Stage 4

Stage 4: Testing the psychometric performance of candidate items

Stage 4 involved a large survey with patients (acute, long-term conditions, and mental health service users), social care users, carers and the general public to test the psychometric performance of items that were retained in Stage 3 and their response options. This was undertaken in the United Kingdom (UK) as well as in five other countries (Argentina, Australia, China, Germany, USA) by international collaborators.

The findings from this stage were used alongside the Stage 3 results to summarise the evidence on the performance of the items. The aim was to use this information to support the selection of questions for a longer questionnaire and a shorter health classification system. The latter would be taken forward to the next stage for valuation. 

Methods and reports

  Psychometric analysis

 To assess the performance of items retained in Stage 3 in terms of content validity, known group validity as well as dimensions and performance of items


Survey with patients, carers, social care users and members of the general public  (see summary documents below) [Translations]


Overall summary – face validity and psychometrics and country specific results and the country specific  findings (Tables and figures): 


Results from this stage and Stage 3 were used to provide an overall summary of the evidence of the questions/items that were reviewed. Consultation with the project advisory group as well as other potential stakeholders was undertaken. The aim was to ensure that the inclusion of views of those who will potentially use the measure in the context of decision-making. This video tells you more about the consultation process. 

The New Measure – EQ Health and Wellbeing instrument (EQ-HWB)

The new measure has 25 items with a shorter version (EQ-HWB-S) with the latter designed for valuation which will be undertaken in the next stage. The new measure has been transferred to the EuroQol Research Foundation who will hold IP. You can find out more about the measure by visiting the EuroQol website: EQ-HWB