States in UK, Spanish and US valuations, showing simple direct comparisons available between states. Solid lines between states are simple comparisons where only one dimension is different by a single rating step. Whether these states are valued by the same valuers depends on the design of the selection scheme chosen to construct manageable valuations subsets. EQ-5D dimensions (left to right): Mobility, Self-care, Usual activities, Pain/discomfort, Anxiety/depression. Response codes: 1=‘No problems’, 2=‘Some problems’, 3=‘Extreme problems’.