Exploration of visual analogue scale versions with the EQ-HWB-9 to measure health, social care, and carer-related quality of life: a VASt landscape.

purposeVisual analog scales (VAS) serve as brief, informative patient reported outcome measures. The EQ VAS is an important component of EQ-5D instruments but is not currently included in the EQ-HWB-9. This study qualitatively assessed perceptions of alternative VAS constructs and recall periods for potential inclusion alongside the EQ-HWB-9 and quantitatively examined VAS ratings.

methodsUS adults who were: (1) diagnosed with chronic illness; (2) unpaid caregivers; (3) social care users (e.g., received caregiving, living with disability) completed an online survey and interview where they assessed VAS versions with health, health and wellbeing (HWB), and/or quality of life (QoL), as the specified construct. Participants discussed construct interpretation, appropriateness of recall periods (none, today, past 7 days), and whether these influenced their responses. Interviews were analyzed qualitatively through thematic analysis.

resultsAmong 34 participants, mean (SD) responses for health, HWB, and QoL were 61.9 (SD = 21.3), 60.9 (SD = 21.8) and 66.4 (SD = 21.5), respectively. All three VAS items were strongly correlated (r = 0.84-0.96). Interpretations of health focused on clinical, physical health more than mental/emotional health, HWB indicated mental/emotional health, and QoL evoked broader assessments encompassing finances or social-relationships. Most participants preferred having no specified recall period, allowing consideration of timeframes relevant to their experiences.

conclusionAlthough quantitative results suggested that the constructs of health, HWB, and QoL were similar, qualitative results found that they were perceived differently, highlighting the importance of a mixed-methods approach. Further research in larger samples and other countries could help to inform the extent to which constructs and recall periods affect VAS responses.