Exploring the Issues of Valuing Child and Adolescent Health States Using a Mixed Sample of Adolescents and Adults

Rowen, Donna; Mukuria, Clara; Powell, Philip A.; Wailoo, Allan

doi:10.1007/s40273-022-01133-x

Cited by 7 publications

(6 citation statements)

References 63 publications

(80 reference statements)

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“…A recent study has shown, for example, that respondents are less willing to trade lifeyears on behalf of others [22]. A promising new approach is to elicit preferences from a mixed sample of adults and adolescents [24]. There are numerous strengths of this study.…”

Section: Discussionmentioning

confidence: 99%

“…Arguments supporting this approach include coherence with the population used to generate value sets for adult measures; adults bear the costs of healthcare through health insurance; adults' capacity of decision making (both in general and about health) and legal rights to participate in certain activities (e.g. voting, signing a contract, getting married); ethical difficulties around the acceptability of valuation exercises involving the concept of death for young populations; and matters of understanding and cognitive burden associated with the task in adolescents or children [24][25][26][27]. In Hungary, no value set exists for the EQ-5D-Y-3L or any other youth-specific health status measure.…”

Section: Introductionmentioning

confidence: 99%

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Value Set for the EQ-5D-Y-3L in Hungary

et al. 2022

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Background The Hungarian health technology assessment guidelines recommend the use of the EuroQol instrument family in quality-adjusted life-year calculations. However, no national value set exists for the EQ-5D-Y-3L or any other youth-specific instrument. Objective This study aims to develop a national value set of the EQ-5D-Y-3L for Hungary based on preferences of the general adult population. Methods This study followed the international valuation protocol for the EQ-5D-Y-3L. Two independent samples, representative of the Hungarian general adult population in terms of age and sex were recruited to complete online discrete choice experiment (DCE) tasks and composite time trade-off (cTTO) tasks by computer-assisted personal interviews. Adults valued hypothetical EQ-5D-Y-3L health states considering the health of a 10-year-old child. DCE data were modelled using a mixed logit model with random-correlated coefficients. Latent DCE utility estimates were mapped onto mean observed cTTO utilities using ordinary least squares regression. Results Overall, 996 and 200 respondents completed the DCE and cTTO surveys, respectively. For each domain, the value set resulted in larger utility decrements with more severe response levels. The relative importance of domains by level 3 coefficients was as follows: having pain or discomfort > feeling worried, sad or unhappy > mobility > doing usual activities > looking after myself. Overall, 12.3% of all health states had negative utilities in the value set, with the worst health state having the lowest predicted utility of − 0.485. Conclusion This study developed a national value set of the EQ-5D-Y-3L for Hungary. The value set enables to evaluate the cost utility of health technologies for children and adolescents based on societal preferences in Hungary. Supplementary Information The online version contains supplementary material available at 10.1007/s40273-022-01190-2.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Value Set for the EQ-5D-Y-3L in Hungary

et al. 2022

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“…However, for normative reasons, some relevant stakeholders (i.e., local end-users) may have priorities that extend beyond the alignment between the resulting value set and the observed cTTO values. There may be cases where alignment with the DCE data is prioritised, such as when mixed samples are sought [ 27 ]. For example, if adolescents complete the DCE and adults complete the cTTO, the use of linear mapping will ensure that adolescents’ preferences (in relation to the relative importance of dimensions) are fully represented in the value set.…”

Section: Discussionmentioning

confidence: 99%

“…However, the protocol was only considered to be a starting point, with further updates expected in future due to the various ongoing normative and methodological debates in the context of child health valuation [ 4 , 25 ]. These debates include, but are not limited to, the source of preference data [ 26 , 27 ], the perspective taken in the task [ 6 , 7 , 9 , 28 ], and the choice of valuation method [ 29 ].…”

Section: Introductionmentioning

confidence: 99%

Analytical Considerations When Anchoring Discrete Choice Experiment Values Using Composite Time Trade-Off Data: The Case of EQ-5D-Y-3L

et al. 2022

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Discrete choice experiments (DCEs) are becoming increasingly used to elicit preferences for children’s health states. However, DCE data need to be anchored to produce value sets, and composite time trade-off (cTTO) data are typically used in the context of EQ-5D-Y-3L valuation. The objective of this paper is to compare different anchoring methods, summarise the characteristics of the value sets they produce, and outline key considerations for analysts. Three anchoring methods were compared using data from published studies: (1) rescaling using the mean value for the worst health state; (2) linear mapping; and (3) hybrid modelling. The worst state rescaling value set had the largest range. The worst state rescaling and linear mapping value sets preserved the relative importance of the dimensions from the DCE, whereas the hybrid model value set did not. Overall, the predicted values from the hybrid model value set were more closely aligned with the cTTO values. These findings are relatively generalisable. Deciding upon which anchoring approach to use is challenging, as there are numerous considerations. Where cTTO data are collected for more than one health state, anchoring on the worst health state will arguably be suboptimal. However, the final choice of approach may require value judgements to be made. Researchers should seek input from relevant stakeholders when commencing valuation studies to help guide decisions and should clearly set out their rationale for their preferred anchoring approach in study outputs. Supplementary Information The online version contains supplementary material available at 10.1007/s40273-022-01214-x.

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“…There is also evidence from the literature that adults think that adults and children have different coping abilities. For example, children and adolescents are thought to be more flexible and can adapt more easily to health challenges than can adults, in part because they will be able to get support from their parents/caregivers and society 29–32…”

Section: Introductionmentioning

confidence: 99%

Understanding the valuation of paediatric health-related quality of life: a qualitative study protocol

Luo

Bahrampour

et al. 2023

BMJ Open

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IntroductionThere is evidence from previous studies that adults value paediatric health-related quality of life (HRQoL) and adult HRQoL differently. Less is known about how adolescents value paediatric HRQoL and whether their valuation and decision-making processes differ from those of adults. Discrete choice experiments (DCEs) are widely used to develop value sets for measures of HRQoL, but there is still much to understand about whether and how the methods choices in the implementation of DCE valuation tasks, such as format, presentation and perspective, affect the decision-making process of participants. This paper describes the protocol for a qualitative study that aims to explore the decision-making process of adults and adolescents when completing DCE valuation tasks. The study will also explore the impact of methodological choices in the design of DCE studies (including decisions about format and presentation) on participants’ thinking process.Methods and analysisAn interview protocol has been developed using DCE valuation tasks. Interviews will be conducted online via Zoom with both an adolescent and adult sample. In the interview, the participant will be asked to go through some DCE valuation tasks while ‘thinking aloud’. After completion of the survey, participants will then be asked some predetermined questions in relation to various aspects of the DCE tasks. Interviews will be recorded and transcribed and analysed using a thematic analysis approach.Ethics and disseminationEthics approval for this study has been received for the adult sample (UTS ETH20-9632) as well as the youth sample (UTS ETH22-6970) from the University of Technology Sydney Human Research Ethics Committee. Results from this study will inform the methods to be used in development of value sets for use in the health technology assessment of paediatric interventions and treatments. Findings from this study will also be disseminated through national/international conferences and peer-reviewed journals.

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Exploring the Issues of Valuing Child and Adolescent Health States Using a Mixed Sample of Adolescents and Adults

Abstract: for comments on a previous draft. We would also like to thank Donna Davis and Liz Mclintock for project management and formatting of the report, and Ruth Wong for undertaking the literature searches.

Cited by 7 publications

References 63 publications

Value Set for the EQ-5D-Y-3L in Hungary

Value Set for the EQ-5D-Y-3L in Hungary

Analytical Considerations When Anchoring Discrete Choice Experiment Values Using Composite Time Trade-Off Data: The Case of EQ-5D-Y-3L

Understanding the valuation of paediatric health-related quality of life: a qualitative study protocol

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