Responsiveness of the EQ-5D to HADS-identified anxiety and depression

David K Whynes, The TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal smears) Group

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


RATIONALE: The use of generic measures of health-related quality of life enables cost effectiveness comparisons of different health care interventions to be made. Nevertheless, there exists a concern that generic instruments may be insufficiently sensitive to detect the differences or changes in outcome identified by condition-specific instruments. This paper compares the psychometric properties of the EQ-5D generic instrument with a widely used specific measure of distress, the Hospital Anxiety and Depression Scale (HADS). METHOD: The analysis was based on data obtained from a large sample of women (n = 3119) with low-grade cervical cytological abnormalities detected at routine screening. These women completed EQ-5D and HADS questionnaires at recruitment and at 12 months thereafter. We examined the strength of association between HADS-determined severity of distress and EQ-5D scores at recruitment and between changes in severity and in scores over time. RESULTS: A higher likelihood of HADS-identified anxiety and/or depression was associated with significantly lower EQ-5D index and visual analogue scores. Over time, the EQ-5D score rose significantly when the likelihood of an individual representing a HADS-defined anxiety and/or depression case decreased. CONCLUSION: We conclude that the EQ-5D has shown itself to be responsive to differing degrees of HADS-assessed distress, although generalization beyond the UK context requires further investigation.
Original languageEnglish
Pages (from-to)820-825
Number of pages6
JournalJournal of Evaluation in Clinical Practice
Issue number5
Publication statusPublished - 1 Oct 2009


  • adult
  • anxiety
  • depression
  • female
  • health status
  • humans
  • multicenter studies as topic
  • pain measurement
  • psychometrics
  • quality of life
  • questionnaires
  • severity of illness index
  • vaginal smears
  • young adult


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