Purpose: To investigate the alleged insensitivity of the EuroQol (EQ5D).

Methods: Longitudinal EQ5D and visual analogue scale (VAS) data were obtained from two studies on palliative radiotherapy in patients with painful bone metastases (n=1023) or non-small-cell lung cancer (n=247). Group differences on the five EQ5D domains, three EQ5D tariffs (UK, Dutch and US), and the VAS were analyzed, by comparing the six-month area under the curve prior to death.

Results: Over the last year, the UK tariff decreased by 0.68 (0.56 to -0.12), the Dutch tariff by 0.51 (0.62 to 0.11), the US tariff by 0.50 (0.68 to 0.18), and the VAS by 0.35 (0.55 to 0.20). The decrease accelerated towards death, especially due to mobility and self-care. On all measures, men were better off than women (p≤0.047). Older patients (65+) were better off than younger patients on pain/discomfort (p<0.001), anxiety/depression (p=0.046) and the Dutch tariff (p=0.035). Longer survivors (>6 months) were better off than shorter survivors on usual activities (p=0.014), pain/discomfort (p<0.001) and the EQ5D tariffs (p≤0.030). Patients in the bone metastases study were better off than patients in the lung study on the VAS (p=0.033), but were worse off on all EQ5D domains (p≤0.007) except mobility (p=0.435) and on the EQ5D tariffs (p<0.001).

Conclusions: In our study the EuroQol proved sensitive to the approach of death and was able to distinguish most investigated subgroups. Moreover, it was consistently more sensitive to group differences than the VAS.