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Outcome After Injury—A Systematic Literature Search of Studies Using the EQ-5D

Derrett, Sarah PhD; Black, James BBioMedSci; Herbison, G Peter MSc

The Journal of Trauma: Injury, Infection, and Critical Care: October 2009 - Volume 67 - Issue 4 - p 883-890
doi: 10.1097/TA.0b013e3181ae6409
Review Article

Purpose: Information is required about recovery after injury, including general health measures such as the EQ-5D. This project aimed to: (1) search for studies of injury outcome using the EQ-5D, (2) describe EQ-5D administration and analysis, (3) summarize reliability and validity, and (4) report EQ-5D outcomes.

Methods: A systematic search was undertaken for publications (January 1990 to May 2008). Studies were excluded if the EQ-5D was not used or if injury was a secondary outcome or resulted from a degenerative condition.

Results: Of 79 potentially eligible articles retrieved, 35 were excluded and 44 remained. Sample sizes ranged between n = 14 and n = 3,231. Two thirds of studies described injury outcomes, the remainder focused on specific treatments after injury. Of studies reporting EQ-5D index scores, most used the UK value set, and 29% did not specify a value set. In 16 studies, the EQ-5D was self-completed by participants, and in others, administration was by interviewer, proxy, or unspecified. Time of administration varied between 6 days and 7 years after injury. The absence of a cognitive dimension in the EQ-5D was a concern.

Discussion: Given the global impact of injury-related disability, our search supports calls for comprehensive population-level research exploring outcomes. Many studies considered only specific treatments after injury, had small sample sizes, or were undertaken in wealthy countries. Although noting reservations about the EQ-5D, such as the absence of a cognitive dimension; the EQ-SD being freely available to nonprofit-making organizations, and with many language versions available, seems suitable for studies in wealthy and poorer nations alike.

From the Injury Prevention Research Unit (S.D., J.B.) and the Department of Preventative and Social Medicine (G.P.H.), Dunedin School of Medicine, University of Otago, New Zealand (S.D., J.B.).

Submitted for publication November 5, 2008.

Accepted for publication May 14, 2009.

Supported by EuroQol Executive Committee.

Presented at the Euroqol Group 25th Plenary Scientific Meeting, Lake Maggiore, Italy, September 2008.

Sarah Derrett is a member of the EuroQol Scientific Committee.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal's Web site (

Address for reprints: James Black, BBioMedSci, Injury Prevention Research Unit, PO Box 913, Dunedin 9054, New Zealand; email:

© 2009 Lippincott Williams & Wilkins, Inc.