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Background: Recently, a vision "bolt-on" EuroQol five-dimensional questionnaire (EQ-5D) was developed and tentative utility values (i.e., a "value set") for this new descriptive system were estimated.Objectives: To compare the discriminatory power of this bolt-on and standard utility-based EQ-5D health indices.Methods: Cross-sectional data on the (3-level) vision bolt-on EQ-5D were collected through face-to-face interviews with 500 and 336 individuals with and without visual impairment, respectively. To assess the discriminatory power of the vision bolt-on index relative to the standard EQ-5D index developed in the vision bolt-on valuation study, 16 pairs of mutually exclusive subgroups of individuals defined by the individuals' visual acuity and responses to the 14-item visual function questionnaire were compared pairwise. The absolute mean difference in the two index scores and the corresponding F statistic derived from the comparisons were used as measures of discriminatory power.Results: The absolute mean difference in the bolt-on index score was larger than that in the standard EQ-5D index score in 14 of the 16 comparisons. The bolt-on index score exhibited a larger F-statistic value than did the standard EQ-5D index score in all known-group comparisons, with the F-statistic ratio ranging from 0.415 to 0.770.Conclusions: The vision bolt-on EQ-5D appears to be more discriminative than the standard EQ-5D in measurement of vision problems. Future studies should investigate the extent to which the vision bolt-on item can increase the sensitivity of the EQ-5D to vision change in interventional studies. [ABSTRACT FROM AUTHOR]

Objective To assess the impact of visual impairment (VI) on health-related quality of life and to compare the health burden of VI and other health conditions in Singapore. Design Population-based cross-sectional study. Participants We studied the 10 009 adults (3353 Chinese, 3397 Indians, and 3259 Malays) who underwent a comprehensive eye assessment and completed the European Quality of Life-5 Dimensions (EQ-5D) questionnaire in the Singapore Epidemiology of Eye Disease Study. Methods We estimated the effects of VI, obesity, hypertension, diabetes, and hyperlipidemia on the EQ-5D index score using linear regression models and the association between VI and self-reported EQ-5D health problems using logistic regression models. We compared prevalence-based quality-adjusted life-year (QALY) loss associated with VI and other health conditions. For each condition, QALY loss was calculated for 100 000 persons in 1 year using associated reduction in EQ-5D index score estimated in regression analysis as disutility. Main Outcome Measures The EQ-5D index score and annual QALY loss. Results The EQ-5D index score decreased with increasing VI severity in all 3 ethnicities. For example, after adjusting for sociodemographic characteristics, the difference in EQ-5D index score between adults with bilateral severe VI and those without VI was −0.044 (95% confidence interval [CI], −0.089 to 0.001) in Chinese, −0.127 (95% CI, −0.237 to −0.017) in Indians, and −0.085 (95% CI, −0.148 to −0.022) in Malays. In all 3 ethnicities, VI was associated with reporting of problems in mobility (e.g., odds ratio [OR], 3.69 for Chinese with bilateral severe VI; 95% CI, 1.21–12.13) and usual activities (e.g., OR, 6.51 for Chinese with bilateral severe VI; 95% CI, 1.59–26.58). In Indians, VI was also associated with anxiety or depression (e.g., OR, 2.68 for bilateral severe VI; 95% CI, 1.11–6.50). The annual QALY loss associated with VI was 511.8 in Chinese, 608.8 in Indians, and 706.7 in Malays, greater than that associated with other health conditions examined in this study. Conclusions Visual impairment is associated with substantial health burden among Asians in Singapore. The relatively high burden of VI highlights the importance of VI prevention. The ethnic difference exhibited in this burden warrants further study. [ABSTRACT FROM AUTHOR]