*This screen is not part of the EQ-5D instrument, it has been added to this demo for information purposes

Welcome to the EQ-5D-5L Device-independent version demo

Would you like to get to know our products better? Please try our EQ-5D Device-independent version demo.You can try this EQ-5D demo on our website without disclosing any personal data. When you try our EQ-5D demo, no scores on the EQ-5D dimensions or any other data will be stored on our servers.

Demo Disclaimer

Health Questionnaire

English version for the UK

VERSION FOR INTERVIEWER ADMINISTRATION

Note to interviewer: although allowance should be made for the interviewer’s particular style of speaking, the wording of the questionnaire instructions should be followed as closely as possible. In the case of the EQ-5D-5L descriptive system of the questionnaire, the precise wording must be followed.

If the respondent has difficulty choosing a response or asks for clarification, the interviewer should repeat the question word for word and ask the respondent to answer in a way that most closely resembles his or her thoughts about his or her health today.

INTRODUCTION

(Note to interviewer: please read the following to the respondent.)

We are trying to find out what you think about your health. I will explain what to do as I go along, but please interrupt me if you do not understand something or if things are not clear to you. There are no right or wrong answers. We are interested only in your personal view.

First, I am going to read out some questions. Each question has a choice of five answers. Please tell me which answer best describes your health TODAY.

Do not choose more than one answer in each group of questions.

(Note to interviewer: first read all five options for each question. Then ask the respondent to choose which one applies to him/herself. Repeat the question and options if necessary. Mark the appropriate box under each heading. You may need to remind the respondent regularly that the timeframe is TODAY.)

EQ-5D DESCRIPTIVE SYSTEM

First, I would like to ask you about MOBILITY. Would you say that:

Next, I would like to ask you about SELF-CARE. Would you say that:

Next, I would like to ask you about USUAL ACTIVITIES, for example, work, study, housework, family or leisure activities. Would you say that:

Next, I would like to ask you about PAIN OR DISCOMFORT. Would you say that:

Finally, I would like to ask you about ANXIETY OR DEPRESSION. Would you say that:

EQ-5D VAS

  • Now, I would like to ask you to say how good or bad your health is TODAY.
  • I would like you to picture in your mind a vertical line that is numbered from 0 to 100.
    (Note to interviewer: if interviewing face-to-face, please show the respondent the VAS line.)
  • 100 at the top of the line means the best health you can imagine.
    0 at the bottom of the line means the worst health you can imagine.
  • I would now like you to tell me the point on this line where you would put your health TODAY.
    (Note to interviewer: mark the line at the point indicating the respondent’s health today.)
THE RESPONDENT’S HEALTH TODAY = 
*This screen is not part of the EQ-5D instrument, it has been added to this demo for information purposes

You have now completed this questionnaire.

If you would like to change any of your answers, you may do so by pressing the "Previous" button prior to finalizing the questionnaire.

Please finalize the questionnaire by pressing the ”Finalize" button. Once you press ”Finalize", you will not be able to go back to review or change your answers.

*This screen is not part of the EQ-5D instrument, it has been added to this demo for information purposes

Thank you for completing EQ-5D