Comparing Psychometric Properties of 6 of the 5-Level and 3-Level EQ-5D Bolt-Ons in a Large, Multinational, Longitudinal General Population Sample
Bibliographic record
Abstract
OBJECTIVES: This study systematically compared the psychometric properties of 6 of the 5-level and 3-level EQ-5D bolt-ons (vision, breathing, tiredness, sleep, social relationships, and self-confidence). METHODS: Population Norms Study (POP-UP) is a longitudinal survey collecting general population data from United States, Canada, United Kingdom, Italy, Spain, Germany, the Netherlands, and Belgium. Respondents entered demographics and health conditions data and completed the EQ-5D-5L/3L with bolt-ons, Myasthenia Gravis Activities of Daily Living (MG-ADL), and Health Utility Index-3 (HUI-3). Psychometric properties included ceiling/floor, informativity, divergent and convergent validity, reliability, known-groups validity, and responsiveness. RESULTS: A total of 9,758 respondents completed the survey in 2021, and 4,839 respondents in 2023. The 5-level bolt-ons reduced ceiling effects by 35% and floor effects by 55% compared with the 3-level, with the largest reductions for vision and sleep (42%/57%) and the smallest for breathing (29%/44%). Informativity was higher for the 5-level bolt-ons (3%-11%) than 3-level (2%-9%), except for breathing (-2%). Most bolt-ons showed weak to moderate correlations with EQ-5D dimensions, except for social relationships, which correlated strongly with anxiety/depression (r = 0.61). Both measures showed strong convergent validity for breathing (5-level r = 0.68; 3-level r = 0.66) and lower for vision (5-level r = 0.37; 3-level r = 0.32). EQ-5D + 5-level and EQ-5D-5L + 3-level bolt-ons had excellent reliability (Intraclass Correlation Coefficients = 0.92-0.97). Adding bolt-ons did not significantly improve known-groups validity, except for breathing (relative efficiency EQ-5D + 5-level = 1.12; EQ-5D-5L + 3-level = 1.10). The 5-level bolt-ons improved responsiveness, detecting 47.1% more improvements and 55.7% more worsening over time. CONCLUSIONS: All 6 of the 5-level EQ-5D bolt-ons outperformed the 3-level bolt-ons by reducing ceiling and floor, enhancing informativity, demonstrating divergent validity, and improving responsiveness.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".