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. 2025 May 7;23(1):48.
doi: 10.1186/s12955-025-02378-8.

Population norms of health-related quality of life in Iran: findings from a national EQ-5D-5L study

Satar Rezaei  1
Affiliations

Population norms of health-related quality of life in Iran: findings from a national EQ-5D-5L study

Satar Rezaei. Health Qual Life Outcomes. .

Abstract

Background: Evaluating health-related quality of life (HRQoL) in the general population is essential for establishing benchmarks for health outcome assessments. This study aimed to generate population norms for the EQ-5D-5L dimensions, EQ-VAS (EuroQol-Visual Analogue Scale) scores, and EQ-5D-5L index scores in Iran, stratified by sex and age.

Methods: Data for this cross-sectional study were gathered through face-to-face interviews with 3,518 adults from the general population across nine provinces in Iran, employing a multistage sampling approach. Respondents assessed their own health state across the EQ-5D-5L dimensions-mobility, self-care, usual activities, pain/discomfort, and anxiety/depression-along with the EQ-VAS to evaluate their overall health. The EQ-5D-5L score was calculated using the value set derived from the Iranian general population. Dimension scores and index values (EQ-5D-5L index and EQ-VAS score) were analyzed using multiple logistic regression and generalized linear model (GLM), respectively.

Results: The estimated mean ± standard deviation [SD] of EQ-5D-5L index for the general population of Iran was 0.789 ± 0.258, while the EQ-VAS score was estimated at 74.34 ± 18.67. Among the study participants, 35.8% reported being in the best health state (11111), while the remaining 64.2% experienced problems in at least one of the five dimensions. The most commonly reported problems were related to anxiety/depression (49.2%), followed by pain/discomfort (45.3%). Regression analyses revealed that females reported significantly more problems across the five dimensions of the EQ-5D-5L and had lower EQ-5D-5L index and EQ-VAS scores compared to males. Anxiety/depression were more prevalent among younger individuals, while problems in other dimensions tended to increase with age.

Conclusions: The findings indicate that nearly two-thirds of respondents experienced problems in at least one dimension, with anxiety/depression being the most prevalent, particularly among younger individuals. Females reported lower utility scores and more problems across all dimensions in all age groups. To effectively improve the health status of the Iranian population and ensure optimal resource allocation, it is vital to develop and implement targeted interventions that specifically address the needs highlighted in this study.

Keywords: EQ-5D-5L; Health-related quality of life; Population norm; Utility.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The research protocol was approved by the Research Deputy of Kermanshah University of Medical Sciences, with the approval number IR.KUMS.REC.1403.337. The study adhered to the ethical principles outlined in the Declaration of Helsinki. Before data collection, the researchers provided a verbal explanation of the study’s purpose to each potential participant, and informed consent was obtained from all subjects. Participants were also informed of their right to withdraw from the study at any time without facing any consequences. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Percentage of respondents reporting problems (slight, moderate, severe, or extreme) by dimension and age group for the total sample included in the study (n = 3,518) in 2024
Fig. 2
Fig. 2
Percentage of respondents reporting problems (slight, moderate, severe, or extreme) by dimension and age group for males (n = 1,715) in 2024
Fig. 3
Fig. 3
Percentage of respondents reporting problems (slight, moderate, severe, or extreme) by dimension and age group for females (n = 1,803) in 2024
See this image and copyright information in PMC

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