Evidence map›Paper›PMID 34628587›Full record

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

Inequality and heterogeneity in health-related quality of life: findings based on a large sample of cross-sectional EQ-5D-5L data from the Swedish general population.

Fitsum Sebsibe Teni, Ulf-G Gerdtham, Reiner Leidl, Martin Henriksson, Mimmi Åström, Sun Sun, Kristina Burström

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 43 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed, 2 pooled it
–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

43 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Patient-reported outcome measures within European cohorts of severely injured patients: a systematic review and meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026
    Pooled it
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  5. Socioeconomic inequalities in health-related quality of life during the COVID-19 pandemic: a six-country comparison using the EQ-5D-5 L.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026
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  15. Measuring inequality in quality of life: Why the EQ-5D may underestimate it.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025
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  17. Population norms for the EQ-5D-5L for Hungary: comparison of online surveys and computer assisted personal interviews.The European journal of health economics : HEPAC : health economics in prevention and care · 2025
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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

7 authors.

Fitsum Sebsibe TeniHealth Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18a, 171 77, Stockholm, Sweden.ORCID https://orcid.org/0000-0002-6182-499X
Ulf-G GerdthamDepartment of Economics, Lund University, Lund, Sweden.ORCID http://orcid.org/0000-0002-0647-7817
Reiner LeidlInstitute for Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.ORCID http://orcid.org/0000-0002-7115-7510
Martin HenrikssonCenter for Medical Technology Assessment, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.ORCID http://orcid.org/0000-0003-1699-3185
Mimmi ÅströmHealth Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18a, 171 77, Stockholm, Sweden.ORCID http://orcid.org/0000-0002-6711-5262
Sun SunHealth Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18a, 171 77, Stockholm, Sweden.ORCID http://orcid.org/0000-0001-5948-3025
Kristina BurströmHealth Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18a, 171 77, Stockholm, Sweden. kristina.burstrom@ki.se.ORCID http://orcid.org/0000-0001-9996-4317

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aimed to investigate inequality and heterogeneity in health-related quality of life (HRQoL) and to provide EQ-5D-5L population reference data for Sweden.

methodsBased on a large Swedish population-based survey, 25,867 respondents aged 30‒104 years, HRQoL is described by sex, age, education, income, economic activity, health-related behaviours, self-reported diseases and conditions. Results are presented by EQ-5D-5L dimensions, respondents rating of their overall health on the EQ visual analogue scale (EQ VAS), VAS index value and TTO (time trade-off) index value allowing for calculation of quality-adjusted life years (QALYs). Ordinary Least Squares and multivariable logistic regression analyses were used to study inequalities in observed EQ VAS score between socioeconomic groups and the likelihood to report problems on the dimensions, respectively, adjusted for confounders.

resultsIn total, 896 different health states were reported; 24.1% did not report any problems. Most problems were reported with pain/discomfort. Women reported worse HRQoL than men, and health deteriorated with age. The strongest association between diseases and conditions and EQ VAS score was seen for depression and mental health problems. There was a socioeconomic gradient in HRQoL; adjusting for health-related behaviours, diseases and conditions slightly reduced the differences between educational groups and income groups, but socioeconomic inequalities largely remained.

conclusionEQ-5D-5L population reference (norms) data are now available for Sweden, including socioeconomic differentials. Results may be used for comparisons with disease-specific populations and in health economic evaluations. The observed socioeconomic inequality in HRQoL should be of great importance for policy makers concerned with equity aspects.

Indexed as

Health StatusQuality of LifeAdultAgedAged, 80 and overCross-Sectional StudiesFemaleHumansMaleMiddle AgedSurveys and QuestionnairesSwedenEQ-5D-5LGeneral populationInequalities in health statusReference dataSocioeconomic groupSweden

Identifiers

PMID34628587
PMCPMC8921093

What OpenQuestion holds

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LicenceCC BY
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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.