Preference-based measures (PBMs)

Calculation of quality-adjusted life years (QALY) in cost-effectiveness evaluation requires quality-of-life (QoL) measurements. It is essential to use QOL data measured by preference-based measures (PBMs), not normal (profile-type) health-related QoL (HRQoL) measures for QALY calculation. Here, we introduce typical PBMs and PBMs whose Japanese versions were developed with the involvement of the C2H.
We do not necessarily recommend use of the following measures in the official cost-effectiveness evaluation.

EuroQoL 5-dimensions 3-level (EQ-5D-3L)

The EQ-5D-3L and the EQ-5D-5L (below) are the most commonly used measures worldwide. EQ-5D-3L comprises the following five dimensions: “mobility,” “self-care,” “usual activities,” “pain/discomfort,” and “anxiety/depression.” (Each dimension has three levels of options.) A value set has been developed in Japan.

EuroQoL 5-dimensions 5-level (EQ-5D-5L)

The EQ-5D-5L comprises the same dimensions as in the EQ-5D-3L, but each dimension has five levels of options. A value set has been alsodeveloped in Japan.

EuroQoL 5-dimension youth (EQ-5D-Y)

The EQ-5D-Y was developed for children. It includes basically the same five dimensions as in the adult version but uses child-friendly expressions. Recommended ages are 8-15 years old. (For ages 12-15, the adult version can also be used.)

Health Utilities Index (HUI) 2/3

The HUI is a measure developed by a research group from McMaster University in Canada. It comprises the following eight dimensions: “vision,” “hearing,” “speech,” “ambulation,” “dexterity,” “emotion,” “cognition,” and “pain” (called a classification system). The questionnaire includes 15 items (or 40 items for proxy version). After converting these 15 items to answers in eight dimensions, QoL score can be calculated.

Short form 6 dimension (SF-6D)

The SF-6D was developed by a research group from the University of Sheffield in the United Kingdom. It is used to calculate QoL scores from responses to the SF-36, one of the most popular profile measure. After converting the 36 items to responses in six dimensions, QoL scores can be calculated. It is not recommended to directly respond to the SF-6D.


The 15D is a measure developed by a researcher from the University of Helsinki in Finland and comprises 15 dimensions.

The Assessment of Quality of Life (AQoL)

The AQoL is a measure developed in Australia and comprises 35 items in eight dimensions. It can be used to calculate QoL scores while it can also be used as a profile measure.

The Adult Social Care Outcomes Toolkit (ASCOT)

The ASCOT was developed at the University of Kent in the United Kingdom. It is used to measure social care related QoL (SCRQoL). The questionnaire includes nine items (four levels) in eight dimensions. In addition to the version for care receivers, another Japanese version of the ASCOT is available to measure QoL values of caregivers.

ICEpop CAPability measure (ICECAP)

The ICECAP was developed at the University of Birmingham in the United Kingdom and is designed to measure capability based on Amartya Sen’s approach. The ICECAP-A for an adult population and ICECAP-O for older people are available, and each comprises five items with four levels.

Quality of Life Utility Measure-Core 10 dimensions (EORTC QLU C-10)

The EORTC QLU C-10 was developed based on the EORTC QLQ C-30, a profile measure commonly used in oncology, to calculate QoL scores. After converting 30 responses in the QLQ C-30 to those in 10 dimensions, QoL scores are calculated. It is sometimes called as a disease-specific PBM.