• Ye Wang, Ngiap-Chuan Tan, Ee-Guan Tay, Julian Thumboo, and Nan Luo.
• Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont Street, Boston, MA, USA. yewang@research.bwh.harvard.edu.
• Health Qual Life Out. 2015 Jul 16; 13: 103.

BackgroundThis study aimed to assess the measurement equivalence of the 5-level EQ-5D (EQ-5D-5L) among the English, Chinese, and Malay versions.MethodsA convenience sample of patients with type 2 diabetes mellitus were enrolled from a public primary health care institution in Singapore. The survey questionnaire comprised the EQ-5D-5L and questions assessing participants' socio-demographic and clinical characteristics. Multiple linear regression models were used to assess the difference in EQ-5D-5L index (calculated using an interim algorithm) and EQ-visual analog scale (EQ-VAS) scores across survey language (Chinese vs. English, Malay vs. English, and Malay vs. Chinese). Measurement equivalence was examined by comparing the 90% confidence interval of difference in the EQ-5D-5L index and EQ-VAS scores with a pre-determined equivalence margin. Multiple logistic regression models were used to assess the response patterns of the 5 Likert-type items of the EQ-5D-5L across survey language.ResultsEquivalence was demonstrated between the Chinese and English versions and between the Malay and English versions of the EQ-5D-5L index scores. Equivalence was also demonstrated between the Chinese and English versions and between the Malay and Chinese versions of the EQ-VAS scores. Equivalence could not be determined between the Malay and Chinese versions of the EQ-5D-5L index score and between the Malay and English versions of the EQ-VAS score. No significant difference was found in responses to EQ-5D-5L items between any languages, except that patients who chose to complete the Chinese version were more likely to report "no problems" in mobility compared to those who completed the Malay version of the questionnaire.ConclusionsThis study provided evidence for the measurement equivalence of the different language versions of EQ-5D-5L in Singapore.

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