title: Preliminary findings of an investigation into the relationship between national culture and EQ-5D value sets.
abstract: BACKGROUND
  Despite the growing importance of the EQ-5D descriptive system as a basis for the valuation of QALYs in cost-utility analysis, for most countries, there are no EQ-5D value sets. Researchers and policy makers wishing to use the EQ-5D descriptive system in a country for which there is no value set are advised to use one from a nearby or 'similar' population. Factors other than geographic proximity can affect the relative values of EQ-5D states.
  
  
  OBJECTIVE
  This study explores the links between national culture and EQ-5D value sets.
  
  
  METHODS
  Rank correlation analysis is used to explore relationships between the relative values of a set of EQ-5D states and dimensions of national culture. The latter are taken from Hofstede's framework which operationalizes national culture in five dimensions.
  
  
  RESULTS
  For the data currently available (countries for which EQ-5D value sets and scores on dimensions of culture both exist), moderate and strong correlations were found between the culture dimension of power distance and individualism and the EQ-5D dimensions of pain/discomfort and anxiety/depression. Moderate correlations were also observed between the cultural dimension of masculinity and the EQ-5D dimensions of self care, usual activities and pain/discomfort. Uncertainty avoidance correlates with the EQ-5D dimension of anxiety/depression.
  
  
  CONCLUSIONS
  The correlation patterns observed are generally consistent with a priori expectations based on the nature of the dimensions of culture and the EQ-5D model. This analysis demonstrates the potential of national culture in providing insight into the drivers of the relative values of EQ-5D dimensions for different countries and in informing decisions about which EQ-5D value sets to use in situations where one does not exist.
authors.affiliation: The University of the West Indies, St Augustine Campus, Trinidad and Tobago. hhbailey@gmail.com
authors.forename: Henry
authors.initials: H
authors.lastname: Bailey
authors.forename: Paul
authors.initials: P
authors.lastname: Kind
mesh_terms: D003466:Cultural Characteristics; D005783:Gender Identity; D006304:Health Status; D006801:Humans; D008603:Mental Health; D008962:Models, Theoretical; D019057:Quality-Adjusted Life Years; D012016:Reference Values; D011795:Surveys and Questionnaires