Psychometric benefits of adding bolt-ons to the EQ-5D-5L in populations undergoing minimally invasive cosmetic procedures.
Summary
In a cross-sectional survey of 364 women planning or having undergone minimally invasive cosmetic procedures, adding bolt-ons (particularly self-confidence and tiredness) to EQ-5D-5L reduced ceiling effects and improved construct validity and explanatory power. These bolt-ons enhanced discrimination across known groups and are recommended for clinical studies and health economic evaluations of MICPs.
Key Findings
- Adding tiredness, self-confidence, or sleep bolt-ons reduced EQ-5D-5L ceiling from 47% to 22–27%.
- Self-confidence and social relationships bolt-ons correlated moderately/strongly with RSES and BFNE-S (r = -0.462 to -0.679).
- Tiredness and self-confidence bolt-ons increased EQ VAS explained variance from 37% to 45% and improved known-groups discrimination (relative efficiency 2.72–2.82).
Clinical Implications
Use EQ-5D-5L with self-confidence and tiredness bolt-ons when assessing MICPs to reduce ceiling effects and improve sensitivity; include these dimensions in sensitivity analyses for cost-effectiveness studies.
Why It Matters
Provides a fit-for-purpose enhancement to a widely used generic health measure in aesthetic medicine, enabling better outcome capture and more credible economic evaluations.
Limitations
- Cross-sectional design without longitudinal responsiveness or test–retest reliability.
- Female-only sample may limit generalizability to male patients.
Future Directions
Validate bolt-ons longitudinally (responsiveness, MID) and develop value sets to integrate bolt-ons into utility scoring for economic models.
Study Information
- Study Type
- Cross-sectional study
- Research Domain
- Diagnosis
- Evidence Level
- IV - Observational cross-sectional psychometric assessment without longitudinal follow-up.
- Study Design
- OTHER