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Kyösti E, Mikkonen E, Raj R, Ohtonen P, Peltoniemi O, Skrifvars MB, Ala-Kokko T. Long-Term Quality of Life After Pediatric Traumatic Brain Injury Treated in the Intensive Care Unit. Pediatr Neurol 2024; 157:50-56. [PMID: 38865950 DOI: 10.1016/j.pediatrneurol.2024.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 03/02/2024] [Accepted: 04/29/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND To examine the long-term health-related quality of life (HRQL) after pediatric traumatic brain injury (TBI) treated in the intensive care unit (ICU). METHODS This retrospective cohort study was conducted using data from four university hospital ICUs in Finland. Children aged < 18 years with TBI treated in the ICU during 2003 to 2013 were included. Patients alive at the end of 2020 were sent two different HRQL questionnaires 15/16-dimensional (15D/16D) and RAND-36 and questions regarding chronic diseases, socioeconomical status, and the need for health care support. HRQL was defined as poor when the 15D/16D score total score was below the age- and sex-matched mean population score in Finland minus the minimal clinically important difference. RESULTS A total of 150 of 337 (44%) patients responded (n = 144 15D/16D responses). Median follow-up time was 11 years. Seventy patients (49%) had a poor HRQL according to 15D/16D score. Patients with TBI had significantly poorer 15D scores in every dimension when compared with the matched population mean values. A higher Helsinki CT score, mechanical ventilation, and female sex were associated with poor long-term HRQL according to the 15D/16D. Patients with poor 15D/16D scores also needed significantly more health care services and medications and had more comorbidities than patients with normal scores. A poor 15D/16D score was associated with lower socioeconomic status. CONCLUSIONS Half of long-term pediatric ICU-treated TBI survivors had poor HRQL 11 years after injury. More severe head computed tomographic findings at admission and female sex associated with poor HRQL.
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Affiliation(s)
- Elina Kyösti
- Research Group of Surgery, Anaesthesiology and Intensive Care Medicine, Division of Intensive Care Medicine, Oulu University Hospital, Oulu, Finland; Medical Research Center of Oulu University and Oulu University Hospital, Critical Care Center, Oulu, Finland.
| | - Era Mikkonen
- Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden; Department of Emergency Care and Services, Helsinki University Hospital & University of Helsinki, Helsinki, Finland
| | - Rahul Raj
- Department of Neurosurgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Pasi Ohtonen
- Research Group of Surgery, Anaesthesiology and Intensive Care Medicine, Division of Intensive Care Medicine, Oulu University Hospital, Oulu, Finland; Medical Research Center of Oulu University and Oulu University Hospital, Critical Care Center, Oulu, Finland; Research Service Unit, Oulu University Hospital, Oulu, Finland
| | - Outi Peltoniemi
- Department of Pediatrics and Adolescent Medicine, Oulu University Hospital, Oulu, Finland; Division of Intensive Care Medicine, Department of Paediatrics, Oulu University Hospital, Oulu, Finland
| | - Markus B Skrifvars
- Department of Emergency Care and Services, Helsinki University Hospital & University of Helsinki, Helsinki, Finland
| | - Tero Ala-Kokko
- Research Group of Surgery, Anaesthesiology and Intensive Care Medicine, Division of Intensive Care Medicine, Oulu University Hospital, Oulu, Finland; Medical Research Center of Oulu University and Oulu University Hospital, Critical Care Center, Oulu, Finland
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Kallio MM, Tornivuori A, Kolho KL, Culnane E, Loftus H, Sawyer SM, Kosola S. Changes in health-related quality of life during transition to adult healthcare: an international prospective cohort study. Arch Dis Child 2024; 109:659-665. [PMID: 38768988 PMCID: PMC11287528 DOI: 10.1136/archdischild-2024-327017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 04/26/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVE To study changes in health-related quality of life (HRQoL) in adolescents and young adults (AYAs) with chronic medical conditions across the transfer to adult healthcare and associations of HRQoL with transition readiness and experience of care. METHODS Participants in this international (Finland, Australia) prospective cohort study were recruited in the year prior to transfer to adult health services and studied 12 months later. In addition to two HRQoL scales (Pediatric Quality of Life inventory (PedsQL), 16D), the Am I ON TRAC for Adult Care Questionnaire and Adolescent Friendly Hospital Survey measured transition readiness and experience of care and categorised by quartile. Data were compared before and after transfer to adult healthcare. RESULTS In total, 512 AYAs completed the first survey (0-12 months before transfer of care) and 336 AYAs completed it 1 year later (retention rate 66%, mean ages 17.8 and 18.9 years, respectively). Mean total PedsQL scores (76.5 vs 78.3) showed no significant change, although the social and educational subdomains improved after transfer of care. The mean single-index 16D score remained the same, but in Finland, distress increased and the ability to interact with friends decreased after transfer. AYAs within the best quartiles of experience of care and transition readiness had better HRQoL than AYAs within the worst quartiles. CONCLUSIONS Overall HRQoL of AYAs remained unchanged across the transfer to adult healthcare. Recognising and supporting AYAs with unsatisfactory experience of care and poor transition readiness could improve overall HRQoL during the transition process. TRIAL REGISTRATION NUMBER NCT04631965.
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Affiliation(s)
- Mira Marianne Kallio
- Department of Pediatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- New Children's Hospital, Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Anna Tornivuori
- New Children's Hospital, Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Kaija-Leena Kolho
- Department of Pediatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- New Children's Hospital, Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Evelyn Culnane
- Transition Support Service, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Hayley Loftus
- Transition Support Service, The Royal Children's Hospital, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Susan Margaret Sawyer
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Silja Kosola
- New Children's Hospital, Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Research, Development and Innovations, Western Uusimaa Wellbeing Services County, Espoo, Finland
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Danner E, Sund R, Sintonen H, Niuro L, Niinikoski H, Huopio H, Viikari LA, Jääskeläinen J. Quality of life and socioeconomic and educational status in patients with congenital hypothyroidism. Pediatr Res 2024; 96:502-509. [PMID: 38565918 PMCID: PMC11343712 DOI: 10.1038/s41390-024-03170-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 02/22/2024] [Accepted: 03/02/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND The aim of this study was to investigate the influence of primary congenital hypothyroidism (CH) on quality of life, level of education and socioeconomic status (SES). METHODS Two independent study cohorts, a national and a regional, were collected from Finnish national registers and patient records. Data on social security benefits, SES, marital status, and education were collected from Statistics Finland. Health-related quality of life (HRQoL) was studied in the regional patient cohort with the standardized 15D and 16D instruments. RESULTS There were no statistically significant differences in education level, marital status, or SES between CH patients (n = 40) and their matched controls at the age of 25 years. The mean 15D score was both statistically significantly and clinically importantly lower in CH patients (n = 29) than controls (0.904 vs. 0.953, p = 0.008). CH patients reported significantly lower scores across various dimensions of physical and mental HRQoL, including breathing, sleeping, speech, excretion, mental function, distress, and vitality. The mean 16D score was lower in CH patients compared to controls (0.917, vs. 0.947), but without statistical significance. CONCLUSION SES of CH patients did not differ from matched controls. Thus, most CH patients integrate well into society, but their HRQoL is impaired. IMPACT Most patients with primary congenital hypothyroidism integrate well into society. In the current study, their socioeconomic and marital status did not differ from matched controls at the age of 25 years. However, health-related quality of life measured using 15D instrument was impaired. Every fourth patient reported that congenital hypothyroidism influenced everyday life.
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Affiliation(s)
- Emmi Danner
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland.
| | - Reijo Sund
- School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Harri Sintonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Laura Niuro
- Department of Pediatrics, University of Turku and Turku University Hospital, Turku, Finland
| | - Harri Niinikoski
- Department of Pediatrics, University of Turku and Turku University Hospital, Turku, Finland
| | - Hanna Huopio
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Liisa A Viikari
- Department of Pediatrics, University of Turku and Turku University Hospital, Turku, Finland
| | - Jarmo Jääskeläinen
- Department of Pediatrics, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
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Viani K, Bernardes BF, Veiga MN, Viani RC, Barbuto TM, Barr RD. Translation and cultural adaptation of the Health Utilities Preschool to Brazilian Portuguese. Hematol Transfus Cell Ther 2024; 46:131-136. [PMID: 36868939 DOI: 10.1016/j.htct.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/20/2023] [Indexed: 02/25/2023] Open
Abstract
INTRODUCTION Health research is particularly important in low- and middle-income countries (LMICs), where improvements must be achieved with limited resources, and where the great majority of the world's population, especially children, live. Improvements in public health detection in Brazil have resulted in cancer becoming the most prevalent cause of death by disease in the group aged 1 to 19 years, hence, delivering cost-effective care to the group is a priority. Preference-based measures of health status and health-related quality of life (HRQL) integrate morbidity and mortality and provide utility scores for the estimation of quality-adjusted life years to be used in cost-effectiveness analyses and economic evaluation. The generic preference-based instrument Health Utilities - Preschool (HuPS) measures the health status of young children and is applicable to the age group 2 to 5 years, who carry the highest incidence of cancer in childhood. METHODS The translation of the HuPS classification system followed recommended protocols from published guidelines. Forward and backward translations were performed by a team of six qualified professionals and linguistic validation was undertaken with a sample of parents of preschool children. MAIN RESULTS Initial disagreements on individual words occurring in 0.5-1.5% were resolved by consensus. A final version of the instrument was validated by the sample of parents. CONCLUSIONS The translation and cultural adaptation of the HuPS into Brazilian Portuguese were accomplished as the first step in the validation of the HuPS instrument in Brazil.
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Affiliation(s)
- Karina Viani
- Instituto de Tratamento do Câncer Infantil (ITACI), Instituto da Criança e do Adolescente, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brazil.
| | | | | | | | - Tomas Marzagão Barbuto
- Instituto de Tratamento do Câncer Infantil (ITACI), Instituto da Criança e do Adolescente, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brazil
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Kallio M, Tornivuori A, Miettinen PJ, Kolho KL, Relas H, Culnane E, Loftus H, Sawyer SM, Kosola S. Health-related quality of life and self-reported health status in adolescents with chronic health conditions before transfer of care to adult health care: an international cohort study. BMC Pediatr 2024; 24:163. [PMID: 38459510 PMCID: PMC10921592 DOI: 10.1186/s12887-024-04629-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 02/07/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Heath-related quality of life (HRQoL) is lower in adolescents with chronic health conditions compared to healthy peers. While there is evidence of some differences according to the underlying condition and gender, differences by measure and country are poorly understood. In this study we focus on the differences in HRQoL in adolescents with various chronic medical conditions in the year before transfer of care to adult health services. We also study the associations of two different HRQoL measurements to each other and to self-reported health. METHODS We recruited 538 adolescents from New Children`s Hospital, Helsinki, Finland, and the Royal Children`s Hospital, Melbourne, Australia in 2017-2020. We used two validated HRQoL measurement instruments, Pediatric Quality of Life Inventory (PedsQL) and 16D, and a visual analog scale (VAS) for self-reported health status. RESULTS In total, 512 adolescents (50.4% female, mean age 17.8 [SD 1.2] years), completed the survey measures. Higher HRQoL was reported in males than females in both countries (PedsQL 79.4 vs. 74.1; 16D 0.888 vs. 0.846), and in adolescents from Finland than Australia (80.6 vs. 72.2 and 0.905 vs. 0.825, p < 0.001 for all). Adolescents with diabetes, rheumatological, nephrological conditions and/or organ transplants had higher HRQoL than adolescents with neurological conditions or other disease syndromes (p < 0.001). PedsQL and 16D scores showed a strong correlation to each other (Spearman correlation coefficient r = 0.81). Using the 7-point VAS (1-7), 52% (248 of 479) considered their health status to be good (6-7) and 10% (48 of 479) rated it poor (1-2). Better self-reported health was associated with higher HRQoL. CONCLUSIONS The HRQoL of transition aged adolescents varies between genders, diagnostic groups, and countries of residence. The association between self-reported health and HRQoL suggests that brief assessment using the VAS could identify adolescents who may benefit from in-depth HRQoL evaluation. TRIAL REGISTRATION Trial registration name The Bridge and registration number NCT04631965 ( https://clinicaltrials.gov/ct2/show/NCT04631965 ).
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Affiliation(s)
- Mira Kallio
- Department of Pediatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
- Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
| | - Anna Tornivuori
- Department of Nursing Science, University of Turku, Turku, Finland
- Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Päivi J Miettinen
- Department of Pediatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Kaija-Leena Kolho
- Department of Pediatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Heikki Relas
- Department of Rheumatology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Evelyn Culnane
- Transition Support Service, The Royal Children's Hospital, Melbourne, Australia
| | - Hayley Loftus
- Transition Support Service, The Royal Children's Hospital, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Susan M Sawyer
- Centre for Adolescent Health, Royal Children's Hospital, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Silja Kosola
- Department of Pediatrics, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Pediatric Research Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Research, Development and Innovations, Western Uusimaa Wellbeing Services County, Espoo, Finland
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Bourdeau C, Lippé S, Robaey P, Rondeau É, Krajinovic M, Sinnett D, Laverdière C, Sultan S. Contributing factors to well-being in a sample of long-term survivors of childhood acute lymphoblastic leukemia: the role of social support in emotional regulation. Health Psychol Behav Med 2024; 12:2301550. [PMID: 38239926 PMCID: PMC10795780 DOI: 10.1080/21642850.2023.2301550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 12/26/2023] [Indexed: 01/22/2024] Open
Abstract
Objectives: To understand why some long-term childhood cancer survivors experience positive adjustment in the long run,[Q1] this study aimed to (1) explore associations between well-being, health status, social support, and emotion regulation (ER) strategies in a cohort of long-term childhood lymphoblastic leukemia (cALL) survivors, (2) identify the individual contribution of each ER strategy to well-being (3) and their interaction with social support. Methods: We used data from 92 participants from the PETALE cohort (51% female, aged 24 ± 7 years). Measures included well-being (WHO-5), health status (15D), social support (SSQ-6), cognitive reappraisal and expressive suppression (ERQ), and emotional processing and expression (EAC). We modeled the odds of high well-being adjusting for health status in logistic regressions and explored the moderating role of social support with bootstrap techniques. Independent of clinical history, high well-being was associated with better health status, higher social support, more frequent use of cognitive reappraisal and emotional processing. Results: We found a main contribution of emotional processing to well-being (OR = 2.12, 95% CI = 1.09-5.37). The interaction between low suppression and high social support was significant (OR = .40, 95% CI = .13-.79). Probabilities for high well-being were 96% when expressive suppression was low and social support was high. Results suggest approaching one's own emotions may contribute to well-being in long-term childhood cancer survivors. Clinical implications: Combining curbing emotional suppression with promoting supportive social environment could be a promising target for future supportive care interventions in survivors.
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Affiliation(s)
- Camille Bourdeau
- Department of Psychology, Université de Montréal, Montreal, Canada
- Research Centre, Sainte-Justine University Health Centre, Montreal, Canada
| | - Sarah Lippé
- Department of Psychology, Université de Montréal, Montreal, Canada
- Research Centre, Sainte-Justine University Health Centre, Montreal, Canada
| | - Philippe Robaey
- Research Centre, Sainte-Justine University Health Centre, Montreal, Canada
| | - Émélie Rondeau
- Research Centre, Sainte-Justine University Health Centre, Montreal, Canada
| | - Maja Krajinovic
- Research Centre, Sainte-Justine University Health Centre, Montreal, Canada
- Department of Pediatrics, Université de Montréal, Montreal, Canada
| | - Daniel Sinnett
- Research Centre, Sainte-Justine University Health Centre, Montreal, Canada
- Department of Pediatrics, Université de Montréal, Montreal, Canada
| | - Caroline Laverdière
- Research Centre, Sainte-Justine University Health Centre, Montreal, Canada
- Department of Pediatrics, Université de Montréal, Montreal, Canada
| | - Serge Sultan
- Department of Psychology, Université de Montréal, Montreal, Canada
- Research Centre, Sainte-Justine University Health Centre, Montreal, Canada
- Department of Pediatrics, Université de Montréal, Montreal, Canada
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Kwon J, Bolbocean C, Onyimadu O, Roberts N, Petrou S. Psychometric Performance of Generic Childhood Multi-Attribute Utility Instruments in Preterm and Low Birthweight Populations: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1798. [PMID: 38002889 PMCID: PMC10670192 DOI: 10.3390/children10111798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/16/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Individuals born preterm (gestational age < 37 weeks) and/or at low birthweight (<2500 g) are at increased risk of health impairments from birth to adulthood. This review aimed to evaluate the psychometric performance of generic childhood-specific or childhood-compatible multi-attribute utility instruments (MAUIs) in preterm and/or low birthweight (PLB) populations. METHODS Searches covered seven databases, including studies that targeted childhood (aged < 18 years) and/or adult (≥18 years) PLB populations; provided psychometric evidence for generic childhood-specific or compatible MAUI(s) (any language version); and published in English. Eighteen psychometric properties were evaluated using a four-part criteria rating system. Data syntheses identified psychometric evidence gaps and summarised the psychometric assessment methods/results. RESULTS A total of 42 studies were included, generating 178 criteria rating outputs across four MAUIs: 17D, CHSCS-PS, HUI2, and HUI3. Moreover, 64.0% of outputs concerned the HUI3 MAUI, and 38.2% related to known-group validity. There was no evidence for five psychometric properties. Only 6.7% of outputs concerned reliability and proxy-child agreement. No MAUI outperformed others across all properties. The frequently applied HUI2 and HUI3 lacked content validity evidence. CONCLUSIONS This psychometric evidence catalogue should inform the selection of MAUI(s) suited to the specific aims of applications targeting PLB populations. Further psychometric research is warranted to address the gaps in psychometric evidence.
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Affiliation(s)
- Joseph Kwon
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK; (J.K.); (C.B.); (O.O.)
| | - Corneliu Bolbocean
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK; (J.K.); (C.B.); (O.O.)
| | - Olu Onyimadu
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK; (J.K.); (C.B.); (O.O.)
| | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Oxford OX3 9DU, UK;
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford OX2 6GG, UK; (J.K.); (C.B.); (O.O.)
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Kwon J, Smith S, Raghunandan R, Howell M, Huynh E, Kim S, Bentley T, Roberts N, Lancsar E, Howard K, Wong G, Craig J, Petrou S. Systematic Review of the Psychometric Performance of Generic Childhood Multi-attribute Utility Instruments. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2023; 21:559-584. [PMID: 37133712 DOI: 10.1007/s40258-023-00806-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND Childhood multi-attribute utility instruments (MAUIs) can be used to measure health utilities in children (aged ≤ 18 years) for economic evaluation. Systematic review methods can generate a psychometric evidence base that informs their selection for application. Previous reviews focused on limited sets of MAUIs and psychometric properties, and only on evidence from studies that directly aimed to conduct psychometric assessments. OBJECTIVE This study aimed to conduct a systematic review of psychometric evidence for generic childhood MAUIs and to meet three objectives: (1) create a comprehensive catalogue of evaluated psychometric evidence; (2) identify psychometric evidence gaps; and (3) summarise the psychometric assessment methods and performance by property. METHODS A review protocol was registered with the Prospective Register of Systematic Reviews (PROSPERO; CRD42021295959); reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guideline. The searches covered seven academic databases, and included studies that provided psychometric evidence for one or more of the following generic childhood MAUIs designed to be accompanied by a preference-based value set (any language version): 16D, 17D, AHUM, AQoL-6D, CH-6D, CHSCS-PS, CHU9D, EQ-5D-Y-3L, EQ-5D-Y-5L, HUI2, HUI3, IQI, QWB, and TANDI; used data derived from general and/or clinical childhood populations and from children and/or proxy respondents; and were published in English. The review included 'direct studies' that aimed to assess psychometric properties and 'indirect studies' that generated psychometric evidence without this explicit aim. Eighteen properties were evaluated using a four-part criteria rating developed from established standards in the literature. Data syntheses identified psychometric evidence gaps and summarised the psychometric assessment methods/results by property. RESULTS Overall, 372 studies were included, generating a catalogue of 2153 criteria rating outputs across 14 instruments covering all properties except predictive validity. The number of outputs varied markedly by instrument and property, ranging from 1 for IQI to 623 for HUI3, and from zero for predictive validity to 500 for known-group validity. The more recently developed instruments targeting preschool children (CHSCS-PS, IQI, TANDI) have greater evidence gaps (lack of any evidence) than longer established instruments such as EQ-5D-Y, HUI2/3, and CHU9D. The gaps were prominent for reliability (test-retest, inter-proxy-rater, inter-modal, internal consistency) and proxy-child agreement. The inclusion of indirect studies (n = 209 studies; n = 900 outputs) increased the number of properties with at least one output of acceptable performance. Common methodological issues in psychometric assessment were identified, e.g., lack of reference measures to help interpret associations and changes. No instrument consistently outperformed others across all properties. CONCLUSION This review provides comprehensive evidence on the psychometric performance of generic childhood MAUIs. It assists analysts involved in cost-effectiveness-based evaluation to select instruments based on the application-specific minimum standards of scientific rigour. The identified evidence gaps and methodological issues also motivate and inform future psychometric studies and their methods, particularly those assessing reliability, proxy-child agreement, and MAUIs targeting preschool children.
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Affiliation(s)
- Joseph Kwon
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Sarah Smith
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Martin Howell
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Elisabeth Huynh
- Department of Health Services Research and Policy, Australian National University, Canberra, ACT, Australia
| | - Sungwook Kim
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Thomas Bentley
- Medical Sciences Division, University of Oxford, Oxford, UK
| | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Oxford, UK
| | - Emily Lancsar
- Department of Health Services Research and Policy, Australian National University, Canberra, ACT, Australia
| | - Kirsten Howard
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Germaine Wong
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Jonathan Craig
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
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Mihalopoulos C, Chen G, Scott JG, Bucholc J, Allen C, Coghill D, Jenkins P, Norman R, Ratcliffe J, Richardson J, Stathis S, Viney R. Assessing Outcomes for Cost-Utility Analysis in Children and Adolescents With Mental Health Problems: Are Multiattribute Utility Instruments Fit for Purpose? VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:733-741. [PMID: 36535579 DOI: 10.1016/j.jval.2022.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 10/18/2022] [Accepted: 12/05/2022] [Indexed: 05/03/2023]
Abstract
OBJECTIVES The objective of this study was to compare the concurrent and construct validity, as well as the sensitivity of 5 multiattribute utility instruments (MAUIs), including the Assessment of Quality of Life-6D (AQoL-6D), EQ-5D-Y, Health Utilities Index (HUI)-2 and HUI-3, and the Child Health Utility 9D, 1 generic pediatric quality of life instrument, with 3 routinely collected outcome measures in Australian mental health services (Strengths and Difficulties Questionnaire, Clinical Global Assessment Scale [CGAS] and the Health of the Nation Outcome Scale for Children and Adolescents) in children and adolescents diagnosed of internalizing (eg, anxiety/depression), externalizing (eg, attention deficit hyperactivity disorder/conduct disorders), and trauma/stress related mental disorders. METHODS A cross-sectional survey of measures, including demographic and basic treatment information, in children/adolescents recruited via 5 child and youth mental health services in Queensland and Victoria, Australia. Measures were either proxy or self-report completed, the CGAS and the Health of the Nation Outcome Scale for Children and Adolescents were clinician completed. RESULTS The sample included 426 participants and had a mean age of 13.7 years (range 7-18 years). Utilities (as calculated from MAUIs) were generally lower in older adolescents and those with internalizing disorders. All MAUIs and self-reported clinical measures significantly correlated with each other (absolute correlation range 0.40-0.90), with the AQoL-6D showing generally higher levels of correlations. Correlations between the MAUIs and clinician/proxy-reported measures were weak, regardless of diagnosis (absolute correlation range 0.09-0.47). Generally, EQ-5D-Y, HUI-2, and AQoL-6D were more sensitive than Child Health Utility 9D and HUI-3 when distinguishing between different severities according to clinician-assessed CGAS (effect size range 0.17-0.84). CONCLUSIONS The study showed that the commonly used MAUIs had good concurrent and construct validity compared with routinely used self-complete measures but poor validity when compared with clinician/proxy-completed measures. These findings generally held across different diagnoses.
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Affiliation(s)
- Cathrine Mihalopoulos
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia; School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University.
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
| | - James G Scott
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia; Metro North Mental Health Service, Herston, QLD, Australia
| | - Jessica Bucholc
- Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Cassandra Allen
- Child and Adolescent Mental Health Services Barwon Health, Geelong, VIC, Australia
| | - David Coghill
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia; Royal Children's Hospital, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Peter Jenkins
- Child and Youth Mental Health Service, Eastern Health, Melbourne, VIC, Australia
| | - Richard Norman
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Julie Ratcliffe
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Jeffrey Richardson
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
| | - Stephen Stathis
- Children's Health, Queensland Hospital and Health Service, University of Queensland, Herston, QLD, Australia
| | - Rosalie Viney
- Centre for Health Economics Research and Evaluation, Faculty of Health, University of Technology, Sydney, NSW, Australia
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Tan RLY, Soh SZY, Chen LA, Herdman M, Luo N. Psychometric Properties of Generic Preference-Weighted Measures for Children and Adolescents: A Systematic Review. PHARMACOECONOMICS 2023; 41:155-174. [PMID: 36404365 DOI: 10.1007/s40273-022-01205-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/02/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Preference-weighted measures (PWMs)-also referred to as preference-based measures in the literature-of health status/health-related quality of life plays an essential role in estimating quality-adjusted life-years (QALY) for use in economic evaluations of healthcare products and interventions. However, as PWMs are first and foremost intended to accurately reflect respondent health status, they should ideally demonstrate good psychometric properties for the population in question. This study aimed to systematically review published evidence on the measurement properties of commonly used PWMs for children and adolescents. METHODS Three electronic databases (PubMed, Medline, and PsycINFO) were searched for articles assessing the psychometric properties (content validity, construct validity-including convergent validity and known-group validity, test-retest reliability, and responsiveness) of the PWMs of interest (AQoL-6D, CHU9D, HUI2, HUI3, and EQ-5D-Y). The COsensus-based Standards for the selection of health Measurement INstruments methodology (COSMIN) guidelines were used to assess (a) the methodological quality of the studies included and (b) the psychometric performance of the instruments covered. Data were analysed overall as well as by population (country and disease group) and perspective (self-report or proxy-report). The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42021277296). RESULTS In total, 53 articles were included in this systematic review. Health Utilities Index (HUI) was tested only in patient populations, CHU9D was most frequently tested in general population samples, while EQ-5D-Y was tested in both populations. Overall, there was high-quality evidence supporting sufficient construct validity for all instruments except AQoL-6D. Evidence supporting test-retest and responsiveness was scarce. There was high-quality evidence supporting sufficient responsiveness of HUI2 and HUI3, and inconsistent test-retest reliability of CHU9D and EQ-5D-Y. Evidence for content validity was minimal and therefore not extracted and synthesized for any PWMs. CONCLUSION This review provides updated evidence on the measurement properties of existing generic PWMs for children and adolescents. High-quality evidence for all relevant psychometric properties and across a range of populations was not available for any of the instruments included, indicating that further work is needed in this direction. This study has identified some of the most noticeable evidence gaps for each of the individual measures. Users can use this information to guide their decision on the choice of PWM to administer.
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Affiliation(s)
- Rachel Lee-Yin Tan
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Sonia Zhi Yi Soh
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Le Ann Chen
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Michael Herdman
- Office of Health Economics, 105 Victoria Street, London, SW1E 6QT, UK
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore.
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Rissanen A, Roine R, Marttunen M, Sintonen H, Lindberg N. Health care costs and changes in subjective health-related quality of life among Finnish adolescents referred to secondary psychiatric out-patient services: a one-year follow-up study. Scand J Child Adolesc Psychiatr Psychol 2023; 11:34-43. [PMID: 37273801 PMCID: PMC10236378 DOI: 10.2478/sjcapp-2023-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Background There has been growing interest in economic evidence regarding treatment of mental disorders. Objective The purpose of this one-year follow-up study was to evaluate the secondary health care costs and changes in health-related quality of life (HRQoL) in three common adolescent psychiatric disorder groups. Further, HRQoL of patients was compared to that of population controls. Methods Twelve- to fourteen-year-old adolescents with behavioral and emotional disorders (n = 37), mood disorders (n = 35), and anxiety disorders (n = 34), completed the 16D HRQoL questionnaire when they entered the adolescent psychiatric outpatient clinics (baseline) and at follow-up. The direct secondary health care costs were calculated using a clinical patient administration system. Population controls included 373 same-aged pupils from randomly selected 13 comprehensive schools. Results The direct secondary health care costs did not differ significantly between the three patient groups. However, in adolescents with mood disorders, this investment generated a significant and clinically important improvement in HRQoL, which was not observed in the other two patient groups. Conclusions The costs of health care alone do not necessarily reflect its quality.
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Affiliation(s)
- Anne Rissanen
- Department of Adolescent Psychiatry, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Risto Roine
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Mauri Marttunen
- Department of Adolescent Psychiatry, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Harri Sintonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Nina Lindberg
- Department of Forensic Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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12
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Brown SC, Whelan K, Frampton C, Wall CL, Gearry RB, Day AS. Food-Related Quality of Life in Children and Adolescents With Crohn's Disease. Inflamm Bowel Dis 2022; 28:1838-1843. [PMID: 35166341 DOI: 10.1093/ibd/izac010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Food-related quality of life (FRQoL) encompasses the psychosocial elements of eating and drinking. The FRQoL of children and adolescents with inflammatory bowel disease has not yet been assessed. This study aimed to evaluate the utility of the validated FR-Qol-29 instrument in children with Crohn's disease (CD). METHODS Children diagnosed with CD, a shared home environment healthy sibling, and healthy control subjects 6 to 17 years of age were recruited to this single-center, prospective, cross-sectional study. Children or their parent or guardian completed the FR-QoL-29 instrument. Internal consistency was assessed by completing Cronbach's α. Construct validity was established by correlating the CD FR-QoL-29 sum scores with the Physician Global Assessment and Pediatric Crohn Disease Activity Index scores. The discriminant validity was analyzed using a 1-way analysis of variance, and a Spearman's correlation coefficient test was completed to identify any correlations associated with FRQoL. RESULTS Sixty children or their parent or guardian completed the FR-QoL-29 instrument (10 children in each subgroup). The internal consistency was excellent (Cronbach's α = 0.938). The mean FR-QoL-29 sum scores were 94.3 ± 27.6 for CD, 107.6 ± 20 for siblings, and 113.7 ± 13.8 for control subjects (P = .005). Those with higher disease activity had worse FRQoL (Physician Global Assessment P = .021 and Pediatric Crohn Disease Activity Index P = .004). Inflammatory bowel disease FR-QoL-29 sum scores correlated with weight (P = .027), height (P = .035), body mass index (P = .023), and age (P = .015). CONCLUSIONS FRQoL is impaired in children with CD. Healthy siblings also have poorer FRQoL than control subjects. Several clinical factors are associated with poorer FRQoL in children with CD including age and level of nutritional risk (weight, height, and body mass index). Further research is required validate these findings and to develop strategies for the prevention or treatment of impaired FRQoL in children with CD.
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Affiliation(s)
- Stephanie C Brown
- Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand
| | - Kevin Whelan
- Department of Nutritional Sciences, King's College London, London, United Kingdom
| | - Chris Frampton
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Catherine L Wall
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Richard B Gearry
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Andrew S Day
- Department of Paediatrics, University of Otago Christchurch, Christchurch, New Zealand
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13
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Mpundu-Kaambwa C, Bulamu N, Lines L, Chen G, Dalziel K, Devlin N, Ratcliffe J. A Systematic Review of International Guidance for Self-Report and Proxy Completion of Child-Specific Utility Instruments. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:1791-1804. [PMID: 35667950 DOI: 10.1016/j.jval.2022.04.1723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 03/04/2022] [Accepted: 04/10/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This study aimed to identify and summarize published guidance and recommendations for child self- and proxy assessment of existing child-specific instruments of health-related quality of life (HRQoL) that are accompanied by utilities. METHODS A total of 9 databases plus websites of (1) health technology assessment and health economics outcomes research organizations and (2) instrument developers were systematically searched. Studies were included if they reported guidance for child self- and proxy assessment for child populations (0-18 years old). Three reviewers independently screened titles, abstracts, and full-text reviews against the inclusion criteria. Key features of the guidance identified were summarized. RESULTS A total of 19 studies met the inclusion criteria. In general, journal articles provided little guidance on child self- and proxy assessment, with the majority focused on instrument development and psychometric performance more broadly. Instrument developers' websites provided more guidance for child self- and proxy reports with specific guidance found for the EQ-5D-Y and the Pediatric Quality of Life Inventory. This guidance included the minimum age for self-report and mode of administration; recommended proxy types, age range of child for whom proxy report can be completed, and target population; and recall period. Websites of leading organizations provided general guidance on HRQoL evaluation in children but lacked specific guidance about self- and proxy completion. CONCLUSIONS EQ-5D-Y and Pediatric Quality of Life Inventory developers' websites provided the most comprehensive guidance for self-report and proxy report of their respective instruments. More evidence is required for developing best practice guidance on why, when, and how to use self- and proxy reports in assessing HRQoL in child populations.
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Affiliation(s)
| | - Norma Bulamu
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Lauren Lines
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, Victoria, Australia
| | - Kim Dalziel
- Murdoch Children's Research Institute, Parkville, Melbourne, Victoria, Australia; Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Nancy Devlin
- Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Julie Ratcliffe
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
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Readability of Commonly Used Quality of Life Outcome Measures for Youth Self-Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159555. [PMID: 35954923 PMCID: PMC9367855 DOI: 10.3390/ijerph19159555] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/29/2022] [Accepted: 07/29/2022] [Indexed: 12/15/2022]
Abstract
Self-report measures are central in capturing young people’s perspectives on mental health concerns and treatment outcomes. For children and adolescents to complete such measures meaningfully and independently, the reading difficulty must match their reading ability. Prior research suggests a frequent mismatch for mental health symptom measures. Similar analyses are lacking for measures of Quality of Life (QoL). We analysed the readability of 13 commonly used QoL self-report measures for children and adolescents aged 6 to 18 years by computing five readability formulas and a mean reading age across formulas. Across measures, the mean reading age for item sets was 10.7 years (SD = 1.2). For almost two-thirds of the questionnaires, the required reading age exceeded the minimum age of the target group by at least one year, with an average discrepancy of 3.0 years (SD = 1.2). Questionnaires with matching reading ages primarily targeted adolescents. Our study suggests a frequent mismatch between the reading difficulty of QoL self-report measures for pre-adolescent children and this group’s expected reading ability. Such discrepancies risk undermining the validity of measurement, especially where children also have learning or attention difficulties. Readability should be critically considered in measure development, as one aspect of the content validity of self-report measures for youth.
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15
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Bailey C, Howell M, Raghunandan R, Salisbury A, Chen G, Coast J, Craig JC, Devlin NJ, Huynh E, Lancsar E, Mulhern BJ, Norman R, Petrou S, Ratcliffe J, Street DJ, Howard K, Viney R. Preference Elicitation Techniques Used in Valuing Children's Health-Related Quality-of-Life: A Systematic Review. PHARMACOECONOMICS 2022; 40:663-698. [PMID: 35619044 PMCID: PMC9270310 DOI: 10.1007/s40273-022-01149-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/18/2022] [Indexed: 05/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Valuing children's health states for use in economic evaluations is globally relevant and is of particular relevance in jurisdictions where a cost-utility analysis is the preferred form of analysis for decision making. Despite this, the challenges with valuing child health mean that there are many remaining questions for debate about the approach to elicitation of values. The aim of this paper was to identify and describe the methods used to value children's health states and the specific issues that arise in the use of these methods. METHODS We conducted a systematic search of electronic databases to identify studies published in English since 1990 that used preference elicitation methods to value child and adolescent (under 18 years of age) health states. Eligibility criteria comprised valuation studies concerning both child-specific patient-reported outcome measures and child health states defined in other ways, and methodological studies of valuation approaches that may or may not have yielded a value set algorithm. RESULTS A total of 77 eligible studies were identified from which data on country setting, aims, condition (general population or clinically specific), sample size, age of respondents, the perspective that participants were asked to adopt, source of values (respondents who completed the preference elicitation tasks) and methods questions asked were extracted. Extracted data were classified and evaluated using narrative synthesis methods. The studies were classified into three groups: (1) studies comparing elicitation methods (n = 30); (2) studies comparing perspectives (n = 23); and (3) studies where no comparisons were presented (n = 26); selected studies could fall into more than one group. Overall, the studies varied considerably both in methods used and in reporting. The preference elicitation tasks included time trade-off, standard gamble, visual analogue scaling, rating/ranking, discrete choice experiments, best-worst scaling and willingness to pay elicited through a contingent valuation. Perspectives included adults' considering the health states from their own perspective, adults taking the perspective of a child (own, other, hypothetical) and a child/adolescent taking their own or the perspective of another child. There was some evidence that children gave lower values for comparable health states than did adults that adopted their own perspective or adult/parents that adopted the perspective of children. CONCLUSIONS Differences in reporting limited the conclusions that can be formed about which methods are most suitable for eliciting preferences for children's health and the influence of differing perspectives and values. Difficulties encountered in drawing conclusions from the data (such as lack of consensus and poor reporting making it difficult for users to choose and interpret available values) suggest that reporting guidelines are required to improve the consistency and quality of reporting of studies that value children's health using preference-based techniques.
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Affiliation(s)
- Cate Bailey
- Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Melbourne, VIC, Australia.
| | - Martin Howell
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Rakhee Raghunandan
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Amber Salisbury
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Gang Chen
- Centre for Health Economics, Monash University, Melbourne, VIC, Australia
| | - Joanna Coast
- Health Economics Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Nancy J Devlin
- Centre for Health Policy, University of Melbourne, Melbourne, VIC, Australia
| | - Elisabeth Huynh
- Department of Health Services and Policy Research, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Emily Lancsar
- Department of Health Services and Policy Research, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Brendan J Mulhern
- Centre for Health Economics, Research and Evaluation (CHERE), University of Technology Sydney, Sydney, NSW, Australia
| | - Richard Norman
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Julie Ratcliffe
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Deborah J Street
- Centre for Health Economics, Research and Evaluation (CHERE), University of Technology Sydney, Sydney, NSW, Australia
| | - Kirsten Howard
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Rosalie Viney
- Centre for Health Economics, Research and Evaluation (CHERE), University of Technology Sydney, Sydney, NSW, Australia
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Rowen D, Mukuria C, Powell PA, Wailoo A. Exploring the Issues of Valuing Child and Adolescent Health States Using a Mixed Sample of Adolescents and Adults. PHARMACOECONOMICS 2022; 40:479-488. [PMID: 35292942 DOI: 10.1007/s40273-022-01133-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/24/2022] [Indexed: 06/14/2023]
Abstract
Preferences for child and adolescent health states used to generate health state utility values can be elicited from adults, young adults, adolescents, or combinations of these. This commentary paper provides a critical overview of issues and implications arising from valuing child and adolescent health states using a novel approach of a mixed sample of adolescents and adults. The commentary is informed by critical analysis of normative, ethical, practical and theoretical arguments in the health state valuation literature. Discussion focusses upon adolescent empowerment, understanding and psychosocial maturity; ethical concerns; elicitation tasks; perspective; and selection of sample proportions across adolescents and adults. It is argued that valuation of child and adolescent health states by both adolescents and adults could involve all participants completing the same preference elicitation task using the same perspective (e.g. time trade-off imagining they are living in the health state), and all preferences being modelled to generate a combined value set that reflects both adolescent and adult preferences. It is concluded that the valuation of child and adolescent health states by a mixed adolescent and adult sample appears feasible and has the advantage that it includes some of the population who can potentially experience the health states, thus enabling adolescents to express their views around matters that may affect them, and the population that are taxpayers and voters. However, both the relative proportion of adults and adolescents to include in a valuation sample and the elicitation technique require careful consideration.
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Affiliation(s)
- Donna Rowen
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent St, Sheffield, S1 4DA, UK.
| | - Clara Mukuria
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent St, Sheffield, S1 4DA, UK
| | - Philip A Powell
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent St, Sheffield, S1 4DA, UK
| | - Allan Wailoo
- School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent St, Sheffield, S1 4DA, UK
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17
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Kwon J, Freijser L, Huynh E, Howell M, Chen G, Khan K, Daher S, Roberts N, Harrison C, Smith S, Devlin N, Howard K, Lancsar E, Bailey C, Craig J, Dalziel K, Hayes A, Mulhern B, Wong G, Ratcliffe J, Petrou S. Systematic Review of Conceptual, Age, Measurement and Valuation Considerations for Generic Multidimensional Childhood Patient-Reported Outcome Measures. PHARMACOECONOMICS 2022; 40:379-431. [PMID: 35072935 PMCID: PMC9007803 DOI: 10.1007/s40273-021-01128-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/19/2021] [Indexed: 05/20/2023]
Abstract
BACKGROUND AND AIMS Patient-reported outcome measures (PROMs) for children (aged ≤ 18 years) present methodological challenges. PROMs can be categorised by their diverse underlying conceptual bases, including functional, disability and health (FDH) status; quality of life (QoL); and health-related quality of life (HRQoL). Some PROMs are designed to be accompanied by preference weights. PROMs should account for childhood developmental differences by incorporating age-appropriate health/QoL domains, guidance on respondent type(s) and design. This systematic review aims to identify generic multidimensional childhood PROMs and synthesise their characteristics by conceptual basis, target age, measurement considerations, and the preference-based value sets that accompany them. METHODS The study protocol was registered in the Prospective Register of Systematic Reviews (CRD42021230833), and reporting followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted systematic database searches for generic multidimensional childhood PROMs covering the period 2012-2020, which we combined with published PROMs identified by an earlier systematic review that covered the period 1992-2011. A second systematic database search identified preference-based value sets for generic multidimensional PROMs. The PROMs were categorised by conceptual basis (FDH status, QoL and HRQoL) and by target age (namely infants and pre-schoolers aged < 5 years, pre-adolescents aged 5-11, adolescents aged 12-18 and multi-age group coverage). Descriptive statistics assessed how PROM characteristics (domain coverage, respondent type and design) varied by conceptual basis and age categories. Involvement of children in PROM development and testing was assessed to understand content validity. Characteristics of value sets available for the childhood generic multidimensional PROMs were identified and compared. RESULTS We identified 89 PROMs, including 110 versions: 52 FDH, 29 QoL, 12 HRQoL, nine QoL-FDH and eight HRQoL-FDH measures; 20 targeted infants and pre-schoolers, 29 pre-adolescents, 24 adolescents and 37 for multiple age groups. Domain coverage demonstrated development trajectories from observable FDH aspects in infancy through to personal independence and relationships during adolescence. PROMs targeting younger children relied more on informant report, were shorter and had fewer ordinal scale points. One-third of PROMs were developed following qualitative research or surveys with children or parents for concept elicitation. There were 21 preference-based value sets developed by 19 studies of ten generic multidimensional childhood PROMs: seven were based on adolescents' stated preferences, seven were from adults from the perspective of or on behalf of the child, and seven were from adults adopting an adult's perspective. Diverse preference elicitation methods were used to elicit values. Practices with respect to anchoring values on the utility scale also varied considerably. The range and distribution of values reflect these differences, resulting in value sets with notably different properties. CONCLUSION Identification and categorisation of generic multidimensional childhood PROMs and value sets by this review can aid the development, selection and interpretation of appropriate measures for clinical and population research and cost-effectiveness-based decision-making.
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Affiliation(s)
- Joseph Kwon
- School of Health and Related Research, University of Sheffield, Sheffield, England, UK
| | - Louise Freijser
- Centre for Health Policy, University of Melbourne, Melbourne, Australia
| | - Elisabeth Huynh
- Department of Health Services Research and Policy, Australian National University, Canberra, Australia
| | - Martin Howell
- School of Public Health, University of Sydney, Sydney, Australia
| | - Gang Chen
- Centre for Health Economics, Monash University, Melbourne, Australia
| | - Kamran Khan
- Centre for Health Economics at Warwick, University of Warwick, Coventry, England, UK
| | - Shahd Daher
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England, UK
| | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Oxford, England, UK
| | - Conrad Harrison
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, England, UK
| | - Sarah Smith
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, England, UK
| | - Nancy Devlin
- Centre for Health Policy, University of Melbourne, Melbourne, Australia
| | - Kirsten Howard
- School of Public Health, University of Sydney, Sydney, Australia
| | - Emily Lancsar
- Department of Health Services Research and Policy, Australian National University, Canberra, Australia
| | - Cate Bailey
- Centre for Health Policy, University of Melbourne, Melbourne, Australia
| | - Jonathan Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Kim Dalziel
- Health Economics Unit, University of Melbourne, Melbourne, Australia
| | - Alison Hayes
- School of Public Health, University of Sydney, Sydney, Australia
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia
| | - Germaine Wong
- School of Public Health, University of Sydney, Sydney, Australia
| | - Julie Ratcliffe
- Caring, Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England, UK
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Petrou S. Methodological challenges surrounding QALY estimation for paediatric economic evaluation. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2022; 20:10. [PMID: 35241102 PMCID: PMC8896090 DOI: 10.1186/s12962-022-00345-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/17/2022] [Indexed: 11/10/2022] Open
Abstract
Cost-utility analysis remains the preferred form of economic evaluation for health technology assessment, pricing and reimbursement authorities in several countries. The results of cost-utility analyses are commonly expressed in terms of incremental cost per quality-adjusted life year (QALY) gained where the QALY combines length of life and health-related quality of life in a single metric. This commentary provides an overview of key methodological challenges surrounding QALY estimation for paediatric economic evaluation. These challenges include issues surrounding the relevant attributes to incorporate into measurement instruments, appropriate respondents for the measurement and valuation tasks, perspectives adopted when completing valuation tasks, potential sources of bias in the description and valuation processes, and the paucity of psychometric evidence for existing measures. In addition, the commentary considers methodological challenges raised by research aimed at assessing whether a QALY gain by a child should be valued equally to a QALY gain by an adult.
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Affiliation(s)
- Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.
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19
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Kariola L, Varimo T, Huopio H, Tenhola S, Voutilainen R, Kosola S, Toppari J, Sintonen H, Miettinen PJ, Raivio T, Hero M. Health-related quality of life in boys with constitutional delay of growth and puberty. Front Endocrinol (Lausanne) 2022; 13:1028828. [PMID: 36518253 PMCID: PMC9743641 DOI: 10.3389/fendo.2022.1028828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/10/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Constitutional delay of growth and puberty (CDGP) is the most common reason for delayed puberty in healthy male adolescents. The main indication for medical treatment for this condition is psychosocial burden. However, to the best of our knowledge, no previous study has addressed the impact of puberty-promoting treatment on health-related quality of life (HRQoL) among boys with CDGP. METHODS We investigated HRQoL in 22 boys with CDGP, who participated in a randomized controlled trial in four Finnish pediatric endocrinology outpatient clinics between 2013 and 2017. The boys were randomized to receive either aromatase inhibitor letrozole (2.5mg/day; n=11) or intramuscular testosterone (1mg/kg/every 4 weeks; n=11) for 6 months and followed up to 12 months. HRQoL was assessed with a generic self-assessment 16D© instrument developed and validated for adolescents aged 12 to 15 years. The 16D includes 16 dimensions (vitality, sight, breathing, distress, hearing, sleeping, eating, discomfort and symptoms, speech, physical appearance, school and hobbies, mobility, friends, mental function, excretion and depression). The results were compared with an age-matched reference population that included 163 boys from the Finnish capital-city area. The study protocol is registered to ClinicalTrials.gov (registration number: NCT01797718). RESULTS At baseline, the mean 16D score of the CDGP boys was similar to the age-matched reference population (0.95 vs 0.96, p=0.838). However, the physical appearance score (satisfaction with general appearance, height and weight) was significantly lower in the CDGP boys (0.75 vs 0.92, p=0.004) than their peers. Twelve months after treatment, Appearance had improved significantly (0.75 vs 0.87, p=0.004) and no HRQoL dimension was inferior compared to the age-matched reference population. DISCUSSION In terms of HRQoL, the main impact of delayed puberty was dissatisfaction with physical appearance. Puberty promoting therapy was associated with a positive change in perceived appearance, with no clear difference between low-dose testosterone and letrozole treatments.
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Affiliation(s)
- Laura Kariola
- Helsinki University Hospital, New Children’s Hospital, Pediatric Research Center, Helsinki University, Helsinki, Finland
| | - Tero Varimo
- Helsinki University Hospital, New Children’s Hospital, Pediatric Research Center, Helsinki University, Helsinki, Finland
| | | | - Sirpa Tenhola
- Department of Pediatrics, Kymenlaakso Central Hospital, Kotka, Finland
| | | | - Silja Kosola
- Helsinki University Hospital, New Children’s Hospital, Pediatric Research Center, Helsinki University, Helsinki, Finland
| | - Jorma Toppari
- Institute of Biomedicine, Research Centre for Integrative Physiology and Pharmacology, and Centre for Population Health Research, University of Turku, and Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - Harri Sintonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Päivi J. Miettinen
- Helsinki University Hospital, New Children’s Hospital, Pediatric Research Center, Helsinki University, Helsinki, Finland
| | - Taneli Raivio
- Helsinki University Hospital, New Children’s Hospital, Pediatric Research Center, Helsinki University, Helsinki, Finland
- Translational Stem Cell Biology and Metabolism Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Matti Hero
- Helsinki University Hospital, New Children’s Hospital, Pediatric Research Center, Helsinki University, Helsinki, Finland
- *Correspondence: Matti Hero,
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20
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Łaszewska A, Helter TM, Nagel A, Perić N, Simon J. Patient-reported outcome measures suitable for quality of life/well-being assessment in multisectoral, multinational and multiperson mental health economic evaluations. EVIDENCE-BASED MENTAL HEALTH 2021; 25:85-92. [PMID: 34949634 PMCID: PMC9046758 DOI: 10.1136/ebmental-2021-300334] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 12/07/2021] [Indexed: 12/02/2022]
Abstract
Question The aim was to systematically collate and synthesise existing, publicly available patient-reported outcome measure (PROM) information suitable for quality of life (QOL)/well-being measurement in mental health economic evaluations, with specific focus on their applicability in multisectoral, multinational, multiperson economic evaluations and to develop an electronic PROM compendium with meta-data. Study selection and analysis A systematic literature search for non-disease-pecific PROMs and their versions suitable for the measurement of QOL/well-being or recovery was conducted from 2008 to February 2020. Six criteria were applied to judge their suitability in multisectoral, multinational, multiperson economic evaluations: (i) availability of separate adult and child/adolescent versions, (ii) availability of a proxy-completion option, (iii) assessing outcomes beyond health, (iv) availability of translations (≥2 language versions), (v) availability of a preference-based valuation, (vi) availability of value sets in more than one country. Findings The final ProgrammE in Costing, resource use measurement and outcome valuation for Use in multisectoral National and International health economic evaluAtions (PECUNIA) PROM-MH Compendium includes 204 unique scales, out of which 88 are individual instruments, while the remaining 116 scales belong to 46 PROM families with more than one distinctive version. Out of the total 134 individual PROMs/PROM families, 72% have at least two language versions, 8% measure broader well-being beyond health-related QOL, 11% have preference-based valuation, with multiple country sets available for 60% of these. None of the identified PROMs met all six proposed criteria. Conclusions The PECUNIA PROM-MH Compendium provides a unique overview of the relevant PROMs and their linked meta-data, and should be a helpful tool when choosing a suitable instrument for future mental health economic evaluations.
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Affiliation(s)
- Agata Łaszewska
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Wien, Austria
| | - Timea Mariann Helter
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Wien, Austria
| | - Anna Nagel
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Wien, Austria
| | - Nataša Perić
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Wien, Austria
| | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Wien, Austria
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Mpundu-Kaambwa C, Chen G, Dalziel K, Devlin N, Ratcliffe J. International guidelines for self-report and proxy completion of paediatric health-related quality of life measures: a protocol for a systematic review. BMJ Open 2021; 11:e052049. [PMID: 34880018 PMCID: PMC8655531 DOI: 10.1136/bmjopen-2021-052049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Measures of health-related quality of life (HRQoL), accompanied by the values (or utilities) required to estimate quality-adjusted life-years, are crucial for determining health benefits within economic evaluation and health technology assessment. Several generic and condition-specific measures or instruments of HRQoL, accompanied by values, currently exist for application with child populations. However, there is a lack of a structured summary of guidelines and recommendations for applying these measures in practice. This protocol describes a systematic review of guidelines and recommendations for child and proxy completion of child-specific measures of HRQoL. The aims of the review are to (1) identify and summarise published guidelines and recommendations for existing child-specific measures of HRQoL, (2) determine whether the identified guidelines and recommendations differ by instrument and child characteristics, (3) identify current gaps in these guidelines and recommendations and (4) identify best practices for child self and proxy assessment in paediatric HRQoL measurement for economic evaluation and health technology assessment. METHODS AND ANALYSIS The review will identify, collate and synthesise published guidelines and recommendations for existing child-specific utility measures of HRQoL. Electronic databases to be searched include the Cochrane Library, Medline, Scopus, Web of Science, EconLit, PsycINFO, CINAHL, Embase and Informit. The search will be extended to websites of (1) international organisations for health technology assessment, (2) regulation, health economics and HRQoL outcomes research and (3) instrument developers. Three reviewers will independently screen titles and abstracts against the inclusion criteria. A narrative synthesis will describe the key features of the guidelines identified. ETHICS AND DISSEMINATION Ethical approval is not required as the proposed systematic review will not use primary data. A paper of the systematic review will be submitted to a peer-reviewed journal for publication. PROSPERO REGISTRATION NUMBER CRD42020207160.
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Affiliation(s)
- Christine Mpundu-Kaambwa
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Gang Chen
- Centre for Health Economics, Monash University, Melbourne, Victoria, Australia
| | - Kim Dalziel
- Health Economics Unit, The University of Melbourne School of Population Health, Melbourne, Victoria, Australia
- Health Services, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Nancy Devlin
- Health Economics Unit, The University of Melbourne School of Population Health, Melbourne, Victoria, Australia
| | - Julie Ratcliffe
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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22
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Shiroiwa T, Fukuda T. EQ-5D-Y Population Norms for Japanese Children and Adolescents. PHARMACOECONOMICS 2021; 39:1299-1308. [PMID: 34292524 PMCID: PMC8516751 DOI: 10.1007/s40273-021-01063-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/27/2021] [Indexed: 05/20/2023]
Abstract
OBJECTIVE This study was aimed at establishing population norms of EQ-5D-Y in Japan by a nationwide large sample survey. METHODS We performed a door-to-door survey by visiting the homes of children/adolescents aged 8-15 years selected by random sampling. The planned sample size was 3600 from 100 districts in Japan. Children/adolescents were asked to respond to the EQ-5D-Y instrument, and their parents, to background questions on themselves and their children. Summary statistics by age/sex were calculated to obtain the Japanese population norms. A multiple linear regression model was used to examine the relationships between the EQ-5D-Y index and their parents' demographic factors, the children/adolescents' diseases/symptoms and the family environment. RESULTS We collected 3636 responses from 100 districts. The overall EQ-5D-Y index values (all sexes, ages) ranged from 0.90 to 0.95. The percentage of respondents reporting full health ranged from 40 to 60%. In regard to the influence of the children/adolescents' diseases/symptoms on disutility, developmental disability showed the largest disutility values of 0.090. Sleeplessness and body pain were the symptoms that exerted the greatest influence on the EQ-5D-Y index; the effect sizes ranged from - 0.030 to - 0.098 for sleeplessness, and from - 0.023 to - 0.079 for body pain. The EQ-5D-Y index of children/adolescents with parents who reported severe stress was lower by 0.072 (p < 0.001), as compared with that of children/adolescents with parents reporting no stress. CONCLUSIONS Population norms of EQ-5D-Y were established for the first time. We also clarified the relationship between the EQ-5D-Y index value and the children/adolescents' diseases/symptoms and the family environment.
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Affiliation(s)
- Takeru Shiroiwa
- Center for Outcomes Research and Economic Evaluation for Health (C2H), National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan.
| | - Takashi Fukuda
- Center for Outcomes Research and Economic Evaluation for Health (C2H), National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
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Rondeau É, Desjardins L, Laverdière C, Sinnett D, Haddad É, Sultan S. French-language adaptation of the 16D and 17D Quality of Life measures and score description in two Canadian pediatric samples. Health Psychol Behav Med 2021; 9:619-635. [PMID: 34285826 PMCID: PMC8266233 DOI: 10.1080/21642850.2021.1948416] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/19/2021] [Indexed: 10/26/2022] Open
Abstract
PURPOSE The Health state descriptive system includes standardized self-administered instruments for measuring Health-Related Quality of Life (HRQoL) respectively among adolescents, and children. The objectives of the current study were: (1) to translate and adapt the pediatric-adolescent version 16D and 17D from English into French (Canada), (2) to demonstrate their feasibility in pediatric conditions. METHODS The translation methodology combined forward and back translations, and cognitive debriefing with eight adolescents and eight children. Four bilingual translators were involved in the process. We administered the translated versions to two clinical samples, being treated for Primary immunodeficiency (PID, n = 48, aged 14.1 years, 20 girls), and having recovered from pediatric Acute Lymphoblastic Leukemia (ALL, n = 153, aged 14.7 years, 77 girls). RESULTS Cognitive debriefing indicated that that the instructions, items, and response options were clear, easy to understand, and easy to answer. Adjustments were made for clarity. Translated versions were highly usable (measurement completion >90%). HRQoL levels were high for both samples (range 0.85-0.96). Participants reported lower levels if they were adolescents, particularly if they were girls. Older boys with PID reported a lower HRQoL than their counterparts with a history of ALL. PID and ALL patients mainly reported issues with discomfort and pain, concentration/learning, physical appearance, and psychological distress and sleeping, although to a different degree. CONCLUSION The French-language versions of the 16D and 17D are easy to administer and may be used to identify problematic domains. Greater availability of translated versions of short evaluation tools may facilitate broader uptake of screening practices in pediatric care.
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Affiliation(s)
| | | | - Caroline Laverdière
- Sainte-Justine UHC Research Centre, Montreal, Canada
- Department of Pediatrics, Université de Montréal, Montreal, Canada
| | - Daniel Sinnett
- Sainte-Justine UHC Research Centre, Montreal, Canada
- Department of Pediatrics, Université de Montréal, Montreal, Canada
| | - Élie Haddad
- Sainte-Justine UHC Research Centre, Montreal, Canada
- Department of Pediatrics, Université de Montréal, Montreal, Canada
| | - Serge Sultan
- Sainte-Justine UHC Research Centre, Montreal, Canada
- Department of Pediatrics, Université de Montréal, Montreal, Canada
- Department of Psychology, Université de Montréal, Montreal, Canada
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24
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Kosola S, Culnane E, Loftus H, Tornivuori A, Kallio M, Telfer M, Miettinen PJ, Kolho KL, Aalto K, Raivio T, Sawyer S. Bridge study protocol: an international, observational cohort study on the transition of healthcare for adolescents with chronic conditions. BMJ Open 2021; 11:e048340. [PMID: 34155079 PMCID: PMC8217914 DOI: 10.1136/bmjopen-2020-048340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 05/18/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION More than 10% of adolescents live with a chronic disease or disability that requires regular medical follow-up as they mature into adulthood. During the first 2 years after adolescents with chronic conditions are transferred to adult hospitals, non-adherence rates approach 70% and emergency visits and hospitalisation rates significantly increase. The purpose of the Bridge study is to prospectively examine associations of transition readiness and care experiences with transition success: young patients' health, health-related quality of life (HRQoL) and adherence to medical appointments as well as costs of care. In addition, we will track patients' growing independence and educational and employment pathways during the transition process. METHODS AND ANALYSIS Bridge is an international, prospective, observational cohort study. Study participants are adolescents with a chronic health condition or disability and their parents/guardians who attended the New Children's Hospital in Helsinki, Finland, or the Royal Children's Hospital (RCH) in Melbourne, Australia. Baseline assessment took place approximately 6 months prior to the transfer of care and follow-up data will be collected 1 year and 2 years after the transfer of care. Data will be collected from patients' hospital records and from questionnaires completed by the patient and their parent/guardian at each time point. The primary outcomes of this study are adherence to medical appointments, clinical health status and HRQoL and costs of care. Secondary outcome measures are educational and employment outcomes. ETHICS AND DISSEMINATION The Ethics Committee for Women's and Children's Health and Psychiatry at the Helsinki University Hospital (HUS/1547/2017) and the RCH Human Research Ethics Committee (38035) have approved the Bridge study protocol. Results will be published in international peer-reviewed journals and summaries will be provided to the funders of the study as well as patients and their parents/guardians. TRIAL REGISTRATION NUMBER NCT04631965.
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Affiliation(s)
- Silja Kosola
- Pediatric Research Center, New Children's Hospital, Helsinki, Finland
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Evelyn Culnane
- Transition Support Service, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Hayley Loftus
- Transition Support Service, Royal Children's Hospital, Parkville, Victoria, Australia
- Health Services, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | | | - Mira Kallio
- Pediatric Research Center, New Children's Hospital, Helsinki, Finland
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Clinical Research, University of Helsinki, Helsinki, Finland
| | - Michelle Telfer
- Department of Adolescent Medicine, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Päivi J Miettinen
- Pediatric Research Center, New Children's Hospital, Helsinki, Finland
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Kaija-Leena Kolho
- Pediatric Research Center, New Children's Hospital, Helsinki, Finland
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Faculty of Medicine and Medical Technology, Tampere University, Tampere, Finland
| | - Kristiina Aalto
- Pediatric Research Center, New Children's Hospital, Helsinki, Finland
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Taneli Raivio
- Pediatric Research Center, New Children's Hospital, Helsinki, Finland
- Helsinki University Hospital and University of Helsinki, Helsinki, Finland
- Stem Cells and Metabolism Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Susan Sawyer
- Health Services, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Adolescent Medicine, Royal Children's Hospital, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute and the Royal Children's Hospital, Parkville, Victoria, Australia
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Osman AMY, Wu J, He X, Chen G. Eliciting SF-6Dv2 health state utilities using an anchored best-worst scaling technique. Soc Sci Med 2021; 279:114018. [PMID: 33993008 DOI: 10.1016/j.socscimed.2021.114018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 10/21/2022]
Abstract
There is an increasing interest in using ordinal data collection methods, such as the best-worst scaling (BWS), to develop preference-based tariffs (value sets) for health-related quality of life instruments, yet the evidence on their performance is limited. This paper proposed to use an anchored BWS technique (in which the state of "death" served as an anchoring state) to directly develop a utility weight that lies on a scale anchored at 0 = death and 1 = full health for the Simplified Chinese version of the Short Form 6 Dimension version 2 (SF-6Dv2). An online panel from the general population of Mainland China completed an online survey between 20th July and 19th August, 2019 and 463 respondents were included in the main analysis. The Conditional Logit (CL) model, which assumes a homogeneous preference, as well as a Hierarchical Bayes (HB) model, which accounts for preference heterogeneity, were used to analyze the BWS data. The model performances were evaluated based on monotonicity and model-fit statistics. The majority of respondents indicated that the BWS questions were easy to understand and complete. Initial analyses suggested that the best and worst choices should not be pooled together. Based on model fit statistics of separated estimations and previous literature on health state valuation studies using BWS, the best choices were used for developing the final algorithm. The HB estimates were found to have better model performance than the CL estimates. This study provides an essential insight into using an anchored BWS approach in health state valuation. Furthermore, it demonstrates the advantage of using HB compared to the traditional CL model in producing preference values.
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Affiliation(s)
- Ahmed M Y Osman
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, PR China; Center for Social Science Survey and Data, Tianjin University, Tianjin, PR China.
| | - Jing Wu
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, PR China; Center for Social Science Survey and Data, Tianjin University, Tianjin, PR China.
| | - Xiaoning He
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, PR China; Center for Social Science Survey and Data, Tianjin University, Tianjin, PR China.
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Caulfield East, Victoria, Australia.
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Prevolnik Rupel V, Ogorevc M. EQ-5D-Y Value Set for Slovenia. PHARMACOECONOMICS 2021; 39:463-471. [PMID: 33565048 PMCID: PMC8009800 DOI: 10.1007/s40273-020-00994-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/24/2020] [Indexed: 05/02/2023]
Abstract
BACKGROUND A value set for the EuroQoL 5-Dimensions (EQ-5D)-Y in Slovenia is not yet available, making the calculation of quality-adjusted life-years (QALYs) for children and adolescents using this generic instrument impossible. OBJECTIVE The main objective of our study was to obtain adult preferences towards EQ-5D-Y health states in Slovenia, following the EQ-5D-Y-3L international valuation protocol. The adults were asked to take the perspective of a hypothetical 10-year-old child. METHOD A sample of 1074 adults in Slovenia completed an online discrete-choice experiment (DCE) survey on EQ-5D-Y health states. The latent scale issue was addressed by obtaining the value of the anchor (33333) with 200 composite time trade-off (cTTO) interviews. A mixed (random coefficients) logit model was used to estimate the value set. RESULTS All the estimated coefficients of the mixed logit model were statistically significant at the 1% level and had an expected negative sign. The most important health dimension in EQ-5D-Y is pain/discomfort, followed by anxiety/depression, usual activities, and mobility, with self-care being the least important health dimension. CONCLUSIONS The study addresses an important research gap and presents the EQ-5D-Y value set for Slovenia. At the time of writing, no published value sets are available for the EQ-5D-Y-3L appropriate for use in QALY calculations, making this value set the first EQ-5D-Y value set in the world.
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Affiliation(s)
| | - Marko Ogorevc
- Institute for Economic Research, Kardeljeva ploščad 17, 1000, Ljubljana, Slovenia
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Gough Kenyon SM, Palikara O, Lucas RM. Consistency of Parental and Self-Reported Adolescent Wellbeing: Evidence From Developmental Language Disorder. Front Psychol 2021; 12:629577. [PMID: 33776852 PMCID: PMC7991577 DOI: 10.3389/fpsyg.2021.629577] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 02/05/2021] [Indexed: 12/04/2022] Open
Abstract
Research on adolescent wellbeing in Developmental Language Disorder (DLD) has previously been examined through measures of parent (proxy) or self-reported wellbeing, but never has a study included both and enabled comparison between the two. The current study reports parent and self rated wellbeing of adolescents with DLD and Low Language (LL) ability, as well as their typically developing (TD) peers. It also examines consistency between raters and factors influencing correspondence. Adolescents aged 10–11 with DLD (n = 30), LL (n = 29) or TD (n = 48) were recruited from eight UK primary schools. A battery of standardized language, psychosocial and wellbeing assessments, including the KIDSCREEN-27 were administered. Adolescent ratings of wellbeing were similar across groups on three of the five wellbeing dimensions, but those with DLD had lower self-reported Autonomy and Parental Relations than their TD peers, and both the DLD and LL group had lower School Environment scores than their TD peers. By parental report, the DLD and LL group were considered to have lower wellbeing on all five wellbeing dimensions relative to their TD peers. Paired sample t-test analyses indicated a high level of variance between parent and adolescent reported wellbeing for multiple wellbeing domains, especially Psychological Wellbeing. Importantly, predictors of the level of agreement between parent and adolescent reported psychological wellbeing differed between groups: cognitive reappraisal and sociability predicted this level of agreement for adolescents with LL, while social competence predicted agreement in DLD and TD. This study emphasizes the necessity of allowing adolescents of all language abilities to report their own wellbeing, as their perspective does not align with that of their parents. It also highlights the importance of including the full spectrum of need when investigating the impact of language ability on consistency between proxy and self-reported wellbeing.
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Affiliation(s)
| | - Olympia Palikara
- Department of Education Studies, University of Warwick, Coventry, United Kingdom
| | - Rebecca M Lucas
- Department of Psychology, University of Roehampton, London, United Kingdom
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28
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Ngwira LG, Khan K, Maheswaran H, Sande L, Nyondo-Mipando L, Smith SC, Petrou S, Niessen L. A Systematic Literature Review of Preference-Based Health-Related Quality-of-Life Measures Applied and Validated for Use in Childhood and Adolescent Populations in Sub-Saharan Africa. Value Health Reg Issues 2021; 25:37-47. [PMID: 33765659 DOI: 10.1016/j.vhri.2020.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 11/18/2020] [Accepted: 11/30/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Consideration of health status in children and adolescents now includes broader concepts such as health-related quality-of-life (HRQoL). Globally, there is a need for relevant preference-based HRQoL measures (PBMs) for use in children and adolescents, yet measurement of HRQoL in these groups presents particular challenges. This article systematically reviews the available generic childhood PBMs and their application and cross-cultural validation in sub-Saharan African (sSA). METHODS A systematic review of published literature from January 1, 1990, to February 8, 2017, was conducted using MEDLINE (through OvidSP), EMBASE (OvidSP), EconLit (EBSCOhost), PsycINFO, Web of Science, and PubMed. RESULTS A total of 220 full-text articles were included in a qualitative synthesis. Ten generic childhood PBMs were identified, of which 9 were adapted from adult versions and only 1 was developed specifically for children. None of the measures were originally developed in sSA or other resource-constrained settings. The Health Utilities Index Mark 3 (HUI3) and the EQ-5D-Y were the only measures that had been applied in sSA settings. Further, the HUI3 and the EQ-5D-Y were the only generic childhood PBM that attempted to establish cross-cultural validation in sSA. Five of the 6 of these validation studies were conducted using the EQ-5D-Y in a single country, South Africa. CONCLUSIONS The findings show that application of generic childhood PBMs in sSA settings has hitherto been limited to the HUI3 and EQ-5D-Y. Most adaptations of existing measures take an absolutist approach, which assumes that measures can be used across cultures. Nevertheless, there is also need to ensure linguistic and conceptual equivalence and undertake validation across a range of sSA cultural contexts.
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Affiliation(s)
- Lucky G Ngwira
- Liverpool School of Tropical Medicine & Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Chichiri, Malawi.
| | - Kamran Khan
- Warwick Medical School, University of Warwick, Coventry, England
| | | | - Linda Sande
- London School of Hygiene & Tropical Medicine & Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Chichiri, Malawi
| | - Linda Nyondo-Mipando
- Health Systems Department, College of Medicine, Chimutu Building, Chichiri, Malawi
| | - Sarah C Smith
- London School of Hygiene & Tropical Medicine, London, England
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, England
| | - Louis Niessen
- Liverpool School of Tropical Medicine & John Hopkins School of Public Health, Pembroke Place, Liverpool, England
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Shiroiwa T, Ikeda S, Noto S, Fukuda T, Stolk E. Valuation Survey of EQ-5D-Y Based on the International Common Protocol: Development of a Value Set in Japan. Med Decis Making 2021; 41:597-606. [PMID: 33754886 PMCID: PMC8191148 DOI: 10.1177/0272989x211001859] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND EQ-5D-Y is a preference-based measure for children and adolescents (aged 8-15 y). This is the first study to develop an EQ-5D-Y value set for converting EQ-5D-Y responses to index values. METHODS We recruited 1047 respondents (aged 20-79 y) from the general population, stratified by gender and age group, in 5 Japanese cities. All data were collected through face-to-face surveys. Respondents were asked to value EQ-5D-Y states for a hypothetical 10-y-old child from a proxy perspective using composite time tradeoff (cTTO) and a discrete choice experiment (DCE). The discrete choice data were analyzed using a mixed logit model. Latent DCE values were then converted to a 0 (death)/1 (full health) scale by mapping them to the cTTO values. RESULTS The mean observed cTTO value of the worst health state [33333] was 0.20. Analysis of the DCE data showed that the coefficients of the domains related to mental functions ("Having pain or discomfort" and "Feeling worried, sad, or unhappy") were larger than those for the domains related to physical and social functions. By converting latent DCE values to a utility scale, we constructed a value set for EQ-5D-Y. No inconsistencies were observed. The minimum predicted score was 0.288 [33333], and the second-best score was 0.957 [12111]. CONCLUSION A value set for EQ-5D-Y was successfully constructed. This is the first survey of an EQ-5D-Y value set. Interpreting the differences between EQ-5D-Y and EQ-5D-5L value sets is a future task with implications for health care policy.
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Affiliation(s)
- Takeru Shiroiwa
- Center for Outcomes Research and Economic Evaluation for Health (C2H), National Institute of Public Health, Wako, Saitama, Japan
| | - Shunya Ikeda
- Department of Medicine, International University of Health and Welfare, Narita, Chiba, Japan
| | - Shinichi Noto
- Department of Health Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Takashi Fukuda
- Center for Outcomes Research and Economic Evaluation for Health (C2H), National Institute of Public Health, Wako, Saitama, Japan
| | - Elly Stolk
- EuroQol Research Foundation, Rotterdam, South Holland, The Netherlands
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Poder TG, Guertin JR, Touré M, Pratte G, Gauvin C, Feeny D, Furlong W, Camden C. Canadian French translation and linguistic validation of the health-related quality of life utility measure for pre-school children. Expert Rev Pharmacoecon Outcomes Res 2021; 21:1195-1201. [PMID: 33625303 DOI: 10.1080/14737167.2021.1895754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND There is a need to perform a Canadian French translation and linguistic validation of the health-related quality of life utility measure for pre-school children (HuPS) conceptually equivalent to the original Canadian English version. RESEARCH DESIGN AND METHODS The translation process consisted of forward and back translations. The linguistic validation was performed with the parents of preschool children during face-to-face cognitive debriefing interviews. The whole process was done in accordance with academic standards and the guidance of the Food and Drug Administration (FDA) for patient-reported outcome instruments. RESULTS The results of back translations indicated that 89% of the sentences were identical or almost identical to the original English-language wording. The review of the back translations led to a change in 13 sentences out of 91 from the reconciled forward translation, while the linguistic validation process with 13 parents led to 14 additional changes. Preliminary reliability validation results indicate a Cronbach's alpha of 0.73. CONCLUSION The translation and linguistic testing processes were successful in creating a valid HuPS in Canadian French (HuPS-CF). This translation should be the subject of reliability and validity studies in a wide variety of clinical and general populations before to use in research projects.
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Affiliation(s)
- Thomas G Poder
- Department de management, evaluation and health policy, School of Public Health, University of Montreal.,Centre de recherche de l'IUSMM, CIUSSS de l'Est-de-l'Île de Montréal, Montreal, QC, Canada
| | - Jason R Guertin
- Department of social and preventive medicine, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Moustapha Touré
- Department of economics, School of Management, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Gabrielle Pratte
- School of rehabilitation, Faculty of Medicine and Health Science, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Cheyenne Gauvin
- School of rehabilitation, Faculty of Medicine and Health Science, University of Sherbrooke, Sherbrooke, QC, Canada
| | - David Feeny
- Center for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
| | - William Furlong
- Center for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
| | - Chantal Camden
- School of Rehabilitation, University of Sherbrooke, Sherbrooke, QC, Canada
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Kerklaan J, Hannan E, Baumgart A, Manera KE, Ju A, McCulloch M, Admani B, Dominello A, Esezobor C, Foster B, Hamilton A, Jankauskiene A, Johnson RJ, Liu I, Marks SD, Neu A, Schaefer F, Sutton S, Wolfenden S, Craig JC, Groothoff J, Howell M, Tong A. Patient- and parent proxy-reported outcome measures for life participation in children with chronic kidney disease: a systematic review. Nephrol Dial Transplant 2021; 35:1924-1937. [PMID: 32743664 DOI: 10.1093/ndt/gfaa132] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 04/29/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The burden of chronic kidney disease (CKD) and its treatment may severely limit the ability of children with CKD to do daily tasks and participate in family, school, sporting and recreational activities. Life participation is critically important to affected children and their families; however, the appropriateness and validity of available measures used to assess this outcome are uncertain. The aim of this study was to identify the characteristics, content and psychometric properties of existing measures for life participation used in children with CKD. METHODS We searched MEDLINE, Embase, PsychINFO, Cumulative Index to Nursing and Allied Health Literature and the Cochrane Kidney and Transplant register to August 2019 for all studies that used a measure to report life participation in children with CKD. For each measure, we extracted and analyzed the characteristics, dimensions of life participation and psychometric properties. RESULTS From 128 studies, we identified 63 different measures used to assess life participation in children with CKD. Twenty-five (40%) of the measures were patient reported, 7 (11%) were parent proxy reported and 31 (49%) had both self and parent proxy reports available. Twenty-two were used in one study only. The Pediatric Quality of Life Inventory version 4.0 generic module was used most frequently in 62 (48%) studies. Seven (11%) were designed to assess ability to participate in life, with 56 (89%) designed to assess other constructs (e.g. quality of life) with a subscale or selected questions on life participation. Across all measures, the three most frequent activities specified were social activities with friends and/or family, leisure activities and self-care activities. Validation data in the pediatric CKD population were available for only 19 (30%) measures. CONCLUSIONS Life participation is inconsistently measured in children with CKD and the measures used vary in their characteristics, content and validity. Validation data supporting these measures in this population are often incomplete and are sparse. A meaningful and validated measure for life participation in children with CKD is needed.
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Affiliation(s)
- Jasmijn Kerklaan
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Elyssa Hannan
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Amanda Baumgart
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Karine E Manera
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Angela Ju
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Mignon McCulloch
- Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - Bashir Admani
- Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Amanda Dominello
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Christopher Esezobor
- Department of Paediatrics, College of Medicine, University of Lagos, Lagos, Nigeria.,Department of Paediatrics, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Bethany Foster
- Department of Pediatrics, Division of Nephrology, Montreal Children's Hospital of the McGill University Health Centre, Montreal, QB, Canada
| | | | - Augustina Jankauskiene
- Pediatric Center, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - Rebecca J Johnson
- Division of Developmental and Behavioral Health, Children's Mercy Kansas City, University of Missouri Kansas City School of Medicine, Kansas City, MO, USA
| | - Isaac Liu
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Stephen D Marks
- Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.,University College London Great Ormond Street Institute of Child Health, NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Alicia Neu
- Division of Pediatric Nephrology, John Hopkins University School of Medicine, Baltimore, MD, USA
| | - Franz Schaefer
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany
| | - Shanna Sutton
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Sebastian Wolfenden
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Jaap Groothoff
- Department of Pediatric Nephrology, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Martin Howell
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Allison Tong
- Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, Westmead, NSW, Australia
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Mierau JO, Kann-Weedage D, Hoekstra PJ, Spiegelaar L, Jansen DEMC, Vermeulen KM, Reijneveld SA, van den Hoofdakker BJ, Buskens E, van den Akker-van Marle ME, Dirksen CD, Groenman AP. Assessing quality of life in psychosocial and mental health disorders in children: a comprehensive overview and appraisal of generic health related quality of life measures. BMC Pediatr 2020; 20:329. [PMID: 32620157 PMCID: PMC7333319 DOI: 10.1186/s12887-020-02220-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 06/22/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Mental health problems often arise in childhood and adolescence and can have detrimental effects on people's quality of life (QoL). Therefore, it is of great importance for clinicians, policymakers and researchers to adequately measure QoL in children. With this review, we aim to provide an overview of existing generic measures of QoL suitable for economic evaluations in children with mental health problems. METHODS First, we undertook a meta-review of QoL instruments in which we identified all relevant instruments. Next, we performed a systematic review of the psychometric properties of the identified instruments. Lastly, the results were summarized in a decision tree. RESULTS This review provides an overview of these 22 generic instruments available to measure QoL in children with psychosocial and or mental health problems and their psychometric properties. A systematic search into the psychometric quality of these instruments found 195 suitable papers, of which 30 assessed psychometric quality in child and adolescent mental health. CONCLUSIONS We found that none of the instruments was perfect for use in economic evaluation of child and adolescent mental health care as all instruments had disadvantages, ranging from lack of psychometric research, no proxy version, not being suitable for young children, no age-specific value set for children under 18, to insufficient focus on relevant domains (e.g. social and emotional domains).
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Affiliation(s)
- Jochen O Mierau
- Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
- Aletta Jacobs School of Public Health, Groningen, The Netherlands
| | | | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lisan Spiegelaar
- Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
| | - Danielle E M C Jansen
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Karin M Vermeulen
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Barbara J van den Hoofdakker
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Erik Buskens
- University Medical Center Groningen and Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
| | - M Elske van den Akker-van Marle
- Department of Biomedical Data Sciences, section Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
| | - Carmen D Dirksen
- Department of Clinical Epidemiology and Medical Technology Assessment, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands
| | - Annabeth P Groenman
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, freepostnumber 176, 9700VB, Groningen, The Netherlands.
- Department of Psychology, Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands.
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Hill H, Rowen D, Pennington B, Wong R, Wailoo A. A Review of the Methods Used to Generate Utility Values in NICE Technology Assessments for Children and Adolescents. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2020; 23:907-917. [PMID: 32762993 DOI: 10.1016/j.jval.2020.02.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/19/2019] [Accepted: 02/12/2020] [Indexed: 05/21/2023]
Abstract
OBJECTIVE This review summarizes and critically examines methods used to generate utilities for child and adolescent health states in previous National Institute for Health and Care Excellence (NICE) technology assessments (TA) and highly specialized technology (HST) evaluations. METHODS We identified all NICE TA and HST evaluations in which the licensed indication for the technology included people younger than 18 and included in the review all evaluations using a cost-utility analysis. RESULTS The review includes 40 TA and HST evaluations. Most assessments generated utility values with the EQ-5D scored using the adult version of the EQ-5D either exclusively (n = 16) or alongside other utility measures and direct elicitation methods of patient own utility (n = 17), although 7 did not use the EQ-5D. Eight assessments used both the EQ-5D child- and adolescent-specific preference-based measures: Health Utilities Index Mark 2 (n = 6), child- and adolescent-specific preference-based measure for atopic dermatitis (n = 1), and youth version of the EQ-5D (EQ-5D-Y) valued using the adult EQ-5D value set (n = 1) or generated using mapping and valued using the adult EQ-5D value set (n = 2). Some cost-utility analyses used age adjustment (utility subtractions, weights, and published mapping formulae) from the adult EQ-5D UK population norms to reflect the general population or disease-free health for children and adolescents (n = 9), and 1 assessment assumed full health (utility value of 1). CONCLUSION The review found limited use of child and adolescent population-specific measures to generate health state utility values for children and adolescents in NICE technology assessments. Often assessments involve the use of an adult-specific measure to reflect the health of children.
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Affiliation(s)
- Harry Hill
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, England, UK.
| | - Donna Rowen
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, England, UK
| | - Becky Pennington
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, England, UK
| | - Ruth Wong
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, England, UK
| | - Allan Wailoo
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, England, UK
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Ramos-Goñi JM, Oppe M, Stolk E, Shah K, Kreimeier S, Rivero-Arias O, Devlin N. International Valuation Protocol for the EQ-5D-Y-3L. PHARMACOECONOMICS 2020; 38:653-663. [PMID: 32297224 DOI: 10.1007/s40273-020-00909-3] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
The EQ-5D-Y-3L is a generic, health-related, quality-of-life instrument for use in younger populations. Some methodological studies have explored the valuation of children's EQ-5D-Y-3L health states. There are currently no published value sets available for the EQ-5D-Y-3L that are appropriate for use in a cost-utility analysis. The aim of this article was to describe the development of the valuation protocol for the EQ-5D-Y-3L instrument. There were several research questions that needed to be answered to develop a valuation protocol for EQ-5D-Y-3L health states. Most important of these were: (1) Do we need to obtain separate values for the EQ-5D-Y-3L, or can we use the ones from the EQ-5D-3L? (2) Whose values should we elicit: children or adults? (3) Which valuation methods should be used to obtain values for child's health states that are anchored in Full health = 1 and Dead = 0? The EuroQol Research Foundation has pursued a research programme to provide insight into these questions. In this article, we summarized the results of the research programme concluding with the description of the features of the EQ-5D-Y-3L valuation protocol. The tasks included in the protocol for valuing EQ-5D-Y-3L health states are discrete choice experiments for obtaining the relative importance of dimensions/levels and composite time-trade-off for anchoring the discrete choice experiment values on 1 = Full Health and 0 = Dead. This protocol is now available for use by research teams to generate EQ-5D-Y-3L value sets for their countries allowing the implementation of a cost-utility analysis for younger populations.
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Affiliation(s)
- Juan M Ramos-Goñi
- Axentiva Solutions, C/Calvario, 271-B 1º IZQ, 38350, Tacoronte, Santa Cruz de Tenerife, Spain.
- EuroQol Research Foundation, Rotterdam, The Netherlands.
| | - Mark Oppe
- Axentiva Solutions, C/Calvario, 271-B 1º IZQ, 38350, Tacoronte, Santa Cruz de Tenerife, Spain
- EuroQol Research Foundation, Rotterdam, The Netherlands
| | - Elly Stolk
- EuroQol Research Foundation, Rotterdam, The Netherlands
| | - Koonal Shah
- Office of Health Economics, London, UK
- PHMR, London, UK
| | - Simone Kreimeier
- Department of Health Economics and Health Care Management, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Oliver Rivero-Arias
- National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Nancy Devlin
- Office of Health Economics, London, UK
- Centre for Health Policy, University of Melbourne, Melbourne, VIC, Australia
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Bégo-Le Bagousse G, Jia X, Wolowacz S, Eckert L, Tavi J, Hudson R. Health utility estimation in children and adolescents: a review of health technology assessments. Curr Med Res Opin 2020; 36:1209-1224. [PMID: 32345060 DOI: 10.1080/03007995.2020.1762553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective: Health utility estimates for children and adolescents are critical for cost-utility analyses informing health technology assessment (HTA) authorities' decisions governing access to pediatric treatments. However, in a recent review, only 29% of published pediatric cost-utility models used a utility measure validated for children. We examined utility estimates used in pediatric HTAs.Methods: A targeted review of pediatric HTAs was performed, focusing on agencies reporting utility estimate sources and methods.Results: Searches identified 11 HTAs in pediatric indications and five in mixed populations with separate analyses for adults and children. Among 13 appraisals reporting methodological detail, five used pediatric utility estimates (based on the Health Utilities Index [HUI], n = 3; Atopic Dermatitis Quality of Life [ADQoL], n = 1; or mapping, n = 1). Issues were identified with mapping, use of adult data for some health states, and assumptions about ADQoL responses. In the remaining eight appraisals, adult utility estimates were applied. Caregiver utility was included in two of 16 appraisals.Conclusions: Only 38% of pediatric HTAs reviewed used pediatric utility estimates, and HTA authorities raised concerns about these data in many cases; only 12% of HTAs included caregiver utility. Although several preference-based utility measures are available for pediatric populations, limited data and guidance on selection of measures are available. When estimating pediatric utility weights, alternative measures should be reviewed for suitability given the model population and health condition. Pediatric and adult utility estimates should be applied appropriately as patients age over time, and caregiver and/or family member utility should be included, where relevant. Gaps exist in utility measures for children aged <4 years and caregivers.
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Affiliation(s)
| | - Xiaoying Jia
- Health Economics, RTI Health Solutions, Manchester, UK
| | | | - Laurent Eckert
- Health Economics and Value Assessment, Sanofi, Chilly-Mazarin, France
| | - Jules Tavi
- Health Economics, Ivi-Data Life Sciences, Levallois-Perret, France
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Dalziel K, Catchpool M, García-Lorenzo B, Gorostiza I, Norman R, Rivero-Arias O. Feasibility, Validity and Differences in Adolescent and Adult EQ-5D-Y Health State Valuation in Australia and Spain: An Application of Best-Worst Scaling. PHARMACOECONOMICS 2020; 38:499-513. [PMID: 31974830 DOI: 10.1007/s40273-020-00884-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
BACKGROUND The measurement and valuation of health-related quality of life for and by young people are increasingly important, yet research on the impact of study perspective and validity of preferences obtained from young populations remains limited. OBJECTIVE The objective of this study was to evaluate the feasibility and validity of collecting EQ-5D Youth version (EQ-5D-Y) preferences from adolescents, adults, and adults from a child perspective. METHODS A profile case best-worst scaling (BWS) online survey was administered to representative Australian and Spanish adult (age ≥ 18 years) and child (age 11-17 years) samples. Adults were told to either answer from their own perspective or for a hypothetical 10-year-old child. Marginal best- and worst-choice frequencies, analysis of dominant choices, self-reported difficulty completing the tasks, and time to complete tasks were used to determine the validity of responses. RESULTS In Australia, 2134 adults and 1010 adolescents completed the survey. In Spain, 2007 adults and 1000 adolescents completed it. Analysis of marginal choice frequencies and dominant choices indicated that the pattern of responses between adolescents and adults was similar. For Australian respondents, having no mobility problems was rated as best by adolescents, while adults rated having no pain and discomfort as 'best'. In Spain, both adults and adolescents rated no pain or discomfort as 'best'. Australian adolescents rated very worried, sad or unhappy as 'worst', while Spanish adolescents, Spanish adults and Australian adults rated a lot of pain and discomfort as 'worst'. CONCLUSIONS Results suggest preferences from adolescents using direct BWS are valid. Our descriptive analysis also suggest that there are age-related and country-specific differences in elicitation values for the EQ-5D-Y.
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Affiliation(s)
- Kim Dalziel
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Max Catchpool
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Borja García-Lorenzo
- Health Technology Assessment Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain
- Fundación Canaria de Investigación Sanitaria (FUNCANIS), Tenerife, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Madrid, Spain
| | - Inigo Gorostiza
- Health Services Research on Chronic Patients Network (REDISSEC), Madrid, Spain
- Osakidetza Basque Health Service, Basurto University Hospital, Bilbao, Spain
| | - Richard Norman
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Oliver Rivero-Arias
- Fundación Canaria de Investigación Sanitaria (FUNCANIS), Tenerife, Spain.
- Health Services Research on Chronic Patients Network (REDISSEC), Madrid, Spain.
- National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK.
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Rowen D, Rivero-Arias O, Devlin N, Ratcliffe J. Review of Valuation Methods of Preference-Based Measures of Health for Economic Evaluation in Child and Adolescent Populations: Where are We Now and Where are We Going? PHARMACOECONOMICS 2020; 38:325-340. [PMID: 31903522 DOI: 10.1007/s40273-019-00873-7] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Methods for measuring and valuing health benefits for economic evaluation and health technology assessment in adult populations are well developed. In contrast, methods for assessing interventions for child and adolescent populations lack detailed guidelines, particularly regarding the valuation of health and quality of life in these age groups. This paper critically examines the methodological considerations involved in the valuation of child- and adolescent-specific health-related quality of life by existing preference-based measures. It also describes the methodological choices made in the valuation of existing generic preference-based measures developed with and/or applied in child and adolescent populations: AHUM, AQoL-6D, CHU9D, EQ-5D-Y, HUI2, HUI3, QWB, 16D and 17D. The approaches used to value existing child- and adolescent-specific generic preference-based measures vary considerably. While the choice of whose preferences and which perspective to use is a matter of normative debate and ultimately for decision by reimbursement agencies and policy makers, greater research around these issues would be informative and would enrich these discussions. Research can also inform the other methodological choices required in the valuation of child and adolescent health states. Gaps in research evidence are identified around the impact of the child described in health state valuation exercises undertaken by adults, including the possibility of informed preferences; the appropriateness and acceptability of valuation tasks for adolescents, in particular tasks involving the state 'dead'; anchoring of adolescent preferences; and the generation and use of combined adult and adolescent preferences.
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Affiliation(s)
- Donna Rowen
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - Oliver Rivero-Arias
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Nancy Devlin
- Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Julie Ratcliffe
- Health and Social Care Economics Group, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
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Well-Being, Obesity and Motricity Observatory in Childhood and Youth (WOMO): A Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062129. [PMID: 32210073 PMCID: PMC7143434 DOI: 10.3390/ijerph17062129] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/06/2020] [Accepted: 03/08/2020] [Indexed: 12/16/2022]
Abstract
Background: Childhood obesity is one of the greatest public health problems facing advanced societies, and Spain is one of the countries with the highest incidence. There are many studies that monitor at the national level, but given the lack of specificity, lack of updating and scarcity of epidemiological data on overweight, obesity, physical condition and well-being of children and adolescents in Extremadura, it seems necessary to create a Well-being, Obesity and Motricity Observatory in Childhood and Youth (WOMO) in Extremadura in order to follow up on the evolution of this problem and to propose strategies to combat it. Therefore, this project aims (1) to obtain information on the physical condition, body composition and well-being of children and youth in Extremadura every year and (2) to evaluate the relationship between obesity, overweight, physical condition, well-being, self-perceived physical fitness, physical activity adherence, physical literacy, health-related quality of life (HRQoL), happiness and satisfaction with life, connection with nature, barriers to sports practice, self-concept and bullying in children and youth. Methods: An annual monitoring cross-sectional and follow-up study will be performed. Primary outcome measures will be (1) personal data and anthropometric measurements, (2) family and school information, (3) physical condition, (4) obesity and overweight level, and (5) well-being. Secondary outcome measures will be (1) self-perceived physical fitness, (2) physical activity adherence, (3) physical literacy, (4) HRQoL, (5) happiness and satisfaction with life, (6) connection with nature, (7) barriers to sports practice, (8) self-concept and (9) bullying. Discussion: This project will provide valuable information to adopt appropriate strategies to reduce the level of overweight and obesity in children and youth. Furthermore, orientations will be given to transfer the results obtained to the business sector or to the public sector to evaluate or change the policies adopted.
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Lamsal R, Finlay B, Whitehurst DGT, Zwicker JD. Generic preference-based health-related quality of life in children with neurodevelopmental disorders: a scoping review. Dev Med Child Neurol 2020; 62:169-177. [PMID: 31225644 PMCID: PMC7065222 DOI: 10.1111/dmcn.14301] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/02/2019] [Indexed: 12/11/2022]
Abstract
AIM To describe how generic preference-based health-related quality of life (HRQoL) instruments have been used in research involving children with neurodevelopmental disorders (NDD). METHOD A systematic search of nine databases identified studies that used generic preference-based HRQoL instruments in children with NDD. Data extracted following the Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Review guidelines included type of NDD, instrument used, respondent type, justification, and critical appraisal for these selections. RESULTS Thirty-six studies were identified: four cost-utility analyses; 15 HRQoL assessments; five economic burden studies; three intervention studies; and nine 'other'. The Health Utilities Index (Mark 2 and Mark 3) and EuroQoL 5D (EQ-5D; three-level EQ-5D, five-level EQ-5D, and the youth version of the EQ-5D) instruments were most frequently used (44% and 31% respectively). The relatively low use of these instruments overall may be due to a lack of psychometric evidence, inconsistency in justification for and lack of clarity on appropriate respondent type and age, and geographical challenges in applying preference weights. INTERPRETATION This study highlights the dearth of studies using generic preference-based HRQoL instruments in children with NDD. The use of cost-utility analysis in this field is limited and validation of these instruments for children with NDD is needed. The quality of data should be considered before guiding policy and care decisions. WHAT THIS PAPER ADDS Limited use of generic preference-based health-related quality of life (HRQoL) instruments in studies on children with neurodevelopmental disorders. Only 11% of studies were cost-utility analyses. Inconsistencies in justification for choosing generic preference-based HRQoL instruments and respondent types.
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Affiliation(s)
- Ramesh Lamsal
- School of Public PolicyUniversity of CalgaryCalgaryAlbertaCanada
| | - Brittany Finlay
- School of Public PolicyUniversity of CalgaryCalgaryAlbertaCanada
| | - David G T Whitehurst
- Faculty of Health SciencesSimon Fraser UniversityBurnabyBritish ColumbiaCanada,Centre for Clinical Epidemiology and EvaluationVancouver Coastal Health Research InstituteVancouverBritish ColumbiaCanada
| | - Jennifer D Zwicker
- School of Public PolicyUniversity of CalgaryCalgaryAlbertaCanada,Faculty of KinesiologyUniversity of CalgaryCalgaryAlbertaCanada
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Kwon J, Kim SW, Ungar WJ, Tsiplova K, Madan J, Petrou S. Patterns, trends and methodological associations in the measurement and valuation of childhood health utilities. Qual Life Res 2019; 28:1705-1724. [PMID: 30783876 PMCID: PMC6571090 DOI: 10.1007/s11136-019-02121-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE To systematically assess patterns and temporal changes in the measurement and valuation of childhood health utilities and associations between methodological factors. METHODS Studies reporting childhood health utilities using direct or indirect valuation methods, published by June 2017, were identified through PubMed, Embase, Web of Science, PsycINFO, EconLit, CINAHL, Cochrane Library and PEDE. The following were explored: patterns in tariff application; linear trends in numbers of studies/samples and paediatric cost-utility analyses (CUAs) and associations between them; changes in proportions of studies/samples within characteristic-based categories over pre-specified periods; impact of National Institute for Health and Care Excellence (NICE) guidance on primary UK research and associations between valuation method, age and methodological factors. RESULTS 335 studies with 3974 samples covering all ICD-10 chapters, 23 valuation methods, 12 respondent types and 42 countries were identified by systematic review. 34.0% of samples using indirect methods compatible with childhood applied childhood-derived tariffs. There was no association between numbers of studies/samples and numbers of CUAs. Compared to 1990-2008, 2009-June 2017 saw a significant fall in the proportion of studies using case series; significant compositional changes across ICD-10 chapters and significantly higher sample proportions using childhood-specific and adult-specific indirect valuation methods, and based on pre-adolescents, self-assessment, self-administration and experienced health states. NICE guidance was weakly effective in promoting reference methods. Associations between valuation method, age and methodological factors were significant. CONCLUSION 1990-2017 witnessed significant changes in primary research on childhood health utilities. Health technology assessment agencies should note the equivocal effect of methodological guidance on primary research.
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Affiliation(s)
- Joseph Kwon
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Sung Wook Kim
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - Wendy J Ungar
- Program of Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Kate Tsiplova
- Program of Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Canada
| | - Jason Madan
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - Stavros Petrou
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK.
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Mukuria C, Rowen D, Harnan S, Rawdin A, Wong R, Ara R, Brazier J. An Updated Systematic Review of Studies Mapping (or Cross-Walking) Measures of Health-Related Quality of Life to Generic Preference-Based Measures to Generate Utility Values. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2019; 17:295-313. [PMID: 30945127 DOI: 10.1007/s40258-019-00467-6] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND Mapping is an increasingly common method used to predict instrument-specific preference-based health-state utility values (HSUVs) from data obtained from another health-related quality of life (HRQoL) measure. There have been several methodological developments in this area since a previous review up to 2007. OBJECTIVE To provide an updated review of all mapping studies that map from HRQoL measures to target generic preference-based measures (EQ-5D measures, SF-6D, HUI measures, QWB, AQoL measures, 15D/16D/17D, CHU-9D) published from January 2007 to October 2018. DATA SOURCES A systematic review of English language articles using a variety of approaches: searching electronic and utilities databases, citation searching, targeted journal and website searches. STUDY SELECTION Full papers of studies that mapped from one health measure to a target preference-based measure using formal statistical regression techniques. DATA EXTRACTION Undertaken by four authors using predefined data fields including measures, data used, econometric models and assessment of predictive ability. RESULTS There were 180 papers with 233 mapping functions in total. Mapping functions were generated to obtain EQ-5D-3L/EQ-5D-5L-EQ-5D-Y (n = 147), SF-6D (n = 45), AQoL-4D/AQoL-8D (n = 12), HUI2/HUI3 (n = 13), 15D (n = 8) CHU-9D (n = 4) and QWB-SA (n = 4) HSUVs. A large number of different regression methods were used with ordinary least squares (OLS) still being the most common approach (used ≥ 75% times within each preference-based measure). The majority of studies assessed the predictive ability of the mapping functions using mean absolute or root mean squared errors (n = 192, 82%), but this was lower when considering errors across different categories of severity (n = 92, 39%) and plots of predictions (n = 120, 52%). CONCLUSIONS The last 10 years has seen a substantial increase in the number of mapping studies and some evidence of advancement in methods with consideration of models beyond OLS and greater reporting of predictive ability of mapping functions.
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Affiliation(s)
- Clara Mukuria
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - Donna Rowen
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Sue Harnan
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Andrew Rawdin
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Ruth Wong
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Roberta Ara
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - John Brazier
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
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Rissanen A, Lindberg N, Marttunen M, Sintonen H, Roine R. CAPMH health-related quality of life among adolescent psychiatric outpatients: a 12-month follow-up study among 12-14-year-old Finnish boys and girls. Child Adolesc Psychiatry Ment Health 2019; 13:17. [PMID: 30962819 PMCID: PMC6434830 DOI: 10.1186/s13034-019-0278-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/15/2019] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Little is known about adolescents' perceptions about their health-related quality of life (HRQoL) in the course of routine adolescent psychiatric treatment. The aim of this 1-year follow-up study was to investigate HRQoL and changes in it among youths receiving adolescent psychiatric outpatient treatment. METHODS The study comprised 158 girls and 82 boys aged 12-14 years from 10 psychiatric outpatient clinics in one Finnish hospital district. Same-aged population controls (210 girls and 162 boys) were randomly collected from comprehensive schools. HRQoL was measured using the 16D instrument. The questionnaire was self-administered when the adolescents entered the polyclinics (= baseline), after a treatment period of 6 months, and after 12 months. RESULTS The mean age of respondents was 13.8 years (SD 0.63). At baseline, the mean HRQoL score of both female and male outpatients was significantly lower than that of population controls (p < 0.001). HRQoL of female patients was significantly worse than that of male patients (p < 0.001). In girls, HRQoL improved continuously during the 12-month follow-up, yet it remained worse than that of female population controls. Among boys, HRQoL was substantially better at the 6-month follow-up than at baseline, but this positive development was no longer seen at the 12-month follow-up. CONCLUSIONS From the perspective of HRQoL, girls seem to benefit more than boys from adolescent psychiatric outpatient treatment. Possible explanations for this finding are discussed.
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Affiliation(s)
- Anne Rissanen
- Department of Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Lohja, Finland
| | - Nina Lindberg
- Department of Forensic Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mauri Marttunen
- Department of Adolescent Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Harri Sintonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Risto Roine
- Helsinki University Hospital, Administration, Research, and Development, Helsinki, Finland and Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
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Kreimeier S, Greiner W. EQ-5D-Y as a Health-Related Quality of Life Instrument for Children and Adolescents: The Instrument's Characteristics, Development, Current Use, and Challenges of Developing Its Value Set. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2019; 22:31-37. [PMID: 30661631 DOI: 10.1016/j.jval.2018.11.001] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 10/24/2018] [Accepted: 11/02/2018] [Indexed: 05/18/2023]
Abstract
OBJECTIVES Interest in the measurement of health-related quality of life (HRQoL) in children and adolescents has been increasing, and appropriate instruments are required for this target group. This article focuses on the EQ-5D-Y instrument, presenting an overview of its characteristics, development, and current use, and includes a discussion of methodological and conceptual issues related to the valuation of child health and the development of an EQ-5D-Y value set. METHODS This article brings together the experiences of the research team that developed and validated the EQ-5D-Y, supplemented by information derived from EQ-5D-Y study registrations on the EuroQol Group's website. RESULTS EQ-5D-Y is a child-specific and age-appropriate measure of HRQoL. Study registration data show that the instrument's use has steadily increased since its first publication. It has been used in various types of studies and in different disease areas. Currently there is no value set for EQ-5D-Y, and so its use in cost-utility analysis (CUA) is limited. There are methodological and conceptual issues that affect the design of valuation studies for child health. Issues that are discussed include the need for separate value sets for children and adolescents, the choice of appropriate reference samples and valuation techniques, and the framing of the tasks. CONCLUSIONS Research on EQ-5D-Y and its use has increased in the last years. Further research is required to clarify methodological issues regarding health state valuation in children and adolescents. This will support the development of a value set for EQ-5D-Y and the use of EQ-5D-Y in CUA.
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Affiliation(s)
- Simone Kreimeier
- Department of Health Economics and Health Care Management, Faculty of Health Science, Bielefeld University, Bielefeld, Germany.
| | - Wolfgang Greiner
- Department of Health Economics and Health Care Management, Faculty of Health Science, Bielefeld University, Bielefeld, Germany
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Anestin AS, Lippé S, Robaey P, Bertout L, Drouin S, Krajinovic M, Michon B, Rondeau É, Samoilenko M, Laverdière C, Sinnett D, Sultan S. Psychological risk in long-term survivors of childhood acute lymphoblastic leukemia and its association with functional health status: A PETALE cohort study. Pediatr Blood Cancer 2018; 65:e27356. [PMID: 30084222 DOI: 10.1002/pbc.27356] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/18/2018] [Accepted: 06/19/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND Recent research has suggested that long-term pediatric cancer survivors were at risk of important physical and psychological morbidities. To date, we do not know to what extent functional health status contributes to psychological risk and which domains are most important. The aim of this study was to systematically explore which functional domain could explain anxiety, depression, and distress symptoms. PROCEDURE We used data available for 105 adolescents and 182 adults successfully treated for childhood acute lymphoblastic leukemia at two Canadian sites part of the PETALE cohort. Participants were ≥5 years postdiagnosis, aged 22 ± 6 years, 52% female, and 49% acute lymphoblastic leukemia high-risk status. The contribution of health functional status (15D/16D questionnaires) to self-reported anxiety, depression, and distress (Beck scales and distress thermometer) was evaluated using adjusted logistic regression models. RESULTS Prevalence rates found for mild-severe anxiety, depression, and distress were 14%, 21%, and 30% among adolescents and 27%, 20%, and 19% among adults. Frequent health domains associated with psychological risk were sleeping and breathing in adolescents, and vitality/fatigue, discomfort/symptoms, mental function, and sleeping in adults. Mental function was systematically associated with psychological risk across age groups (median OR = 10.00, 95% CI 3.01-33.71). Exploratory mediation bootstrapping analyses suggested that the effect on psychological risk of overall health status and mental function problems was partly explained by social/work/school functioning. CONCLUSION The results identified important functional health domains that could be targeted for interventions preventing psychological risk: vitality/fatigue, discomfort/symptoms, sleeping, and mental function issues. Health domains probably affect mood partly by limiting social/work/school functioning.
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Affiliation(s)
- Annélie S Anestin
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada.,Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Sarah Lippé
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada.,Department of Psychology, Université de Montréal, Montréal, Québec, Canada
| | - Philippe Robaey
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada.,Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.,University of Ottawa, Ottawa, Ontario, Canada
| | - Laurence Bertout
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada
| | - Simon Drouin
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada
| | - Maja Krajinovic
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada.,Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
| | - Bruno Michon
- Quebec University Health Center (QUHC), Montréal, Québec, Canada
| | - Émélie Rondeau
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada
| | - Mariia Samoilenko
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada.,Université du Québec à Montréal (UQAM), Montréal, Québec, Canada
| | - Caroline Laverdière
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada.,Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
| | - Daniel Sinnett
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada.,Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
| | - Serge Sultan
- Sainte-Justine University Health Center (SJUHC), Montréal, Québec, Canada.,Department of Psychology, Université de Montréal, Montréal, Québec, Canada.,Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
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Rowen D, Mulhern B, Stevens K, Vermaire JH. Estimating a Dutch Value Set for the Pediatric Preference-Based CHU9D Using a Discrete Choice Experiment with Duration. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2018; 21:1234-1242. [PMID: 30314625 DOI: 10.1016/j.jval.2018.03.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 02/13/2018] [Accepted: 03/19/2018] [Indexed: 05/20/2023]
Abstract
OBJECTIVE This article presents the development of the Dutch value set for the Child Health Utility 9D, a pediatric preference-based measure of quality of life that can be used to generate quality-adjusted life-years. METHODS A large online survey was conducted using a discrete choice experiment including a duration attribute with adult members of the Netherlands general population (N = 1276) who were representative in terms of age, gender, marital status, employment, education, and region. Respondents were asked which of two health states they prefer, where each health state was described using the nine dimensions of the Child Health Utility 9D (worried, sad, pain, tired, annoyed, school work/homework, sleep, daily routine, able to join in activities) and duration. The data were modeled using conditional logit with robust standard errors to produce utility values for every health state described by the Child Health Utility 9D. RESULTS The majority of the dimension level coefficients were monotonic, leading to a decrease in utility as severity increases. There was, however, evidence of some logical inconsistencies, particularly for the school work/homework dimension. The value set produced was based on the ordered model and ranges from -0.568 for the worst state to 1 for the best state. CONCLUSION The valuation of the Child Health Utility 9D using online discrete choice experiment with duration with adult members of the Dutch general population was feasible and produced a valid model for use in cost utility analysis. Normative questions are raised around the valuation of pediatric preference-based measures, including the appropriate perspective for imagining hypothetical pediatric health states.
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Affiliation(s)
- Donna Rowen
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK.
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia
| | - Katherine Stevens
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Jan Hendrik Vermaire
- TNO Child Health, Oral Health Division, Leiden, The Netherlands; Centrum voor Tandheelkunde en Mondzorgkunde, University of Groningen, Groningen, The Netherlands
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Liimatta J, Sintonen H, Utriainen P, Voutilainen R, Jääskeläinen J. Children with a History of Premature Adrenarche Have Good Health-Related Quality of Life at the Age of 12 Years. Horm Res Paediatr 2018; 89:184-188. [PMID: 29502117 DOI: 10.1159/000487134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/22/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIM Children with premature adrenarche (PA) are taller and more overweight than their healthy peers, and PA girls have a slightly accelerated pubertal development. There is some evidence that early exposure to androgens may have an influence on psychosocial development. The aim of this cross-sectional case-control study was to evaluate health-related quality of life (HRQoL) in PA children at the age of 12 years. METHODS The HRQoL was assessed for 43 PA (36 girls) and 63 control children (52 girls) at the median age of 12.0 years using the standardized 16D instrument, and the scores of the PA children were compared to those of the control children and reference population. RESULTS The mean overall HRQoL scores did not differ between PA and control girls, PA and control boys, or all PA and control children or the reference population. Independently of PA, overweight girls had a lower mean overall HRQoL score than lean girls, and both overweight girls and boys were on average worse off on the dimension of appearance than their lean peers. CONCLUSIONS PA children have as good self-rated HRQoL as their peers at the age of 12 years. Overweight is associated with a worse HRQoL profile independently of PA.
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Affiliation(s)
- Jani Liimatta
- Department of Pediatrics, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - Harri Sintonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Pauliina Utriainen
- Department of Pediatrics, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - Raimo Voutilainen
- Department of Pediatrics, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - Jarmo Jääskeläinen
- Department of Pediatrics, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
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47
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Poder TG, Carrier N, Mead H, Stevens KJ. Canadian French translation and linguistic validation of the child health utility 9D (CHU9D). Health Qual Life Outcomes 2018; 16:168. [PMID: 30157857 PMCID: PMC6114803 DOI: 10.1186/s12955-018-0998-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 08/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several preference based measures are validated for adults in cost utility analysis, but less are available for children and many researchers have criticized the quality of pediatric economic studies. The objective of this study was to perform a Canadian French translation and linguistic validation of the Child Health Utility 9D (CHU9D) that was conceptually equivalent to the original English version for use in Canada. METHODS The translation and linguistic validation were realized by ICON Clinical Research (UK) Limited in association with the developer of the CHU9D and Canadian collaborators. This was done in accordance with industry standards and the guidance of the Food and Drug Administration (FDA) for patient-reported outcome (PRO) instruments. Five steps were considered: concept elaboration; forward translation; back translation; linguistic validation; proofreading and final verification. RESULTS The CHU9D Canadian French translation and linguistic validation were realized without any major difficulties. Only 3 changes were made after the forward translation and 5 after the back translation. The result of back translation was very similar to the original English version. Six additional changes suggested by the developer team were accepted and the linguistic validation with five children led to 2 additional changes. Most changes were generally to change one word to better sounding Canadian French. CONCLUSION We produced a Canadian French translation and cross-cultural adaptation of the Child Health Utility 9D (CHU9D). Before being used in clinical settings and research projects, the final Canadian French translation needs to be validated for metrological qualities of reliability and validity.
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Affiliation(s)
- Thomas G Poder
- UETMIS and CRCHUS, CIUSSS de l'Estrie - CHUS, Sherbrooke, Canada.
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Factors associated with health-related quality of life 6 years after ICU discharge in a Finnish paediatric population: a cohort study. Intensive Care Med 2018; 44:1378-1387. [PMID: 30136138 DOI: 10.1007/s00134-018-5296-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 06/29/2018] [Indexed: 01/13/2023]
Abstract
PURPOSE Long-term data are urgently needed in children after intensive care. The aim of this study was to measure health-related quality of life 6 years after intensive care in a paediatric intensive care population. METHODS This national, multicentre study enrolled all children and young people admitted to intensive care units (ICUs) in Finland in 2009 and 2010. The data concerning ICU stay were collected retrospectively from the ICU data registries and combined with prospective data from Paediatric Quality of Life Inventory (PedsQL 4.0) questionnaires, the generic 15D, 16D or 17D instrument, and data regarding children's chronic diagnoses and need for healthcare support. RESULTS The questionnaires were answered by 1109 of 3682 living children and adolescents admitted to an ICU, response rate was 30.1%. Among the responders, 90 children (8.4%) had poor (under - 2 SD) PedsQL scores. Children with low scores had a higher rate of chronic diagnoses (94.4% vs. 47.6%), medication on a daily basis (78.7% vs. 29.4%) and a greater need for healthcare services (97.7% vs. 82.2%) than those with normal scores. Diagnoses associated with poor quality of life were asthma, epilepsy, cerebral palsy and other neurological diseases, chromosomal alterations, cancer and long-term pain. These children were mostly admitted electively, and less frequently on an emergency basis, but no other significant differences were found during the intensive care stay. CONCLUSIONS The long-term quality of life after paediatric intensive care is good for the majority of children and young people, and it is dependent on the number of chronic diagnoses and the burden of the chronic disease, especially neurological diseases.
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Tonmukayakul U, Le LKD, Mudiyanselage SB, Engel L, Bucholc J, Mulhern B, Carter R, Mihalopoulos C. A systematic review of utility values in children with cerebral palsy. Qual Life Res 2018; 28:1-12. [PMID: 30073470 DOI: 10.1007/s11136-018-1955-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE Project aims include the following: (i) to identify reported utility values associated with CP in children aged ≤ 18 years; (ii) to explore utility value elicitation techniques in published studies; and (iii) to examine performance of the measures and/or elicitation approaches. METHODS Peer-reviewed studies published prior to March 2017 were identified from six electronic databases. Construct validity, convergent validity, responsiveness, and reliability of instruments were assessed. RESULTS Five studies met the inclusion criteria. Utility values of hypothetical general CP states obtained from a general population of parents ranged from 0.55 to 0.88 using time trade off (TTO) and 0.60-0.87 using standard gamble (SG) techniques. Utility values reported by clinicians of three hypothetical spastic quadriplegic CP states, using the Health Utility Index Mark 2 (HUI-2), ranged from 0.40 to 0.13. Other sources of utilities identified were based on both proxy and child ratings using Health Utility Index Mark 3 (HUI-3) (values ranged from - 0.013 to 0.84 depending on the valuation source) and the Assessment of Quality of Life 4 Dimension instrument, with values ranging from 0.01 to 0.58. Construct validity of the HUI-3 varied from moderate to strong, whereas mixed results were found for convergent validity. Responsiveness and reliability were not reported. CONCLUSION There was substantial variation in reported utilities. Indirect techniques (i.e. via multi-attribute utility instruments) were more frequently used than direct techniques (e.g. TTO, SG). Further research is required to improve the robustness of utility valuation of health-related quality of life in children with CP for use in economic evaluation.
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Affiliation(s)
- Utsana Tonmukayakul
- Deakin Health Economics, Centre for Population Health Research, Deakin University, Locked Bag 20000, Geelong, VIC, 3220, Australia. .,Deakin Health Economics, Centre for Population Health Research, Deakin University, 3rd Floor BC Building 221 Burwood Highway, Burwood, Melbourne, VIC, 3125, Australia.
| | - Long Khanh-Dao Le
- Deakin Health Economics, Centre for Population Health Research, Deakin University, Locked Bag 20000, Geelong, VIC, 3220, Australia
| | - Shalika Bohingamu Mudiyanselage
- Deakin Health Economics, Centre for Population Health Research, Deakin University, Locked Bag 20000, Geelong, VIC, 3220, Australia
| | - Lidia Engel
- Deakin Health Economics, Centre for Population Health Research, Deakin University, Locked Bag 20000, Geelong, VIC, 3220, Australia
| | - Jessica Bucholc
- Deakin Health Economics, Centre for Population Health Research, Deakin University, Locked Bag 20000, Geelong, VIC, 3220, Australia
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, 1-59 Quay Street, Hay Market, Sydney, NSW, 2000, Australia
| | - Rob Carter
- Deakin Health Economics, Centre for Population Health Research, Deakin University, Locked Bag 20000, Geelong, VIC, 3220, Australia
| | - Cathrine Mihalopoulos
- Deakin Health Economics, Centre for Population Health Research, Deakin University, Locked Bag 20000, Geelong, VIC, 3220, Australia
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Niemensivu R, Roine RP, Sintonen H, Kentala E. Health-related quality of life in hearing-impaired adolescents and children. Acta Otolaryngol 2018; 138:652-658. [PMID: 29468919 DOI: 10.1080/00016489.2018.1438661] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate health-related quality of life (HRQoL) in hearing-impaired adolescents and children and to compare it with that of hearing individuals. STUDY DESIGN AND SETTING Hearing-impaired adolescents and children were recruited to the study during their annual control visit to the Hearing Clinic of Helsinki University Hospital. They filled in a HRQoL questionnaire, either the 16-dimensional 16D (adolescents aged 12-17 years) or the 17-dimensional 17D (children aged 7-11 years). The total HRQoL scores were compared with previously collected data, matched for age and gender, from adolescents and children without any known handicaps or illnesses. RESULTS In total 50 adolescents and 50 children completed the questionnaire. Of the 16/17 dimensions of the HRQoL instrument, hearing and communication were affected the most. The total HRQoL scores were somewhat lower in adolescents and children with hearing impairment than in the general populations of age-matched peers (p < .001 for adolescents and .030 for children). CONCLUSIONS HRQoL in hearing-impaired adolescents and children is only slightly worse than in hearing adolescents and children. SIGNIFICANCE This study evaluates the impact of hearing loss on HRQoL to enhance the care of these children.
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Affiliation(s)
- Riina Niemensivu
- Department of Otorhinolaryngology-Head and Neck Surgery, Hearing Clinic, Helsinki University Hospital, Helsinki, Finland
| | - Risto Paavo Roine
- Group Administration, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Harri Sintonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Erna Kentala
- Department of Otorhinolaryngology-Head and Neck Surgery, Hearing Clinic, Helsinki University Hospital, Helsinki, Finland
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