Valuing EQ-5D-Y: the current state of play

Abstract

Background For nearly a decade, value sets for the EQ-5D-Y were not available, reflecting challenges in valuing child HRQoL. A methodological research programme led to publication of a valuation protocol in 2020, which was rapidly taken up by local study teams. By the end of 2022, between 11 and 17 EQ-5D-Y value sets will be available, more than for any other child HRQoL measure. It is timely to review the experience of those using the protocol to identify early learnings and remaining issues where more research is needed. Methods In June 2021, the EuroQol Group organised a three-day workshop, bringing together all those involved in EQ-5D-Y value set studies and related methodological research concerning EQ-5D-Y and valuation. Workshop discussions were captured by note taking and recording all sessions and online chat. A narrative summary of all sessions was produced and synthesised to identify points of agreement and aspects of methods where uncertainty remains. Results There was broad agreement that DCE is working well as the principal valuation method. However, the most appropriate means of anchoring the latent scale values produced by DCE remains unclear. Some studies have deviated from the protocol by extending the number of states included in TTO tasks, to better support modelling of DCE and TTO. There is ongoing discussion about the relative merits of alternative variants of TTO and other methods for anchoring. Very few studies have consulted with local end-users to gauge the acceptability of methods used to value EQ-5D-Y. Conclusions Priority areas for research include testing alternative methods for anchoring DCE data; exploring the preferences of adolescents; and scale differences in values for EQ-5D-Y and adult EQ-5D states, and implications of such differences for the use of EQ-5D-Y values in HTA. Given the normative elements of the protocol, engaging with HTA bodies and other local users should be the first step for all future value set studies. Value sets undertaken to date are for the three-level EQ-5D-Y. However, the issues discussed in this paper are equally relevant to valuation of the five-level version of EQ-5D-Y; indeed, similar challenges are encountered valuing any measure of child HRQoL.

Core outcome measurement set for research and clinical practice in post-COVID-19 condition (long COVID) in children and young people: an international Delphi consensus study “PC-COS Children”

“…The PedsQL and EQ-5D families of instruments offer multiple age-specific versions [ 15 , 16 ]. These versions contain questions pertinent to a child's development, and they have been translated into various languages and are used across different medical disciplines.…”

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“…Given that many of the EQ-5D-5L and EQ-5D-3L-Y value sets have used a hybrid model, extension of the modeling approach to joint estimation using cTTO and DCE data is an important area for future research. Furthermore, with increasing interest in DCE with duration as a standalone approach to valuation, 32 , 33 methods that account for state-level model misspecification using DCE data alone are needed.…”

The RETRIEVE Checklist for Studies Reporting the Elicitation of Stated Preferences for Child Health-Related Quality of Life

“…This paper reports the first checklist for studies reporting values for HRQoL of children. There has been a notable increase in research aimed at producing values for child HRQoL in recent years; for instance, many value-sets for the EQ-5D-Y-3L (for example [ 18 , 22 – 26 ]) instrument have commenced or been completed since 2020 [ 27 ]. However, the methods being used to value the EQ-5D-Y-3L and other childhood HRQoL instruments vary widely [ 3 , 8 ], are not always fully reported, and the values can have quite different characteristics.…”