EQ-5D
A brief, generic health-related quality-of-life instrument applicable across conditions.
By Claire White
- Self-completed. It takes a few minutes.
- Five dimensions: mobility, self-care, usual activities, pain or discomfort, and anxiety or depression.
- Each dimension is rated at one of five levels in the EQ-5D-5L, which gives 3,125 possible health states.
- An EQ VAS rates health today from 0 to 100.
- Published by the EuroQol Group.
What does the EQ-5D measure?
The EQ-5D describes health across five dimensions: mobility, self-care, usual activities, pain or discomfort, and anxiety or depression. In the EQ-5D-5L each dimension is rated at one of five levels, which gives 3,125 possible health states. A second part, the EQ VAS, asks the person to mark how good or bad their health is today on a line running from 0 to 100.
| Level | Label |
|---|---|
| 1 | No problems |
| 2 | Slight problems |
| 3 | Moderate problems |
| 4 | Severe problems |
| 5 | Extreme problems |
The point of a generic instrument is comparison. Because the EQ-5D carries no condition-specific content, a score from someone with epilepsy sits on the same scale as a score from someone after spinal surgery, which is what health technology assessment needs and what a disease-specific questionnaire cannot give.
What does an EQ-5D score mean?
The five-digit profile is the primary result. It can be summarised into a single index value using a value set, which is a table of general-population preferences for each health state. Those weights are what turn the profile into the quality-adjusted life years used in health economic evaluation.
There are no published severity bands for the index. What is fixed are the two anchors: 1 is full health, and 0 is a state judged equivalent to being dead. Values below 0 are part of the scale and describe states judged worse than dead, so an index is not a 0 to 1 number. Value sets are national or regional and differ from each other, so the value set used has to be reported alongside the score.
The EQ VAS is read separately, as the person's own global rating of health today. It is reference information for the care team, tracked over time.
How the EQ-5D is administered
- Administered by
- Designed for self-completion. Also used in face-to-face and telephone interviews, and proxy versions exist where self-completion is not possible.
- Time to administer
- A few minutes
- Equipment
- The questionnaire, on paper or in a digital version
- Cost
- Free to take here.
- Published by
- EuroQol Group
- Registration required
- Yes, with the EuroQol Group, for anyone administering the questionnaire themselves
- Age range
- Adults for the EQ-5D-3L and EQ-5D-5L. EQ-5D-Y-3L and EQ-5D-Y-5L cover children and adolescents, with interviewer or proxy administration advised for ages 4 to 7.
- Available languages
- More than 150 for the paper self-complete EQ-5D-5L
The EQ-5D is owned by the EuroQol Research Foundation. The questionnaire itself is not reproduced here. Registered users obtain the official versions from euroqol.org.
Related instruments
- EORTC QLQ-C30The cancer-specific companion. Oncology trials commonly collect both, one generic and one targeted
- Oswestry Disability Index (ODI)Low back pain disability. Spine studies and registries routinely report the ODI and the EQ-5D side by side
- QOLIE-31Epilepsy-specific quality of life, run alongside the EQ-5D so results compare with other conditions
- Y-BOCSObsessive-compulsive symptom severity. Trials pair it with the EQ-5D as the generic quality-of-life outcome
EQ-5D questions, answered
How is the EQ-5D scored?
In two parts. The descriptive system gives a five-digit profile, one digit per dimension, so 11111 means no problems anywhere and 12345 means no problem with mobility through to extreme anxiety or depression. The EQ VAS is a separate line the person marks to rate their health today from 0 to 100. The profile can then be converted into a single index value using a value set, which carries the preferences of a general population for each health state.
What is a good EQ-5D score?
There are no published severity bands for the index, so no number marks the line between good and poor. What is fixed are the anchors. An index value of 1 is full health and 0 is a state judged equivalent to being dead. Values below 0 are possible and describe states judged worse than dead. Because value sets are national or regional, the same profile can carry a different index value in different countries, which is why the value set has to be reported with the score.
How long does the EQ-5D take?
A few minutes. EuroQol describes it as cognitively undemanding, which is why it is used as the add-on generic measure in trials that already have a longer condition-specific questionnaire.
Is the EQ-5D free?
Yes. It is free to take here. The EQ-5D itself is published by the EuroQol Group, which is who to approach about administering it in your own practice.
Do you need permission to use the EQ-5D?
Not to take it here. The EuroQol Group asks anyone who wants to administer the questionnaire themselves to register with it first.
What is the difference between the EQ-5D-3L and the EQ-5D-5L?
The number of response levels on each dimension, three against five, which takes the number of describable health states from 243 to 3,125. In a study of 3,919 people across six countries the five-level version cut the ceiling effect from 20.2 percent to 16.0 percent and raised discriminatory power, with a Shannon index of 1.87 against 1.24. About 2.9 percent of responses were inconsistent between the two versions.
Does the EQ-5D diagnose anything?
No. It describes health state and produces reference information. It carries no diagnostic content, which is the point of a generic measure.
Evidence, psychometrics and provenance
Developed by the EuroQol Group, an international research network established in 1987. The first instrument was published in Health Policy in 1990. The three-level EQ-5D-3L came first, and the five-level EQ-5D-5L was introduced in 2011 to reduce the ceiling effect and add detail at the mild end.
Psychometrics
The literature on the EQ-5D reports comparative measurement properties rather than a single reliability coefficient for the index, because the index depends on which country value set is applied. The figures below come from the multi-country comparison of the two adult versions.
- Ceiling effect
- 16.0 percent on the 5L, against 20.2 percent on the 3L (Janssen et al., 2013)
- Discriminatory power
- Shannon index 1.87 on the 5L, against 1.24 on the 3L (Janssen et al., 2013)
- Agreement between versions
- 2.9 percent of responses inconsistent between the 5L and the 3L (Janssen et al., 2013)
- Comparison sample
- 3,919 people across eight patient groups and a student cohort in six countries
References
- 1.EuroQol Group. EuroQol: a new facility for the measurement of health-related quality of life. Health Policy. 1990;16(3):199-208.
- 2.Herdman M, Gudex C, Lloyd A, Janssen M, Kind P, Parkin D, Bonsel G, Badia X. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res. 2011;20(10):1727-1736.
- 3.Janssen MF, Pickard AS, Golicki D, Gudex C, Niewada M, Scalone L, Swinburn P, Busschbach J. Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups: a multi-country study. Qual Life Res. 2013;22(7):1717-1727.
- 4.EuroQol Research Foundation. EQ-5D-5L User Guide, version 3.1, 2025.
This assessment uses a validated instrument and is reference information, not a diagnosis.