Psychometric properties of the modified EQ-HWB and EQ-HWB-S in a general Chinese population : a comparative analysis with EQ-5D-5L, SF-6Dv2, ICECAP-A, SWEMWBS, and WHO-5

Abstract

Objectives: The Modified EQ Health and Well-being (EQ-HWB) and its short version (EQ-HWB-S) are new health and well-being measures nearing finalization. Since the 2022 version, the development group has proposed revisions to the item order, response levels, and wording. This study aimed to assess the psychometric properties of the modified Simplified Chinese EQ-HWB and EQ-HWB-S and compare their performance with other measures. Methods: The data were collected through a web-based survey of the Chinese general population (n = 1053). Outcome measures included the modified EQ-HWB, EQ-5D-5L, SF-6Dv2, ICEpop CAPability measure for Adults, short version of Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS), and World Health Organization Well-Being Index 5-Item. We examined psychometric properties, such as distributional characteristics (ceiling and floor), convergent (correlations),known-group(effect sizes), and structural validity (principal component analysis). Results: At the instrument level, neither the modified EQ-HWB nor EQ-HWB-S showed a ceiling effect. The response distribution of the 3 items (enjoyable activities, excluded by others, and negative feelings about oneself), modified from positively to negatively framed, was in the range of the other items. The EQ-HWB “getting around inside or outside,” “day-to-day activities,”and “enjoyable activities” itemsshowedonlymoderatecorrelationswiththecorrespondingEQ-5D5LandSF-6Dv2dimensions (rho=0.31-0.36). The EQ-HWB items mainly loaded on separate factors from the ICEpop CAPability measure for Adults, the short version of the Warwick-Edinburgh Mental Wellbeing Scale, and the World Health Organization Well-Being Index 5-Item items. The EQ-5D-3L effectively differentiated between sociodemographic and health-related known groups with larger effects than the EQ-HWB-S. Conclusions: The modified EQ-HWB and EQ-HWB-S demonstrated mixed psychometric performance. Several modified items showed improved distributional characteristics compared with earlier findings with the original EQ-HWB. However, item-level correlations were somewhat weaker than those reported in previous studies using the original version