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. 2025 Mar;26(2):275-297.
doi: 10.1007/s10198-024-01701-2. Epub 2024 Jul 9.

The EQ-5D-3L valuation study for Bermuda: using an on-line EQ-VT protocol

Henry Bailey  1   2 , Bram Roudijk  3   4 , Ricky Brathwaite  5
Affiliations

The EQ-5D-3L valuation study for Bermuda: using an on-line EQ-VT protocol

Henry Bailey et al. Eur J Health Econ. 2025 Mar.

Abstract

Background: In many countries, methods of economic evaluation and Health Technology Assessment are used to inform healthcare resource allocation decisions. These approaches often require EQ-5D health outcomes measures. This study aimed to create an EQ-5D-3L value set for Bermuda from which EQ-5D-5L Crosswalk values could be obtained.

Methods: Respondents in Bermuda were recruited locally. A team of Trinidad-based interviewers with prior EQ-5D-3L valuation experience conducted valuation interviews on-line using the EQ-VT protocol. Respondents completed composite time-trade off (cTTO) and discrete choice experiment (DCE) tasks. A hybrid model that included both the cTTO and DCE data was estimated. An EQ-5D-5L crosswalk value set was then created from the EQ-5D-3L index values. Coefficients in the resulting crosswalk model were compared with those of crosswalk and valuation studies from other countries.

Results: The valuation tasks were completed by a near-representative sample of 366 adult Bermuda citizens. Half of the respondents reported being in state 11111. The lowest EQ VAS and EQ-5D-3L index values were 20 and - 0.120 respectively. The hybrid model produced all logically consistent and statistically significant coefficients that in turn produced index values that were very similar to those obtained in a preliminary model (MAD of 0.027).

Discussion: The on-line EQ-VT valuation study was successfully conducted in Bermuda and the values therein can now be used for economic analysis in Bermuda. The Bermuda values differed considerably from those of the other countries against which they were compared. Challenges were encountered with recruitment for an on-line survey in a small population.

Keywords: Bermuda; Composite time trade off; Discrete choice experiment; EQ-5D-3L; EQ-5D-5L.

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Conflict of interest statement

Declarations. Conflict of Interest: The authors have no relevant financial or non-financial interests to disclose. Henry Bailey and Bram Roudijk are members of the EuroQol Research Foundation. Bram Roudijk is employed by the EuroQol Research Foundation. Ricky Brathwaite is employed by the Bermuda Health Council.

Figures

Fig. 1
Fig. 1
Similarity between the value sets generated by the Hybrid and TTO Bootstrap Models
Fig. 2
Fig. 2
Bland–Altman Plot for the value sets generated by the Hybrid and TTO Bootstrap Models
See this image and copyright information in PMC

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