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Arch Public Health. 2017 Feb 6;75:6. doi: 10.1186/s13690-017-0174-z. eCollection 2017.

Mapping EQ-5D utilities to GBD 2010 and GBD 2013 disability weights: results of two pilot studies in Belgium.

Author information

Institute of Health and Society (IRSS), Université catholique de Louvain Clos Chapelle-aux-Champs, 30 bte B1.30.15, Brussels, 1200 Belgium.
Department of Public Health and Surveillance, Scientific Institute of Public Health, Rue Juliette Wytsman 14, 1050 Brussels, Belgium.
National Institute for Public Health and the Environment, Centre for Health and Society, P.O. Box 1, 3720, BA Bilthoven, The Netherlands.
Department of Public Health, Erasmus MC, Dr. Molewaterplein 50, 3015 GE Rotterdam, The Netherlands.
Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98121 USA.



Utilities and disability weights (DWs) are metrics used for calculating Quality-Adjusted Life Years and Disability-Adjusted Life Years (DALYs), respectively. Utilities can be obtained with multi-attribute instruments such as the EuroQol 5 dimensions questionnaire (EQ-5D). In 2010 and 2013, Salomon et al. proposed a set of DWs for 220 and 183 health states, respectively. The objective of this study is to develop an approach for mapping EQ-5D utilities to existing GBD 2010 and GBD 2013 DWs, allowing to predict new GBD 2010/2013 DWs based on EQ-5D utilities.


We conducted two pilot studies including respectively four and twenty-seven health states selected from the 220 DWs of the GBD 2010 study. In the first study, each participant evaluated four health conditions using the standard written EQ-5D-5 L questionnaire. In the second study, each participant evaluated four health conditions randomly selected among the twenty-seven health states using a previously developed web-based EQ-5D-5 L questionnaire. The EQ-5D responses were translated into utilities using the model developed by Cleemput et al. A loess regression allowed to map EQ-5D utilities to logit transformed DWs.


Overall, 81 and 393 respondents completed the first and the second survey, respectively. In the first study, a monotonic relationship between derived utilities and predicted GBD 2010/2013 DWs was observed, but not in the second study. There were some important differences in ranking of health states based on utilities versus GBD 2010/2013 DWs. The participants of the current study attributed a relatively higher severity level to musculoskeletal disorders such as 'Amputation of both legs' and a relatively lower severity level to non-functional disorders such as 'Headache migraine' compared to the participants of the GBD 2010/2013 studies.


This study suggests the possibility to translate any utility derived from EQ-5D scores into a DW, but also highlights important caveats. We observed a satisfactory result of this methodology when utilities were derived from a population of public health students, a written questionnaire and a small number of health states in the presence of a study leader. However the results were unsatisfactory when utilities were derived from a sample of the general population, using a web-based questionnaire. We recommend to repeat the study in a larger and more diverse sample to obtain a more representative distribution of educational level and age.


DW; EQ-5D; GBD2010; GBD2013; Mapping; Utilities

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