Generating EQ-5D-3L health utility scores from the Edinburgh Postnatal Depression Scale: a perinatal mapping study

Elizabeth M. Camacho, Gemma E. Shields, Carolyn A. Chew-Graham, Emily Eisner, Simon Gilbody, Elizabeth Littlewood, Dean McMillan, Kylie Watson, Pasco Fearon, Deborah J. Sharp

Research output: Contribution to journalArticlepeer-review


Perinatal depression (PND) describes depression experienced by parents during pregnancy or in the first year after a baby is born. The EQ-5D instrument (a generic measure of health status) is not often collected in perinatal research, however disease-specific measures, such as the Edinburgh Postnatal Depression Scale (EPDS) are widely used. Mapping can be used to estimate generic health utility index values from disease-specific measures like the EPDS.

To develop a mapping algorithm to estimate EQ-5D utility index values from the EPDS.

Patient-level data from the BaBY PaNDA study (English observational cohort study) provided 1068 observations with paired EPDS and EQ-5D (3-level version; EQ-5D-3L) responses. We compared the performance of six alternative regression model types, each with four specifications of covariates (EPDS score and age: base, squared, and cubed). Model performance (ability to predict utility values) was assessed by ranking mean error, mean absolute error, and root mean square error. Algorithm performance in 3 external datasets was also evaluated.

There was moderate correlation between EPDS score and utility values (coefficient: -0.42). The best performing model type was a two-part model, followed by ordinary least squared. Inclusion of squared and cubed covariates improved model performance. Based on graphs of observed and predicted utility values, the algorithm performed better when utility was above 0.6.

This direct mapping algorithm allows the estimation of health utility values from EPDS scores. The algorithm has good external validity but is likely to perform better in samples with higher health status.
Original languageEnglish
JournalThe European Journal of Health Economics
Publication statusAccepted/In press - 11 Apr 2023


  • Utility
  • Mapping
  • EQ-5D
  • Edinburgh Postnatal Depression Scale
  • Perinatal depression


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