ArticleQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation2026
Population norms for the EQ-5D-3L and EQ-5D-5L in Peninsular Malaysia.
Article in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposePopulation norms for preference-based health-related quality of life (HRQoL) instruments provide essential reference data for burden-of-disease assessments, economic evaluations, and quality-adjusted life year (QALY) calculations. Although Malaysian EQ-5D value sets are available, population norms have not been established. This study aimed to establish the first population norms for the EQ-5D-3L and EQ-5D-5L in Peninsular Malaysia, compare their distributional characteristics, and identify factors associated with HRQoL.
methodsWe conducted a cross-sectional study among 1,137 adults aged 18 years or older across eight locations in four regional clusters of Peninsular Malaysia. Quota-based sampling was stratified by urbanicity, sex, age, and ethnicity. Participants completed the EQ-5D-5L, EQ-5D-3L, and EQ visual analogue scale (EQ VAS). We calculated index scores using Malaysian value sets and constructed survey weights using iterative proportional fitting to the 2020 Malaysian census. We estimated population norms overall and by sociodemographic strata. Multivariable regression analyses identified factors independently associated with HRQoL.
resultsThe weighted mean EQ-5D-5L index score was 0.919 (SD 0.105), the EQ-5D-3L index score was 0.945 (SD 0.090), and the EQ VAS score was 85.4 (SD 12.5). The ceiling effect was substantially lower for the EQ-5D-5L than for the EQ-5D-3L (44.4% vs. 68.5%), with 96 and 29 unique health profiles observed, respectively. Pain/discomfort and anxiety/depression were the most frequently reported problems. Older age, unemployment, rural residence, and doctor-diagnosed disease were associated with lower HRQoL.
conclusionThis study provides the first population norms for the EQ-5D-3L and EQ-5D-5L in Peninsular Malaysia. These norms serve as essential reference values for clinical research, economic evaluations, and health policy decision-making.
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