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. Author manuscript; available in PMC: 2015 Dec 1.
Published in final edited form as: Health Serv Outcomes Res Methodol. 2014 Sep 6;14(4):213–231. doi: 10.1007/s10742-014-0125-x

Table 1.

EQ-5D and SF-12 Items and Response Categories

Instrument Item
EQ-5D 1) Mobility
    1. I have no problems walking about
    2. I have some problems walking about
    3. I am confined to bed
2) Self-care
    1. I have no problems with self-care
    2. I have some problems washing or dressing myself
    3. I am unable to wash or dress myself
3) Usual Activities (e.g. work, study, housework, family or leisure activities)
    1. I have no problems with performing my usual activities
    2. I have some problems with performing my usual activities
    3. I am unable to perform my usual activities
4) Pain/discomfort
    1. I have no pain or discomfort
    2. I have moderate pain or discomfort
    3. I have extreme pain or discomfort
5) Anxiety/depression
    1. I am not anxious or depressed
    2. I am moderately anxious or depressed
    3. I am extremely anxious or depressed

SF-12 6) In general, would you say your health today is:
    1. Excellent
    2. Very good
    3. Good
    4. Fair
    5. Poor
The following two questions are about activities you might do during a typical day. Does your health now limit you in these activities? If so, how much?
7) Moderate activities such as moving a table, pushing vacuum cleaner, bowling, or playing golf:
    1. No. Not limited at all
    2. Yes. Limited a little
    3. Yes. Limited a lot
8) Climbing several flights of stairs:
    1. No. Not limited at all
    2. Yes. Limited a little
    3. Yes. Limited a lot
During the past 4 weeks, have you had any of the following problems with your work or regular activities as a result of your physical health?
9) Accomplished less than you would like?
    1. No
    2. Yes
10) Were limited in the kind of work or other activities
    1. No
    2. Yes
During the past 4 weeks, were you limited in the kind of work you do or other regular activities as a result of any emotional problems (such as feeling depressed or anxious)
11) Accomplished less than you would like?
    1. No
    2. Yes
12) Didn't do work or other activities as carefully as usual:
    1. No
    2. Yes
13) During the past 4 weeks, how much did pain interfere with your normal work (including both work outside the home and housework)?
    1. Not at all
    2. A little bit
    3. Moderately
    4. Quite a bit
    5. Extremely
The next three questions are about how you feel and how things have been during the past 4 weeks. For each question, please give the one answer that comes closest to the way you have been feeling. How much of the time during the past 4 weeks:
14) Have you felt calm and peaceful?
    1. All of the time
    2. Most of the time
    3. A good bit of the time
    4. Some of the time
    5. A little of the time
    6. None of the time
15) Did you have a lot of energy?
    1. All of the time
    2. Most of the time
    3. A good bit of the time
    4. Some of the time
    5. A little of the time
    6. None of the time
16) Have you felt downhearted and blue?
    1. None of the time
    2. Some of the time
    3. A good bit of the time
    4. Most of the time
    5. All of the time
17) During the past 4 weeks, how much of the time has your physical health or your emotional problems interfered with your social activities (like visiting with friends, relatives, etc.)?
    1. None of the time
    2. Some of the time
    3. A good bit of the time
    4. Most of the time
    5. All of the time