1. Are values cultural determined…..
Many believe that QoL is cultural determined
One of the starting points of the EuroQol group

2. First international comparisons in 1988 with EQ-6D and VAS

3. Does TTO differs in Western Europe ?

4. Replication TTO in the UK

5. Do European values differs to the rest of the world ?

6. Does VAS differs across nations?

7. Positive TTO values differ little

8. Negative TTO values seem to matter

9. New evidence UK US Publication bias Scottish population is tougher
Only publish in main report US
Black, Hispanic differ
Yet to be published
Publication bias
Difficulty disentangle
Test retest reliability
Cultural effect
What should be the consequence of cultural difference?

10. Conclusions Patient values include coping Cultural differences exists
High values
Cultural differences exists
Especially in (negative) TTO values
Not yet clear what the consequences are
Or should be…