A comparative study of health and wellbeing measures in Ireland using EQ-HWB, EQ-HWB-S, EQ-5D-5L, and ICECAP-A

Abstract

Objectives: The EQ Health and Wellbeing (EQ-HWB) is a new experimental measure of health and wellbeing, having been validated in an increasing number of countries and languages. This study aims to examine the psychometric properties of the EQ-HWB and its short version (EQ-HWB-S) in Ireland and compare them to the EQ-5D-5L and ICECAP-A. Methods: A secondary analysis of cross-sectional data from a 2023 Irish general population survey (n=1220). The survey included the EQ-HWB, EQ-5D-5L, ICECAP-A, and socioeconomic and health-related questions. EQ-HWB-S responses were derived from the EQHWB. The UK or Irish value sets were used for each measure to compute index values. Ceiling effects, convergent, divergent validity, known-group validity were assessed, exploratory factor analysis was conducted. Results: Mean index values were 0.755, 0.760-0.830, and 0.807 for the EQ-HWB-S, EQ-5D5L, and ICECAP-A, respectively. Ceiling effects were 3%, 7%, 23%, and 15% for EQ-HWB, EQ-HWB-S, EQ-5D-5L, and ICECAP-A. EQ-HWB-S index values correlated strongly with EQ-5D-5L (r=0.740-0.759) and ICECAP-A (r=0.604) index values. All measures demonstrated good known-group validity for health-related variables, with EQ-5D-5L performing best overall. Factor analysis identified five factors: psychosocial health, pain and discomfort, sensory and physical functioning, capability wellbeing, and positive psychological states. Stability was the only ICECAP-A item that loaded on the same factor (psychosocial health) as any EQ-HWB items. Conclusion: This is the first study to compare the measurement performance of EQ-HWB, EQ-HWB-S with ICECAP-A. The EQ-HWB and EQ-HWB-S showed good psychometric performance in an Irish population sample. Limited overlap was observed between EQ-HWB and ICECAP-A wellbeing concepts.