Why Do Adults Value EQ-5D-Y-3L Health States Differently for Themselves Than for Children and Adolescents: A Think-Aloud Study

Reckers-Droog, Vivian; Karimi, Milad; Lipman, Stefan A.; Verstraete, J

doi:10.1016/j.jval.2021.12.014

Cited by 24 publications

(24 citation statements)

References 18 publications

(31 reference statements)

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“…Indeed, there is discussion on whether values derived considering a 10-year-old in the valuation tasks are suitable for the whole age range of the instrument. A recently published qualitative study indicated that health state preferences for a 10-year-old child might not be representative for the full EQ-5D-Y age range [ 33 ], whereas quantitate studies did not find significantly different values when different age descriptions were used [ 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

EQ-5D-Y Value Set for Germany

et al. 2022

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Background Demand is increasing for youth-specific preference-based health-related quality-of-life measures for inclusion in evaluations of healthcare interventions for children and adolescents. The EQ-5D-Youth (EQ-5D-Y) has the potential to become such a preference-based measure. Objective This study applied the recently published EQ-5D-Y valuation protocol to develop a German EQ-5D-Y value set and explored the differences between values given to youth health by parents and non-parents. Methods To elicit EQ-5D-Y health state preferences, a representative sample of 1030 adults of the general population completed a discrete choice experiment (DCE) online survey, and 215 adults participated in face-to-face interviews applying composite time trade-off (cTTO). Respondents were asked to consider a 10-year-old child living in the health states. DCE data were modelled using a mixed logit model. To derive the value set, DCE latent scale values were anchored onto adjusted mean cTTO values using a linear mapping approach. Results Adult respondents considered pain/discomfort and feeling worried/sad/unhappy as the two most important dimensions in terms of youth health. Adjusted mean cTTO values ranged from − 0.350 for health state 33333 to 0.970 for health state 21111. The EQ-5D-Y value set showed a logical order for all parameter estimates, and predicted values ranged from − 0.283 to 1. Differences in preferences by parental status were mainly observed for cTTO results, where mean values were larger for parents than for non-parents. Conclusions Applying the valuation protocol, a German EQ-5D-Y value set with internally consistent coefficients was developed. This enables the instrument to be used in economic evaluations of paediatric healthcare interventions. Supplementary Information The online version contains supplementary material available at 10.1007/s40273-022-01143-9.

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Section: Discussionmentioning

confidence: 99%

EQ-5D-Y Value Set for Germany

et al. 2022

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“…Finally, in both the DCE and cTTO tasks, health states were valued considering the health of a 10-year-old child. Further research is warranted if such preferences are representative for the entire age range of the instrument (8–15 years) [ 50 , 51 ].…”

Section: Discussionmentioning

confidence: 99%

“…Finally, in both the DCE and cTTO tasks, health states were valued considering the health Table 3 Results of DCE modelling BFGS Broyden-Fletcher-Goldfarb-Shanno, BIC Bayesian information criterion, LAM looking after myself, MAE mean absolute error, MO mobility, MSE mean squared error, PD having pain or discomfort, SE standard error, UA doing usual activities, WSU feeling worried, sad or unhappy a The mixed logit model with random correlated coefficients was estimated using 5000 pseudo-random draws and the BFGS optimisation algorithm b p values were estimated for the difference from the previous level of a 10-year-old child. Further research is warranted if such preferences are representative for the entire age range of the instrument (8-15 years) [50,51].…”

Section: Discussionmentioning

confidence: 99%

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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“…Qualitative studies performed in EQ-5D-Y-3L valuation could also provide some insights into these processes [ 22 , 37 ]. However, seeing as adults are unlikely to know or anticipate what a child wants, it appears relevant to contrast our results to earlier or future work comparing time trade-off valuation in adults and children or adolescents.…”

Section: Discussionmentioning

confidence: 99%

“…[ 36 ]) and qualitative (e.g. [ 37 ]) studies may help in providing such insight. Third, the sample used in this study was made up of Dutch citizens and predominantly women and highly educated respondents.…”

Section: Discussionmentioning

confidence: 99%

In a Child’s Shoes: Composite Time Trade-Off Valuations for EQ-5D-Y-3L with Different Proxy Perspectives

et al. 2022

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Background and Objectives EQ-5D-Y-3L health states are commonly valued by asking adults to complete stated preference tasks, ‘given their views about a 10-year-old child’ (hereafter referred to as proxy 1). The use of this perspective has been a source of debate. In this paper, we investigated an alternative proxy perspective: i.e. adults considered what they think a 10-year old-child would decide for itself (hereafter, proxy 2 (substitute)]. Our main objective was to explore how the outcomes, dispersion and response patterns of a composite time trade-off valuation differ between proxy 1 and proxy 2. Methods A team of four trained interviewers completed 402 composite time trade-off interviews following the EQ-5D-Y-3L protocol. Respondents were randomly allocated to value health states in either the proxy 1 or proxy 2 (substitute) perspective. Each respondent valued ten health states with the perspective they were assigned to, as well as one health state with the alternative perspective (33333). Results The use of different proxy perspectives yielded differences in EQ-5D-Y-3L valuation. For states in which children had considerable pain and were very worried, sad or unhappy, respondents’ valuations were lower in proxy 1 than in proxy 2 (substitute) perspectives, by about 0.2. Within-subject variation across health states was lower for proxy 2 (substitute) than proxy 1 perspectives. Analyses of response patterns suggest that data for proxy 2 (substitute) perspectives were less clustered. Conclusions There are systematic differences between composite time trade-off responses given by adults deciding for children and adults considering what children would want for themselves. In addition to warranting further qualitative exploration, such differences contribute to the ongoing normative discussion surrounding the source and perspective used for valuation of child and adolescent health. Supplementary Information The online version contains supplementary material available at 10.1007/s40273-022-01202-1.

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Why Do Adults Value EQ-5D-Y-3L Health States Differently for Themselves Than for Children and Adolescents: A Think-Aloud Study

Cited by 24 publications

References 18 publications

EQ-5D-Y Value Set for Germany

EQ-5D-Y Value Set for Germany

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

In a Child’s Shoes: Composite Time Trade-Off Valuations for EQ-5D-Y-3L with Different Proxy Perspectives

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