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Exercise Vital Sign and EQ-5D-5L

Exercise Vital Sign 

The EVS was selected for the Active Hospitals toolkit as it is a simple and quick way of assessing an individual’s physical activity level. It consists of two questions:

  1. On average, how many days per week do you engage in moderate intensity or greater (like a brisk walk)?


  1. On average, how many minutes do you engage in exercise at this level?

The two self-reported responses are then multiplied to give a total minutes per week of moderate or strenuous exercise.

The EVS  has been validated in a cohort of over 1.5 million people in the USA, is comparable to other population-based self-reported measures of physical activity [1,2] and is in use worldwide[3].


EQ-5D is a generic patient-reported outcome measure (PROM) designed to provide evidence on a patients’ health-related quality of life.  It was selected for the patient data collection tool as, internationally, it is the most widely used generic PROM [4].  Additionally, it has been shown to be valid and reliable in many disease areas [5,6] and is being increasingly used in clinical settings within the NHS,  clinical trials and in UK population health surveys [7].

The EQ-5D-5L is the latest version of the EQ-5D and asks patient to indicate a response (level) from 5 options (no, slight, moderate, severe or extreme problems) across 5 dimensions (mobility, self-care, usual activities, pain / discomfort and anxiety / depression).


  1. Sallis R, Franklin B, Joy L, et al. Strategies for promoting physical activity in clinical practice. Prog Cardiovasc Dis 2015;57:375–86.
  2. Coleman KJ, Ngor E, Reynolds K, et al. Initial Validation of an Exercise ‘Vital Sign’ in Electronic Medical Records. Med Sci Sport Exerc 2012;44:2071–6
  3. Golightly YM, Allen KD, Ambrose KR, et al. Physical Activity as a Vital Sign: A Systematic Review. Prev Chronic Dis 2017;14:E123.
  4. Devlin, N., & Brooks, R. (2017). EQ‐5D and the EuroQol group: Past, present, future. Applied Health Economics and Health Policy, 15(2), 127–137.
  5. Pickard, A. S., Wilke, C. T., Lin, H. W.,&Lloyd, A. (2007). Health utilities using theEQ‐5D in studies of cancer. PharmacoEconomics, 25, 365–384.
  6. Janssen, M. F., Lubetkin, E. I., Sekhobo, J. P., & Pickard, A. S. (2011). The use of the EQ‐5D preference‐based health status measure in adults with type 2 diabetes mellitus. Diabetes Medicine, 28, 395–413.
  7. Devlin NJ, Shah KK, Feng Y, Mulhern B, van Hout B. Valuing health‐related quality of life: An EQ‐5D‐5L value set for England. Health Economics. 2017;1–16.