Abstract
Background
Despite the growing importance of the EQ-5D descriptive system as a basis for the valuation of QALYs in cost-utility analysis, for most countries, there are no EQ-5D value sets. Researchers and policy makers wishing to use the EQ-5D descriptive system in a country for which there is no value set are advised to use one from a nearby or ‘similar’ population. Factors other than geographic proximity can affect the relative values of EQ-5D states.
Objective
This study explores the links between national culture and EQ-5D value sets.
Method
Rank correlation analysis is used to explore relationships between the relative values of a set of EQ-5D states and dimensions of national culture. The latter are taken from Hofstede’s framework which operationalizes national culture in five dimensions.
Results
For the data currently available (countries for which EQ-5D value sets and scores on dimensions of culture both exist), moderate and strong correlations were found between the culture dimension of power distance and individualism and the EQ-5D dimensions of pain/discomfort and anxiety/depression. Moderate correlations were also observed between the cultural dimension of masculinity and the EQ-5D dimensions of self care, usual activities and pain/discomfort. Uncertainty avoidance correlates with the EQ-5D dimension of anxiety/depression.
Discussion
The correlation patterns observed are generally consistent with a priori expectations based on the nature of the dimensions of culture and the EQ-5D model. This analysis demonstrates the potential of national culture in providing insight into the drivers of the relative values of EQ-5D dimensions for different countries and in informing decisions about which EQ-5D value sets to use in situations where one does not exist.
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Notes
This extends to serious illness. Article: in some cultures, cancer stirs shame—Wall Street Journal, October 4th 2008.
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Bailey, H., Kind, P. Preliminary findings of an investigation into the relationship between national culture and EQ-5D value sets. Qual Life Res 19, 1145–1154 (2010). https://doi.org/10.1007/s11136-010-9678-5
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DOI: https://doi.org/10.1007/s11136-010-9678-5