
  2. Observational
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  7. Psychometric validation of a cognition and social participation bolt-on for the EQ-5D-5L in SARS-CoV-2 infected German healthcare workers.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026
    Article
  8. 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
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  19. Validation of the EQ-5D-Y-5L parent-proxy version among children with juvenile idiopathic arthritis.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024
    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

4 authors.

You-Shan FengInstitute for Clinical Epidemiology and Applied Biometrics, Medical University of Tübingen, Silcherstraße 5 72076, Tübingen, Germany. you-shan.feng@med.uni-tuebingen.de.ORCID http://orcid.org/0000-0003-1509-3409
Ruixuan JiangCenter for Observational and Real-World Evidence, Merck & Co, Kenilworth, NJ, USA.
A Simon PickardCollege of Pharmacy, University of Illinois At Chicago, Chicago, IL, USA.
Thomas KohlmannInstitute for Community Medicine, University of Greifswald, Greifswald, Germany.

Funding

EuroQol Research Foundation EQ Project 20170130
6 · The paper itself

Abstract

backgroundThe EQ-5D-5L is a well-established health questionnaire that estimates health utilities by applying preference-based weights. Limited work has been done to examine alternative scoring approaches when utility weights are unavailable or inapplicable. We examined whether the Mokken scaling approach can elucidate 1) if the level summary score is appropriate for the EQ-5D-5L and 2) an interpretation of such a score.

methodsThe R package "mokken" was used to assess monotonicity (scaling coefficients H, automated item selection procedure) and manifest invariant item ordering (MIIO: paired item response functions [IRF], H

resultsWhile all EQ-5D-5L items demonstrated monotonicity, the anxiety/depression (AD) item had weak scalability (H DISCUSSION: The 5 items of the EQ-5D-5L form a moderate to strong Mokken scale, enabling persons to be ordered using the level summary score. Item ordering suggests that the lower range of the score represents mainly problems with pain and anxiety/depression, the mid-range indicates additional problems with mobility and usual activities, and middle to higher range of scores reveals additional limitations with self-care. Scalability and item ordering are even stronger when the anxiety/depression item is not included in the scale.

Indexed as

DepressionQuality of LifeFeasibility StudiesHumansPsychometricsSurveys and QuestionnairesEQ-5D-5LMokken scalingNon-economic scoring approachesNon-parametric item response theoryUnweighted summary score

Identifiers

PMID34236579
PMCPMC8800896

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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.