Exploration of visual analogue scale versions with the EQ-HWB-9 to measure health, social care, and carer-related quality of life: a VASt landscape.

PURPOSE: Visual analog scales (VAS) serve as brief, informative patient reported outcome measures. The EQ VAS is an important component of EQ-5D instruments but is not currently included in the EQ-HWB-9. This study qualitatively assessed perceptions of alternative VAS constructs and recall periods for potential inclusion alongside the EQ-HWB-9 and quantitatively examined VAS ratings. METHODS: US adults who were: (1) diagnosed with chronic illness; (2) unpaid caregivers; (3) social care users (e.g., received caregiving, living with disability) completed an online survey and interview where they assessed VAS versions with health, health and wellbeing (HWB), and/or quality of life (QoL), as the specified construct. Participants discussed construct interpretation, appropriateness of recall periods (none, today, past 7 days), and whether these influenced their responses. Interviews were analyzed qualitatively through thematic analysis. RESULTS: Among 34 participants, mean (SD) responses for health, HWB, and QoL were 61.9 (SD = 21.3), 60.9 (SD = 21.8) and 66.4 (SD = 21.5), respectively. All three VAS items were strongly correlated (r = 0.84-0.96). Interpretations of health focused on clinical, physical health more than mental/emotional health, HWB indicated mental/emotional health, and QoL evoked broader assessments encompassing finances or social-relationships. Most participants preferred having no specified recall period, allowing consideration of timeframes relevant to their experiences. CONCLUSION: Although quantitative results suggested that the constructs of health, HWB, and QoL were similar, qualitative results found that they were perceived differently, highlighting the importance of a mixed-methods approach. Further research in larger samples and other countries could help to inform the extent to which constructs and recall periods affect VAS responses.