title: Determinants of time trade-off valuations for EQ-5D-5L health states: data from the Canadian EQ-5D-5L valuation study.
abstract: Previous studies suggest that population subgroups have different perceptions of health, as well as different preferences for hypothetical health states.
  
  
  
  To identify determinants of health states preferences elicited using time trade-off (TTO) for the 5-level EQ-5D questionnaire (EQ-5D-5L) in Canada.
  
  
  
  Data were from the Canadian EQ-5D-5L Valuation Study, which took place in Edmonton, Hamilton, Montreal, and Vancouver. Each respondent valued 10 of 86 hypothetical health states during an in-person interview using a computer-based TTO exercise. The TTO scores were the dependent variable and explanatory variables including age, sex, marital status, education, employment, annual household income, ethnicity, country of birth, dwelling, study site, health literacy, number of chronic conditions, previous experience with illness, and self-rated health.
  
  
  
  Average [standard deviation (SD)] age of respondents (N = 1209) was 48 (17) years, and 45 % were male. In multivariable linear regression models with random effects, adjusted for severity of health states and inconsistencies in valuations, older age [unstandardized regression coefficient (β) = -0.077], male sex (β = 0.042), being married (β = 0.069), and urban dwelling (β = -0.055) were significantly associated with health states scores. Additionally, participants from Edmonton (β = -0.124) and Vancouver (β = -0.156), but not those from Hamilton, had significantly lower TTO scores than those from Montreal.
  
  
  
  Socio-demographic characteristics were the main determinants of preferences for EQ-5D-5L health states in this study. Interestingly, preferences were significantly lower in western Canadian cities compared to eastern ones, bringing into question whether a single preference algorithm is suitable for use in all parts of Canada.
authors.affiliation: 2-040 Li Ka Shing Centre for Health Research Innovation, School of Public Health, University of Alberta, Edmonton, AB, T6G 2E1, Canada.
authors.forename: Fatima Al
authors.initials: FA
authors.lastname: Sayah
authors.affiliation: Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Nick
authors.initials: N
authors.lastname: Bansback
authors.affiliation: Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Stirling
authors.initials: S
authors.lastname: Bryan
authors.affiliation: 2-040 Li Ka Shing Centre for Health Research Innovation, School of Public Health, University of Alberta, Edmonton, AB, T6G 2E1, Canada.
authors.forename: Arto
authors.initials: A
authors.lastname: Ohinmaa
authors.affiliation: School of Rehabilitation, Université de Montréal, Montreal, QC, Canada.
authors.forename: Lise
authors.initials: L
authors.lastname: Poissant
authors.affiliation: Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: Eleanor
authors.initials: E
authors.lastname: Pullenayegum
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.|Father Sean O'Sullivan Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.|Program for Health Economics and Outcome Measures, Hamilton, ON, Canada.
authors.forename: Feng
authors.initials: F
authors.lastname: Xie
authors.affiliation: 2-040 Li Ka Shing Centre for Health Research Innovation, School of Public Health, University of Alberta, Edmonton, AB, T6G 2E1, Canada. jeff.johnson@ualberta.ca.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D057240:Patient Preference; D011594:Psychometrics; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Canada; EQ-5D; Health preferences; Time trade-off (TTO)