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Espirito Santo CM, Miyamoto GC, Santos VS, Ben ÂJ, Finch AP, Roudijk B, de Jesus-Moraleida FR, Stein AT, Santos M, Yamato TP. Estimating an EQ-5D-Y-3L Value Set for Brazil. PHARMACOECONOMICS 2024:10.1007/s40273-024-01404-9. [PMID: 38954389 DOI: 10.1007/s40273-024-01404-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/27/2024] [Indexed: 07/04/2024]
Abstract
INTRODUCTION The EQ-5D-Y-3L is a generic measure of health-related quality of life in children and adolescents. Although the Brazilian-Portuguese EQ-5D-Y-3L version is available, there is no value set for it, hampering its use in economic evaluations. This study aimed to elicit a Brazilian EQ-5D-Y-3L value set based on preferences of the general adult population. METHODS Two independent samples of adults participated in an online discrete choice experiment (DCE) survey and a composite time trade-off (cTTO) face-to-face interview. The framing was "considering your views for a 10-year-old child". DCE data were analyzed using a mixed-logit model. The 243 DCE predicted values were mapped into the observed 28 cTTO values using linear and non-linear mapping approaches with and without intercept. Mapping approaches' performance was assessed to estimate the most valid method to rescale DCE predicted values using the model fit (R2), Akaike Information Criteria (AIC), root mean squared error (RMSE), and mean absolute error (MAE). RESULTS A representative sample of 1376 Brazilian adults participated (DCE, 1152; cTTO, 211). The linear mapping without intercept (R2 = 96%; AIC, - 44; RMSE, 0.0803; MAE, - 0.0479) outperformed the non-linear without intercept (R2 = 98%; AIC, - 63; RMSE, 0.1385; MAE, - 0.1320). Utilities ranged from 1 (full health) to - 0.0059 (the worst health state). Highest weights were assigned to having pain or discomfort (pain/discomfort), followed by walking about (mobility), looking after myself (self-care), doing usual activities (usual activities), and feeling worried, sad, or unhappy (anxiety/depression). CONCLUSION This study elicited the Brazilian EQ-5D-Y-3L value set using a mixed-logit DCE model with a power parameter based on a linear mapping without intercept, which can be used to estimate the quality-adjusted life-years for economic evaluations of health technologies targeting the Brazilian youth population.
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Affiliation(s)
- Caique Melo Espirito Santo
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno, 448/475, Tatuapé, São Paulo, 03071-000, Brazil
| | - Gisela Cristiane Miyamoto
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno, 448/475, Tatuapé, São Paulo, 03071-000, Brazil
| | - Verônica Souza Santos
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno, 448/475, Tatuapé, São Paulo, 03071-000, Brazil
| | - Ângela Jornada Ben
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Bram Roudijk
- EuroQol Research Foundation, Rotterdam, The Netherlands
| | | | - Airton Tetelbom Stein
- Department of Public Health, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Marisa Santos
- Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
| | - Tiê Parma Yamato
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno, 448/475, Tatuapé, São Paulo, 03071-000, Brazil.
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, Australia.
- Nepean Blue Mountains Local Health District, Penrith, NSW, Australia.
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Engel L, Chiotelis O, Papadopoulos N, Hiscock H, Howlin P, McGillivray J, Bellows ST, Rinehart N, Mihalopoulos C. Sleeping Sound Autism Spectrum Disorder (ASD): Cost-Effectiveness of a Brief Behavioural Sleep Intervention in Primary School-Aged Autistic Children. J Autism Dev Disord 2024:10.1007/s10803-024-06422-2. [PMID: 38833029 DOI: 10.1007/s10803-024-06422-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2024] [Indexed: 06/06/2024]
Abstract
Disordered sleep is common in autistic children. This study aimed to evaluate the cost-effectiveness of a brief behavioural sleep intervention, the 'Sleeping Sound intervention', in primary school-aged autistic children in Australia. A cost-effectiveness analysis was undertaken alongside a randomised controlled trial over a 6-month follow-up period from both a societal and healthcare sector perspective. Resources used by participants were collected from a resource-use questionnaire and administrative data; intervention costs were determined from study records. Mean costs and quality-adjusted life-years (QALYs) were compared between the intervention and treatment as usual (TAU) groups. Uncertainty analysis using bootstrapping and sensitivity analyses were conducted. The sample included 245 children, with 123 participants randomised to the intervention group and 122 to TAU. The mean total costs were higher for the Sleeping Sound intervention with a mean difference of A$745 (95% CI 248; 1242; p = 0.003) from a healthcare sector perspective and A$1310 (95% CI 584; 2035, p < 0.001) from a societal perspective. However, the intervention also resulted in greater QALYs compared with TAU, with a mean difference of 0.038 (95% CI 0.004; 0.072; p = 0.028). The incremental cost-effectiveness ratio was A$24,419/QALY (95% CI 23,135; 25,703) from a healthcare sector perspective and A$41,922/QALY (95% CI 39,915; 43,928) from a societal perspective; with a probability of being cost-effective of 93.8% and 74.7%, respectively. Findings remained robust in the sensitivity analyses. The Sleeping Sound intervention offers a cost-effective approach in improving sleep in primary school-aged autistic children.Trial registration The trial was registered with the International Trial Registry (ISRCTN14077107).
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Affiliation(s)
- Lidia Engel
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Oxana Chiotelis
- Deakin Health Economics, School of Health and Social Development, Deakin University, Geelong, VIC, Australia
| | - Nicole Papadopoulos
- Krongold Clinic, Faculty of Education, Monash University, Notting Hill, VIC, Australia
- School of Educational Psychology & Counselling, Monash University, Melbourne, VIC, Australia
| | - Harriet Hiscock
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Patricia Howlin
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jane McGillivray
- School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Susannah T Bellows
- School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Nicole Rinehart
- Krongold Clinic, Faculty of Education, Monash University, Notting Hill, VIC, Australia
| | - Cathrine Mihalopoulos
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Deakin Health Economics, School of Health and Social Development, Deakin University, Geelong, VIC, Australia
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Jones R, O'Loughlin R, Xiong X, Bahrampour M, Devlin N, Hiscock H, Chen G, Mulhern B, Dalziel K. Comparative Psychometric Performance of Common Generic Paediatric Health-Related Quality of Life Instrument Descriptive Systems: Results from the Australian Paediatric Multi-Instrument Comparison Study. PHARMACOECONOMICS 2024; 42:39-55. [PMID: 37955799 PMCID: PMC11169028 DOI: 10.1007/s40273-023-01330-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE The aim of this study was to compare the psychometric performance of common generic paediatric health-related quality-of-life instrument descriptive systems (PedsQL generic core 4.0, EQ-5D-Y-3L, EQ-5D-Y-5L, Child Health Utility 9D [CHU9D], Assessment of Quality of Life 6D [AQoL-6D], and Health Utilities Index Mark 3 [HUI3]) by child age, report type, and health status. METHODS Data for children aged 5-18 years were from the Australian Paediatric Multi-Instrument Comparison study. Ceiling effects, test-retest reliability, known-group validity, convergent and divergent validity, and responsiveness were assessed in the total sample and by child age (5-12 years vs 13-18 years), report type (self- vs proxy report), and health status. Instruments were scored using an exploratory level sum score (LSS) approach. RESULTS Survey data were available for 5945 children, with follow-up data available for 2346 children. The EQ-5D-Y-3L demonstrated ceiling effects. The PedsQL, EQ-5D-Y-3L, EQ-5D-Y-5L, and CHU9D demonstrated acceptable test-retest reliability. All instruments demonstrated known-group, convergent, and divergent validity. The EQ-5D-Y-3L, EQ-5D-Y-5L, and CHU9D demonstrated responsiveness to improvements in health and the PedsQL, EQ-5D-Y-3L, EQ-5D-Y-5L, and CHU9D to worsening health. The AQoL-6D and HUI3 had inconclusive test-retest reliability and responsiveness evidence due to small sample size. Importantly, ceiling effects, test-retest reliability and responsiveness varied by subgroup. CONCLUSION Results reflect instrument performance using LSSs, which may differ to utility scores. In the total sample, the EQ-5D-Y-5L and CHU9D descriptive systems demonstrated evidence of good performance (i.e., meeting prespecified criteria) across all psychometric attributes tested. Performance varied by child age and report type, indicating room for considerations by population and study.
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Affiliation(s)
- Renee Jones
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia.
- Health Services and Economics, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
| | - Rachel O'Loughlin
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia
- Health Services and Economics, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Health Services Research Unit, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Xiuqin Xiong
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia
| | - Mina Bahrampour
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Ultimo, NSW, Australia
| | - Nancy Devlin
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia
| | - Harriet Hiscock
- Health Services and Economics, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Health Services Research Unit, Royal Children's Hospital, Melbourne, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Ultimo, NSW, Australia
| | - Kim Dalziel
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia
- Health Services and Economics, Murdoch Children's Research Institute, Melbourne, VIC, Australia
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O'Loughlin R, Jones R, Chen G, Mulhern B, Hiscock H, Devlin N, Dalziel K. Comparing the Psychometric Performance of Generic Paediatric Health-Related Quality of Life Instruments in Children and Adolescents with ADHD, Anxiety and/or Depression. PHARMACOECONOMICS 2024; 42:57-77. [PMID: 38329689 PMCID: PMC11168999 DOI: 10.1007/s40273-024-01354-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 02/09/2024]
Abstract
OBJECTIVE The aim of this study was to examine the validity, reliability and responsiveness of common generic paediatric health-related quality of life (HRQoL) instruments in children and adolescents with mental health challenges. METHODS Participants were a subset of the Australian Paediatric Multi-Instrument Comparison (P-MIC) study and comprised 1013 children aged 4-18 years with attention-deficit/hyperactivity disorder (ADHD) (n = 533), or anxiety and/or depression (n = 480). Participants completed an online survey including a range of generic paediatric HRQoL instruments (PedsQL, EQ-5D-Y-3L, EQ-5D-Y-5L, CHU9D) and mental health symptom measures (SDQ, SWAN, RCADS-25). A subset of participants also completed the HUI3 and AQoL-6D. The psychometric performance of each HRQoL instrument was assessed regarding acceptability/feasibility; floor/ceiling effects; convergent validity; known-group validity; responsiveness and test-retest reliability. RESULTS The PedsQL, CHU9D, EQ-5D-Y-3L and EQ-5D-Y-5L showed similarly good performance for acceptability/feasibility, known-group validity and convergent validity. The CHU9D and PedsQL showed no floor or ceiling effects and fair-good test-retest reliability. Test-retest reliability was lower for the EQ-5D-Y-3L and EQ-5D-Y-5L. The EQ-5D-Y-3L showed the highest ceiling effects, but was the top performing instrument alongside the CHU9D on responsiveness to improvements in health status, followed by the PedsQL. The AQoL-6D and HUI3 showed good acceptability/feasibility, no floor or ceiling effects, and good convergent validity, yet poorer performance on known-group validity. Responsiveness and test-retest reliability were not able to be assessed for these two instruments. In subgroup analyses, performance was similar for all instruments for acceptability/feasibility, known-group and convergent validity, however, relative strengths and weaknesses for each instrument were noted for ceiling effects, responsiveness and test-retest reliability. In sensitivity analyses using utility scores, performance regarding known-group and convergent validity worsened slightly for the EQ-5D-Y-3L and CHU9D, though improved slightly for the HUI3 and AQoL-6D. CONCLUSIONS While each instrument showed strong performance in some areas, careful consideration of the choice of instrument is advised, as this may differ dependent on the intended use of the instrument, and the age, gender and type of mental health condition of the population in which the instrument is being used. TRIAL REGISTRATION ANZCTR-ACTRN12621000657820.
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Affiliation(s)
- Rachel O'Loughlin
- Health Economics Unit, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, 3010, Australia.
- Health Services Research Unit, The Royal Children's Hospital, Parkville, VIC, Australia.
- Health Services and Economics, Murdoch Children's Research Institute, Parkville, VIC, Australia.
| | - Renee Jones
- Health Economics Unit, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, 3010, Australia
- Health Services Research Unit, The Royal Children's Hospital, Parkville, VIC, Australia
- Health Services and Economics, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Gang Chen
- Centre for Health Economics, Monash University, Caulfield East, VIC, Australia
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Ultimo, NSW, Australia
| | - Harriet Hiscock
- Health Services Research Unit, The Royal Children's Hospital, Parkville, VIC, Australia
- Health Services and Economics, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Nancy Devlin
- Health Economics Unit, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - Kim Dalziel
- Health Economics Unit, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, 3010, Australia
- Health Services and Economics, Murdoch Children's Research Institute, Parkville, VIC, Australia
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Perry N, Boulton KA, Hodge A, Ong N, Phillips N, Howard K, Raghunandan R, Silove N, Guastella AJ. A psychometric investigation of health-related quality of life measures for paediatric neurodevelopment assessment: Reliability and concurrent validity of the PEDS-QL, CHU-9D, and the EQ-5D-Y. Autism Res 2024; 17:972-988. [PMID: 38597587 DOI: 10.1002/aur.3127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/19/2024] [Indexed: 04/11/2024]
Abstract
There is a need for tools that can provide a brief assessment of functioning for children with neurodevelopmental conditions, including health-related quality of life (HR-QoL). This study evaluated the psychometric properties of three commonly used and well known HR-QoL measures in a cohort of children presenting to clinical developmental assessment services. The most common diagnoses received in these assessment services were autism spectrum disorders. Findings showed good internal consistency for the PedsQL and the CHU-9D, but not the EQ-5D-Y. This research also found that the CHU-9D, EQ-5D-Y, and PedsQL correlated with relevant functioning domains assessed by the VABS-III. Overall, the measures showed that children with neurodevelopmental conditions experienced poor HR-QoL. The majority of children (>86%) met cut-off criteria for significant health concerns on the PedsQL. On the EQ-5D-Y and CHU-9D, they showed reduced HR-QoL particularly on domains relating to school and homework, being able to join in activities, looking after self, and doing usual activities. This study supports the use of the CHU-9D and PedsQL in this population to assess and potentially track HR-QoL in a broad neurodevelopment paediatric population.
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Affiliation(s)
- N Perry
- Clinic for Autism and Neurodevelopment (CAN) Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - K A Boulton
- Clinic for Autism and Neurodevelopment (CAN) Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - A Hodge
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - N Ong
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - N Phillips
- Clinic for Autism and Neurodevelopment (CAN) Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - K Howard
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - R Raghunandan
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - N Silove
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
- Child Development Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - A J Guastella
- Clinic for Autism and Neurodevelopment (CAN) Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Child Neurodevelopment and Mental Health Team, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
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Mascarenhas E, Miguel LS, Oliveira MD, Fernandes RM. Economic evaluations of medical devices in paediatrics: a systematic review and a quality appraisal of the literature. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2024; 22:33. [PMID: 38678250 PMCID: PMC11056067 DOI: 10.1186/s12962-024-00537-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/21/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND Although economic evaluations (EEs) have been increasingly applied to medical devices, little discussion has been conducted on how the different health realities of specific populations may impact the application of methods and the ensuing results. This is particularly relevant for pediatric populations, as most EEs on devices are conducted in adults, with specific aspects related to the uniqueness of child health often being overlooked. This study provides a review of the published EEs on devices used in paediatrics, assessing the quality of reporting, and summarising methodological challenges. METHODS A systematic literature search was performed to identify peer-reviewed publications on the economic value of devices used in paediatrics in the form of full EEs (comparing both costs and consequences of two or more devices). After the removal of duplicates, article titles and abstracts were screened. The remaining full-text articles were retrieved and assessed for inclusion. In-vitro diagnostic devices were not considered in this review. Study descriptive and methodological characteristics were extracted using a structured template. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 checklist was used to assess the quality of reporting. A narrative synthesis of the results was conducted followed by a critical discussion on the main challenges found in the literature. RESULTS 39 full EEs were eligible for review. Most studies were conducted in high-income countries (67%) and focused on high-risk therapeutic devices (72%). Studies comprised 25 cost-utility analyses, 13 cost-effectiveness analyses and 1 cost-benefit analysis. Most of the studies considered a lifetime horizon (41%) and a health system perspective (36%). Compliance with the CHEERS 2022 items varied among the studies. CONCLUSIONS Despite the scant body of evidence on EEs focusing on devices in paediatrics results highlight the need to improve the quality of reporting and advance methods that can explicitly incorporate the multiple impacts related to the use of devices with distinct characteristics, as well as consider specific child health realities. The design of innovative participatory approaches and instruments for measuring outcomes meaningful to children and their families should be sought in future research.
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Affiliation(s)
- Edgar Mascarenhas
- Centro de Estudos de Gestão do Instituto Superior Técnico (CEG-IST), Instituto Superior Técnico, Universidade de Lisboa, Avenida Rovisco Pais, 1049-001, Lisboa, Portugal.
| | - Luís Silva Miguel
- Centro de Estudos de Medicina Baseada na Evidência, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Mónica D Oliveira
- Centro de Estudos de Gestão do Instituto Superior Técnico (CEG-IST), Instituto Superior Técnico, Universidade de Lisboa, Avenida Rovisco Pais, 1049-001, Lisboa, Portugal
- iBB- Institute for Bioengineering and Biosciences and i4HB- Associate Laboratory Institute for Health and Bioeconomy, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - Ricardo M Fernandes
- Laboratório de Farmacologia e Terapêutica, Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
- Departmento de Pediatria, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal
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do Espirito Santo CDM, Santos VS, Miyamoto GC, Chiarotto A, Santos M, Yamato TP. Measurement properties of the EQ-5D in children and adolescents: a systematic review protocol. Syst Rev 2024; 13:18. [PMID: 38183127 PMCID: PMC10768350 DOI: 10.1186/s13643-023-02443-7] [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: 02/22/2021] [Accepted: 12/21/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Although the EQ-5D instruments have been initially designed for adult populations, there are new studies evaluating and applying these instruments to children and adolescents. The EuroQol Group adapted and created two versions designed for these groups, i.e., the EQ-5D-Y versions. The measurement properties of the EQ-5D have been systematically reviewed in different health conditions. However, there is a lack of a proper systematic assessment including the studies' risk of bias and focusing on recent studies assessing the EQ-5D instruments in children and adolescents. The lack of a systematic assessment of the EQ-5D versions does not allow us to have a comprehensive evaluation of the validity, reliability, and responsiveness of these instruments among children and adolescents. This systematic review aims to critically appraise and summarize the evidence on the measurement properties of the EQ-5D instruments (self-reported version - answered by children and adolescents; and proxy versions - versions reported by parents, caregivers, or health professionals) in children and adolescents. METHODS A systematic review searching the following electronic databases: MEDLINE, EMBASE, CINAHL, EconLit, National Health Service Economic Evaluation Database (NHS-EED), Health Technology Assessment (HTA) database. Two independent reviewers will screen titles and abstracts and select full texts for eligibility. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology will be followed to conduct three main assessment steps: risk of bias, quality criteria for measurement properties, and evidence synthesis. DISCUSSION This systematic review will provide comprehensive information about the evidence regarding the measurement properties of EQ-5D instruments in children and adolescents of different settings and countries. SYSTEMATIC REVIEW REGISTRATION Open Science Framework with Registration https://osf.io/r8kt9/ and PROSPERO: CRD42020218382.
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Affiliation(s)
- Caique de Melo do Espirito Santo
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo Rua Cesário Galeno, 448/475, São Paulo, Tatuapé, 03071-000, Brazil.
| | - Verônica Souza Santos
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo Rua Cesário Galeno, 448/475, São Paulo, Tatuapé, 03071-000, Brazil
| | - Gisela Cristiane Miyamoto
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo Rua Cesário Galeno, 448/475, São Paulo, Tatuapé, 03071-000, Brazil
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Alessandro Chiarotto
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, The Netherlands
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Marisa Santos
- Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil
| | - Tiê Parma Yamato
- Master's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo Rua Cesário Galeno, 448/475, São Paulo, Tatuapé, 03071-000, Brazil
- School of Public Health, Faculty of Medicine and Health, Institute for Musculoskeletal Health, The University of Sydney, Sydney, Australia
- Center for Pain, Health and Lifestyle, Sydney, Australia
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Thai TTH, Engel L, Perez JK, Tan EJ, Eades S, Sanci L, Mihalopoulos C. A systematic review of health state utility values and psychometric performance of generic preference-based instruments for children and adolescents with mental health problems. Qual Life Res 2023; 32:3005-3026. [PMID: 37237136 PMCID: PMC10522744 DOI: 10.1007/s11136-023-03441-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] [Subscribe] [Scholar Register] [Accepted: 05/15/2023] [Indexed: 05/28/2023]
Abstract
AIMS This paper aims to systematically identify reported health state utility values (HSUVs) in children and adolescents with mental health problems (MHPs) aged less than 25 years; to summarise the techniques used to elicit HSUVs; and to examine the psychometric performance of the identified multi-attribute utility instruments (MAUIs) used in this space. METHODS A systematic review was conducted following PRISMA guidelines. Peer-reviewed studies published in English, reporting HSUVs for children and adolescents with MHPs using direct or indirect valuation methods were searched in six databases. RESULTS We found 38 studies reporting HSUVs for 12 types of MHPs across 12 countries between 2005 and October 2021. Attention deficit hyperactivity disorder (ADHD) and depression are the most explored MHPs. Disruptive Behaviour Disorder was associated with the lowest reported HSUVs of 0.06 while cannabis use disorder was associated with the highest HSUVs of 0.88. Indirect valuation method through the use of MAUIs (95% of included studies) was the most frequently used approach, while direct valuation methods (Standard Gamble, Time Trade-Off) were only used to derive HSUVs in ADHD. This review found limited evidence of the psychometric performance of MAUIs used in children and adolescents with MHPs. CONCLUSION This review provides an overview of HSUVs of various MHPs, the current practice to generate HSUVs, and the psychometric performance of MAUIs used in children and adolescents with MHPs. It highlights the need for more rigorous and extensive psychometric assessments to produce evidence on the suitability of MAUIs used in this area.
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Affiliation(s)
- Thao T H Thai
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
| | - Lidia Engel
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Joahna Kevin Perez
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Eng Joo Tan
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Sandra Eades
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 780 Elizabeth Street, Melbourne, VIC, 3000, Australia
| | - Lena Sanci
- Department of General Practice, Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 780 Elizabeth Street, Melbourne, VIC, 3000, Australia
| | - Cathrine Mihalopoulos
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
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9
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Raghunandan R, Howard K, Smith S, Killedar A, Cvejic E, Howell M, Petrou S, Lancsar E, Wong G, Craig J, Hayes A. Psychometric Evaluation of the PedsQL GCS and CHU9D in Australian Children and Adolescents with Common Chronic Health Conditions. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2023; 21:949-965. [PMID: 37789175 PMCID: PMC10627900 DOI: 10.1007/s40258-023-00836-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Generic instruments such as the Pediatric Quality of Life Inventory™ v4.0 Generic Core Scales (PedsQL GCS) and Child Health Utility 9D (CHU9D) are widely used to assess health-related quality of life (HRQOL) of the general childhood population, but there is a paucity of information about their psychometric properties in children with specific health conditions. This study assessed psychometric properties, including acceptability, reliability, validity, and responsiveness, of the PedsQL GCS and the CHU9D in children and adolescents with a range of common chronic health problems. METHODS We used data from the Longitudinal Study of Australian Children (LSAC), for children aged 10-17 years with at least one of the following six parent-reported health conditions: asthma, anxiety/depression, attention deficit hyperactivity disorder (ADHD), autism/Asperger's, epilepsy, and type 1 diabetes mellitus. The LSAC used parent proxy-reported PedsQL GCS and child self-reported CHU9D assessments. The performance of each instrument (PedsQL GCS and CHU9D) for each psychometric property (acceptability, reliability, validity, and responsiveness) was assessed against established criteria. RESULTS The study sample included 7201 children and adolescents (mean age = 14 years; range 10.1-17.9 years; 49% female) with 15,568 longitudinal observations available for analyses. Across the six health conditions, acceptability of the PedsQL GCS was high, while acceptability for the CHU9D was mixed. Both the PedsQL GCS and CHU9D showed strong internal consistency (Cronbach's alpha range: PedsQL GCS = 0.70-0.95, CHU9D = 0.76-0.84; item-total correlations range: PedsQL GCS = 0.35-0.84, CHU9D = 0.32-0.70). However, convergent validity for both the PedsQL GCS and CHU9D was generally weak (Spearman's correlations ≤ 0.3). Known group validity was strong for the PedsQL GCS (HRQOL differences were detected for children with and without asthma, anxiety/depression, ADHD, autism/Asperger's, and epilepsy). CHU9D was only able to discriminate between children with and without anxiety/depression, ADHD, and autism/Asperger's. The responsiveness of both the PedsQL GCS and CHU9D was variable across the six conditions, and most of the estimated effect sizes were relatively small (< 0.5). CONCLUSION This study expands the evidence base of psychometric performance of the PedsQL GCS and CHU9D and can aid in appropriate HRQOL instrument selection for the required context by researchers and clinicians.
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Affiliation(s)
- Rakhee Raghunandan
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia.
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Charles Perkins Centre D17, Sydney, NSW, 2006, Australia.
| | - Kirsten Howard
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Charles Perkins Centre D17, Sydney, NSW, 2006, Australia
| | - Sarah Smith
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, England, UK
| | - Anagha Killedar
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Charles Perkins Centre D17, Sydney, NSW, 2006, Australia
| | - Erin Cvejic
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
| | - Martin Howell
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Charles Perkins Centre D17, Sydney, NSW, 2006, Australia
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Emily Lancsar
- Department of Health Services Research and Policy, Australian National University, Canberra, Australia
| | - Germaine Wong
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
| | - Jonathan Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Alison Hayes
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
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10
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Chorozoglou M, Reading I, Eaton S, Naqvi S, Pardy C, Sloan K, Major C, Demellweek N, Hall NJ. Assessing micro- vs macro-costing approaches for treating appendicitis in children with appendicectomy or non-operatively. Qual Life Res 2023; 32:2987-2999. [PMID: 37286916 PMCID: PMC10473981 DOI: 10.1007/s11136-023-03442-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVES We conducted a health economic sub-study within a feasibility RCT comparing a non-operative treatment pathway as an alternative to appendicectomy for the treatment of uncomplicated acute appendicitis in children. The objectives were to understand and assess data collection tools and methods and to determine indicative costs and benefits assessing the feasibility of conducting a full economic evaluation within the definitive trial. METHODS We compared different methods of estimating treatment costs including micro-costing, hospital administrative data (PLICS) and health system (NHS) reference costs. We compared two different HRQoL instruments (CHU-9D and EQ-5D-5L) in terms of data completeness and sensitivity to change over time, including potential ceiling effects. We also explored how the timing of data collection and duration of the analysis could affect QALYs (Quality Adjusted Life Years) and the results of the cost-utility analysis (CUA) within the future RCT. RESULTS Using a micro-costing approach, the total per treatment costs were in alignment with hospital administrative data (PLICS). Average health system reference cost data (macro-costing using NHS costs) could potentially underestimate these treatment costs, particularly for non-operative treatment. Costs incurred following hospital discharge in the primary care setting were minimal, and limited family borne costs were reported by parents/carers. While both HRQoL instruments performed relatively well, our results highlight the problem of ceiling effect and the importance of the timing of data collection and the duration of the analysis in any future assessment using QALYs and CUA. CONCLUSIONS We highlighted the importance of obtaining accurate individual-patient cost data when conducting economic evaluations. Our results suggest that timing of data collection and duration of the assessment are important considerations when evaluating cost-effectiveness and reporting cost per QALY. CLINICAL TRIAL REGISTRATION Current Controlled Trials ISRCTN15830435.
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Affiliation(s)
| | - Isabel Reading
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Simon Eaton
- Department of Population Health Sciences, University College London Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Shehryer Naqvi
- St George’s University Hospital NHS Foundation Trust, London, UK
| | - Caroline Pardy
- St George’s University Hospital NHS Foundation Trust, London, UK
| | - Keren Sloan
- Southampton Children’s Hospital, Southampton, UK
| | | | | | - Nigel J. Hall
- Faculty of Medicine, University of Southampton, Southampton, UK
- Southampton Children’s Hospital, Southampton, UK
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11
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Jones R, O’Loughlin R, Xiong X, Bahrampour M, McGregor K, Yip S, Devlin N, Hiscock H, Mulhern B, Dalziel K. Collecting Paediatric Health-Related Quality of Life Data: Assessing the Feasibility and Acceptability of the Australian Paediatric Multi-Instrument Comparison (P-MIC) Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1604. [PMID: 37892267 PMCID: PMC10605580 DOI: 10.3390/children10101604] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/19/2023] [Accepted: 09/23/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Collecting data using paediatric health-related quality of life (HRQoL) instruments is complex, and there is a paucity of evidence regarding the comparative performance of paediatric HRQoL instruments. The Australian Paediatric Multi-Instrument Comparison (P-MIC) study was conducted to address this paucity of evidence. This study aims to understand the (1) feasibility of collecting data using paediatric HRQoL instruments in a research setting and (2) acceptability and feasibility for children and their caregivers to complete common paediatric HRQoL instruments using data from the Australian P-MIC study. METHODS Data were from children aged 5-18 years from the Australian P-MIC study. Demographics, cost and time for data collection, dropout rates, and inconsistent responses were used to assess Aim 1. Participant-reported difficulty and completion time were used to assess Aim 2. Subgroup analyses included child age, report type (self/proxy), sample recruitment pathway (hospital/online), and online panel sample type (general population/condition groups). RESULTS Overall, 5945 P-MIC participants aged 5-18 years completed an initial survey, of these, 2346 also completed the follow-up survey (39.5% response rate). Compared with online panel recruitment, hospital recruitment was more costly and time-consuming and had higher follow-up completion (33.5% versus 80.4%) (Aim 1). Data were of similar good quality (based on inconsistent responses) for both recruitment pathways (Aim 1). Participants completed each instrument in <3 min, on average, and >70% reported each instrument as easy to complete (Aim 2). CONCLUSIONS The Australian P-MIC study was able to collect good-quality data using both online panel and hospital recruitment pathways. All instruments were acceptable and feasible to children and their caregivers.
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Affiliation(s)
- Renee Jones
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC 3010, Australia; (R.J.); (R.O.); (X.X.); (N.D.)
- Health Services and Economics, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia (H.H.)
| | - Rachel O’Loughlin
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC 3010, Australia; (R.J.); (R.O.); (X.X.); (N.D.)
- Health Services and Economics, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia (H.H.)
- Health Services Research Unit, Royal Children’s Hospital, Melbourne, VIC 3052, Australia
| | - Xiuqin Xiong
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC 3010, Australia; (R.J.); (R.O.); (X.X.); (N.D.)
| | - Mina Bahrampour
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Ultimo, NSW 2007, Australia; (M.B.); (B.M.)
| | - Kristy McGregor
- Health Services and Economics, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia (H.H.)
| | - Shilana Yip
- Health Services and Economics, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia (H.H.)
| | - Nancy Devlin
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC 3010, Australia; (R.J.); (R.O.); (X.X.); (N.D.)
| | - Harriet Hiscock
- Health Services and Economics, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia (H.H.)
- Health Services Research Unit, Royal Children’s Hospital, Melbourne, VIC 3052, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Ultimo, NSW 2007, Australia; (M.B.); (B.M.)
| | - Kim Dalziel
- Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC 3010, Australia; (R.J.); (R.O.); (X.X.); (N.D.)
- Health Services and Economics, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia (H.H.)
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12
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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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13
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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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14
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Hayes A, Raghunandan R, Killedar A, Smith S, Cvejic E, Howell M, Petrou S, Lancsar E, Wong G, Craig J, Howard K. Reliability, acceptability, validity and responsiveness of the CHU9D and PedsQL in the measurement of quality of life in children and adolescents with overweight and obesity. Int J Obes (Lond) 2023:10.1038/s41366-023-01305-5. [PMID: 37072461 DOI: 10.1038/s41366-023-01305-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 03/26/2023] [Accepted: 03/28/2023] [Indexed: 04/20/2023]
Abstract
BACKGROUND The Paediatric Quality of life Inventory (PedsQLTM) Generic Core Scales and the Child Health Utilities 9 Dimensions (CHU9D) are two paediatric health-related quality of life (HRQoL) measures commonly used in overweight and obesity research. However, no studies have comprehensively established the psychometric properties of these instruments in the context of paediatric overweight and obesity. The aim of this study was to assess the reliability, acceptability, validity and responsiveness of the PedsQL and the CHU9D in the measurement of HRQoL among children and adolescents living with overweight and obesity. SUBJECTS/METHODS Subjects were 6544 child participants of the Longitudinal Study of Australian Children, with up to 3 repeated measures of PedsQL and CHU9D and aged between 10 and 17 years. Weight and height were measured objectively by trained operators, and weight status determined using World Health Organisation growth standards. We examined reliability, acceptability, known group and convergent validity and responsiveness, using recognised methods. RESULTS Both PedsQL and CHU9D demonstrated good internal consistency reliability, and high acceptability. Neither instrument showed strong convergent validity, but PedsQL appears to be superior to the CHU9D in known groups validity and responsiveness. Compared with healthy weight, mean (95%CI) differences in PedsQL scores for children with obesity were: boys -5.6 (-6.2, -4.4); girls -6.7 (-8.1, -5.4) and differences in CHU9D utility were: boys -0.02 (-0.034, -0.006); girls -0.035 (-0.054, -0.015). Differences in scores for overweight compared with healthy weight were: PedsQL boys -2.2 (-3.0, -1.4) and girls -1.3 (-2.0, -0.6) and CHU9D boys: no significant difference; girls -0.014 (-0.026, -0.003). CONCLUSION PedsQL and CHU9D overall demonstrated good psychometric properties, supporting their use in measuring HRQoL in paediatric overweight and obesity. CHU9D had poorer responsiveness and did not discriminate between overweight and healthy weight in boys, which may limit its use in economic evaluation.
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Affiliation(s)
- Alison Hayes
- University of Sydney School of Public Health, Sydney, NSW, Australia.
| | - Rakhee Raghunandan
- University of Sydney School of Public Health, Sydney, NSW, Australia
- Menzies Centre for Health Policy and Economics, University of Sydney, Sydney, NSW, Australia
| | - Anagha Killedar
- Menzies Centre for Health Policy and Economics, University of Sydney, Sydney, NSW, Australia
| | - Sarah Smith
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Erin Cvejic
- University of Sydney School of Public Health, Sydney, NSW, Australia
| | - Martin Howell
- Menzies Centre for Health Policy and Economics, University of Sydney, Sydney, NSW, Australia
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Emily Lancsar
- Department of Health Services Research and Policy, Australia National University, Canberra, ACT, Australia
| | - Germaine Wong
- University of Sydney School of Public Health, Sydney, NSW, Australia
| | - Jonathan Craig
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Kirsten Howard
- University of Sydney School of Public Health, Sydney, NSW, Australia
- Menzies Centre for Health Policy and Economics, University of Sydney, Sydney, NSW, Australia
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15
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Yang Y, Jiang J, Lin Y, Peng Y. Health-related quality of life for children using orthokeratology (OK), peripheral lenslet designed (PLD) and single-vision (SV) spectacles: based on Child Health Utility 9 Dimensions (CHU9D). Cont Lens Anterior Eye 2023; 46:101839. [PMID: 37024413 DOI: 10.1016/j.clae.2023.101839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/03/2023] [Accepted: 03/28/2023] [Indexed: 04/07/2023]
Abstract
PURPOSE This study investigated the health-related quality of life (HRQoL) among children with myopia who used orthokeratology (OK), peripheral lenslet designed (PLD), and single-vision (SV) spectacles. METHODS This cross-sectional study was conducted between February of 2021 and August of 2022. It involved 211, 231, and 206 respondents with OK, PLD, and SV spectacle lenses, respectively. The HRQoL was presented as utility values using a general preference-based Child Health Utility-nine Dimensions (CHU9D) questionnaire. Descriptive statistical analysis and nonparametric hypothesis testing were used to compare the HRQoL in the OK, PLD, and SV groups. RESULTS Of the 648 respondents, the average utility scores was 0.936 (95 % confidence interval (CI): 0.929-0.943). Children who wore the PLD spectacles had a significantly higher utility scores (0.955, 95 % CI: 0.946-0.963) than those who wore the SV spectacles (0.926, 95 % CI: 0.913-0.939) and the OK lenses (0.925, 95 % CI: 0.913-0.937) (p < 0.01). The PLD spectacle wearers were less likely to be worried, sad, tired, or annoyed than those who wore OK and SV spectacles (P < 0.05). Self-reported improved eyesight and lessened eye pain and discomfort from myopia correction using PLD spectacles had higher utility values (P < 0.05). CONCLUSIONS The PLD spectacles had a significantly higher HRQoL than the OK and SV spectacles among children. Having better eyesight and less eye pain/discomfort from myopia correction could improve the HRQoL of children. This data indicates that PLD spectacles may be considered for myopia management in children and adolescents.
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16
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Kelly CB, Soley-Bori M, Lingam R, Forman J, Cecil L, Newham J, Wolfe I, Fox-Rushby J. Mapping PedsQL™ scores to CHU9D utility weights for children with chronic conditions in a multi-ethnic and deprived metropolitan population. Qual Life Res 2023:10.1007/s11136-023-03359-4. [PMID: 36814010 DOI: 10.1007/s11136-023-03359-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE The Child Health Utility-9 Dimensions (CHU9D) is a patient-reported outcome measure to generate Quality-Adjusted Life Years (QALYs), recommended for economic evaluations of interventions to inform funding decisions. When the CHU9D is not available, mapping algorithms offer an opportunity to convert other paediatric instruments, such as the Paediatric Quality of Life Inventory™ (PedsQL), onto the CHU9D scores. This study aims to validate current PedsQL to CHU9D mappings in a sample of children and young people of a wide age range (0 to 16 years of age) and with chronic conditions. New algorithms with improved predictive accuracy are also developed. METHODS Data from the Children and Young People's Health Partnership (CYPHP) were used (N = 1735). Four regression models were estimated: ordinal least squared, generalized linear model, beta-binomial and censored least absolute deviations. Standard goodness of fit measures were used for validation and to assess new algorithms. RESULTS While previous algorithms perform well, performance can be enhanced. OLS was the best estimation method for the final equations at the total, dimension and item PedsQL scores levels. The CYPHP mapping algorithms include age as an important predictor and more non-linear terms compared with previous work. CONCLUSION The new CYPHP mappings are particularly relevant for samples with children and young people with chronic conditions living in deprived and urban settings. Further validation in an external sample is required. Trial registration number NCT03461848; pre-results.
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Affiliation(s)
- Clare B Kelly
- Institute for Women and Children's Health, King's Health Partners, London, UK
- Department of Women's and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK
| | - Marina Soley-Bori
- Institute for Women and Children's Health, King's Health Partners, London, UK.
- Department of Population Health, School of Life Course and Population Sciences, King's College London, London, UK.
- Faculty of Life Sciences and Medicine, School of Life Course & Population Sciences, King's College London, Guy's Campus, Great Maze Pond, London, SE1 1UL, UK.
| | - Raghu Lingam
- School of Women's and Children's Health, University of New South Wales, Sydney, Australia
| | - Julia Forman
- Institute for Women and Children's Health, King's Health Partners, London, UK
- Department of Women's and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK
| | - Lizzie Cecil
- Institute for Women and Children's Health, King's Health Partners, London, UK
- Department of Women's and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK
| | - James Newham
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Ingrid Wolfe
- Institute for Women and Children's Health, King's Health Partners, London, UK
- Department of Women's and Children's Health, School of Life Course and Population Sciences, King's College London, London, UK
| | - Julia Fox-Rushby
- Department of Population Health, School of Life Course and Population Sciences, King's College London, London, UK
- NIHR Biomedical Research Centre, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
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Amien R, Scott D, Verstraete J. The validity and reliability of the interviewer-administered EQ-5D-Y-3L version in young children. Health Qual Life Outcomes 2023; 21:19. [PMID: 36814254 PMCID: PMC9948371 DOI: 10.1186/s12955-023-02100-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 02/14/2023] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVES The aim of this study was to determine the validity and reliability of the EQ-5D-Y-3L interviewer-administered (IA) version in South African children aged 5-7-years compared to 8-10-years. METHODS Children aged 5-10-years (n = 388) were recruited from healthcare facilities, schools for learners with special educational needs and mainstream schools across four known condition groups: chronic respiratory illnesses, functional disabilities, orthopaedic conditions and the general population. All children completed the EQ-5D-Y-3L IA, Moods and Feelings Questionnaire (MFQ), Faces Pain Scale-Revised (FPS-R) and a functional independence measure (WeeFIM) was completed by the researcher. Cognitive debriefing was done after the EQ-5D-Y-3L IA to determine comprehensibility. Test-retest of the EQ-5D-Y-3L IA was done 48 h later and assessed using Cohen's kappa (k). RESULTS Results from children aged 5-7-years (n = 177) and 8-10-years (n = 211) were included. There were significantly higher reports of problems in the Looking After Myself dimension in the 5-7-year-olds (55%) compared to the 8-10-year-olds (28%) (x2 = 31.021; p = 0.000). The younger children took significantly longer to complete the measure (Mann-Whitney U = 8389.5, p < 0.001). Known-group validity was found at dimension level with children receiving orthopaedic management reporting more problems on physical dimensions across both age-groups. Convergent validity between Looking After Myself and WeeFIM items of self-care showed moderate to high correlations for both age-groups with a significantly higher correlation in the 8-10-year-olds for dressing upper (z = 2.24; p = 0.013) and lower body (z = 2.78; p = 0.003) and self-care total (z = 2.01; p = 0.022). There were fair to moderate levels of test-retest reliability across age-groups. CONCLUSION The EQ-5D-Y-3L IA showed acceptable convergent validity and test-retest reliability for measuring health in children aged 5-7-years. There was more report of problems with the dimension of Looking After Myself in the 5-7-year group due to younger children requiring help with dressing, including buttons and shoelaces due to their developmental age, rather than their physical capabilities. Therefore, it may be useful to include examples of age-appropriate dressing tasks. There was further some reported difficulty with thinking about the dimensions in the younger age-group, most notably for Usual Activities which includes a large number of examples. By decreasing the number of examples it may reduce the burden of recall for the younger age-group.
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Affiliation(s)
- Razia Amien
- Division of Physiotherapy, Faculty of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa.
| | - Desiree Scott
- grid.7836.a0000 0004 1937 1151Division of Physiotherapy, Faculty of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa
| | - Janine Verstraete
- grid.7836.a0000 0004 1937 1151Division of Pulmonology, Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
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18
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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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19
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Engel L, Majmudar I, Mihalopoulos C, Tollit MA, Pang KC. Assessment of Quality of Life of Transgender and Gender-Diverse Children and Adolescents in Melbourne, Australia, 2017-2020. JAMA Netw Open 2023; 6:e2254292. [PMID: 36729456 PMCID: PMC9896293 DOI: 10.1001/jamanetworkopen.2022.54292] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
IMPORTANCE Transgender and gender-diverse (TGD) children and adolescents may experience not only gender dysphoria but also depression and anxiety, all of which are likely to be associated with reduced quality of life (QOL). Despite this, little is known about QOL in this population. OBJECTIVES To identify demographic, social, and clinical characteristics associated with reduced QOL in TGD children and adolescents; compare their QOL with age-matched population-based norms and that of young people with common mental health problems; and evaluate the association between gender dysphoria and QOL. DESIGN, SETTING, AND PARTICIPANTS In this cohort study, baseline data were derived from questionnaires completed in a prospective cohort study (Trans20) of TGD children aged 6 to 12 years and adolescents aged 13 to 17 years first seen at the Royal Children's Hospital Gender Service (Melbourne, Australia) between February 2017 and February 2020. MAIN OUTCOMES AND MEASURES The main outcome was QOL, measured using the Child Health Utility 9D instrument (CHU-9D). Data collection included demographic information, social factors (eg, bullying, lack of support, and social transition), and clinical characteristics (eg, gender identity, gender dysphoria, and mental health difficulties). Population norms and CHU-9D data for Australian youths with mental health diagnoses were derived from published literature. RESULTS The TGD cohort comprised 525 children and adolescents aged 6 to 17 years (median age, 14 years [IQR, 12-16 years]; 364 [69.33%] presumed female at birth). The mean (SD) CHU-9D score was 0.46 (0.26). Compared with population norms, TGD children (0.58 [0.27] vs 0.81 [0.16]; P < .001) and adolescents (0.41 [0.25] vs 0.80 [0.14]; P < .001) had significantly lower scores. Within the TGD cohort, mean (SD) scores were significantly lower in adolescents (0.41 [0.24] vs 0.62 [0.25]; P < .001), those assigned female at birth (0.43 [0.26] vs 0.55 [0.25]; P < .001), those reporting mental health problems (0.37 [0.23] vs 0.57 [0.25]; P < .001) and physical health problems (0.41 [0.26] vs 0.48 [0.26]; P = .04), and those who were bullied (0.38 [0.24] vs 0.52 [0.25]; P < .001). Gender dysphoria alone was associated with a lower mean (SD) CHU-9D score (0.51 [0.23]) than that in control adolescents with serious mental health conditions such as depression (0.64 [0.26]) and anxiety (0.70 [0.24]) and was an independent factor associated with QOL. CONCLUSIONS AND RELEVANCE In this cohort study of TGD children and adolescents in Australia, QOL was worse in this population than in age-matched, population-based peers. Quality of life associated with gender dysphoria was substantially worse than that seen in young people with common mental health conditions. These findings emphasize the risk of poor QOL among TGD young people and the need to better support them.
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Affiliation(s)
- Lidia Engel
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ishani Majmudar
- Deakin Health Economics, Deakin University, Burwood, Victoria, Australia
| | - Cathrine Mihalopoulos
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Deakin Health Economics, Deakin University, Burwood, Victoria, Australia
| | - Michelle A. Tollit
- The Royal Children’s Hospital, Parkville, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Ken C. Pang
- The Royal Children’s Hospital, Parkville, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
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20
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Furlong W, Rae C, Feeny D, Ghotra S, Breakey VR, Carter T, Pai N, Pullenayegum E, Xie F, Barr R. Generic Health-Related Quality of Life Utility Measure for Preschool Children (Health Utilities Preschool): Design, Development, and Properties. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:251-260. [PMID: 36031479 DOI: 10.1016/j.jval.2022.07.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 07/10/2022] [Accepted: 07/14/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Health Utilities Preschool (HuPS) was developed to fill the need for a generic preference-based measure (GPM) applicable in early childhood. A GPM has all the properties for higher-order summary measures, such as quality-adjusted life-years, required to inform important policy decisions regarding health and healthcare services. METHODS Development was in accordance with published standards for a GPM, statistical procedures, and modeling. HuPS incorporates key components of 2 existing measurement systems: Health Status Classification System for Preschool Children and Health Utilities Index Mark 3 (HUI3). The study included a series of 4 measurement surveys: definitional, adaptational, quantificational, and evaluational health-related quality of life (HRQL). HuPS measurements were evaluated for reliability, validity, interpretability, and acceptability. RESULTS Definitional measurements identified 8 Health Status Classification System for Preschool Children attributes in common with HUI3 (vision, hearing, speech, ambulation, dexterity, emotion, cognition, and pain and discomfort), making the HUI3 scoring equation commensurate with HuPS health states. Adaptational measurements informed the content of attribute-level descriptions (n = 35). Quantificational measurements determined level scoring coefficients. HRQL scoring inter-rater reliability (intraclass correlation coefficient = 0.79) was excellent. Continuity of HRQL scoring with HUI3 was reliable (intraclass correlation coefficient = 0.80, P < .001) and valid (mean absolute difference = 0.016, P = .396). CONCLUSIONS HuPS is an acceptable, reliable, and valid GPM. HRQL scoring is continuous with HUI3. Continuity expands the applicability of GPM (HUI3) scoring to include subjects as young as 2 years of age. Widespread applications of HuPS would inform important health policy and management decisions as HUI3 does for older subjects.
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Affiliation(s)
- William Furlong
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada.
| | - Charlene Rae
- Division of Hematology and Oncology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - David Feeny
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
| | - Satvinder Ghotra
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Dalhousie University, Halifax, Ontario, Canada
| | - Vicky R Breakey
- Division of Hematology and Oncology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Teresa Carter
- Division of Developmental Pediatrics, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Nikhil Pai
- Division of Gastroenterology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Eleanor Pullenayegum
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Feng Xie
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Ronald Barr
- Division of Hematology and Oncology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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21
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Xiong X, Dalziel K, Huang L, Mulhern B, Carvalho N. How do common conditions impact health-related quality of life for children? Providing guidance for validating pediatric preference-based measures. Health Qual Life Outcomes 2023; 21:8. [PMID: 36698179 PMCID: PMC9878815 DOI: 10.1186/s12955-023-02091-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 01/13/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND There is increasing interest in the validation of pediatric preference-based health-related quality of life measurement instruments. It is critical that children with various degrees of health-related quality of life (HRQoL) impact are included in validation studies. To inform patient sample selection for validation studies from a pragmatic perspective, this study explored HRQoL impairments between known-groups and HRQoL changes over time across 27 common chronic child health conditions and identified conditions with the largest impact on HRQoL. METHODS The health dimensions of two common preference-based HRQoL measures, the EQ-5D-Y and CHU9D, were constructed using Pediatric Quality of Life Inventory items that overlap conceptually. Data was from the Longitudinal Study of Australian Children, a nationally representative sample with over 10,000 children at baseline. Seven waves of data were included for the analysis, with child age ranging from 2 to18 years. Impacts to specific health dimensions and overall HRQoL between those having a specific condition versus not were compared using linear mixed effects models. HRQoL changes over time were obtained by calculating the HRQoL differences between two consecutive time points, grouped by "Improved" and "Worsened" health status. Comparison among various health conditions and different age groups (2-4 years, 5-12 years and 13-18 years) were made. RESULTS Conditions with the largest statistically significant total HRQoL impairments of having a specific condition compared with not having the condition were recurrent chest pain, autism, epilepsy, anxiety/depression, irritable bowel, recurrent back pain, recurrent abdominal pain, and attention deficit hyperactivity disorder (ADHD) for the total sample (2-18 years). Conditions with largest HRQoL improvement over time were anxiety/depression, ADHD, autism, bone/joint/muscle problem, recurrent abdominal pain, recurrent pain in other part, frequent headache, diarrhea and day-wetting. The dimensions included in EQ-5D-Y and CHU9D can generally reflect HRQoL differences and changes. The HRQoL impacts to specific health dimensions differed by condition in the expected direction. The conditions with largest HRQoL impacts differed by age group. CONCLUSIONS The conditions with largest HRQoL impact were identified. This information is likely to be valuable for recruiting patient samples when validating pediatric preference-based HRQoL instruments pragmatically.
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Affiliation(s)
- Xiuqin Xiong
- grid.1008.90000 0001 2179 088XCentre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC Australia
| | - Kim Dalziel
- grid.1008.90000 0001 2179 088XCentre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC Australia
| | - Li Huang
- grid.1008.90000 0001 2179 088XCentre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC Australia
| | - Brendan Mulhern
- grid.117476.20000 0004 1936 7611Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW Australia
| | - Natalie Carvalho
- grid.1008.90000 0001 2179 088XCentre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC Australia
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22
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Valsamis EM, Beard D, Carr A, Collins GS, Brealey S, Rangan A, Santos R, Corbacho B, Rees JL, Pinedo-Villanueva R. Mapping the Oxford Shoulder Score onto the EQ-5D utility index. Qual Life Res 2023; 32:507-518. [PMID: 36169788 PMCID: PMC9911508 DOI: 10.1007/s11136-022-03262-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE In order to enable cost-utility analysis of shoulder pain conditions and treatments, this study aimed to develop and evaluate mapping algorithms to estimate the EQ-5D health index from the Oxford Shoulder Score (OSS) when health outcomes are only assessed with the OSS. METHODS 5437 paired OSS and EQ-5D questionnaire responses from four national multicentre randomised controlled trials investigating different shoulder pathologies and treatments were split into training and testing samples. Separate EQ-5D-3L and EQ-5D-5L analyses were undertaken. Transfer to utility (TTU) regression (univariate linear, polynomial, spline, multivariable linear, two-part logistic-linear, tobit and adjusted limited dependent variable mixture models) and response mapping (ordered logistic regression and seemingly unrelated regression (SUR)) models were developed on the training sample. These were internally validated, and their performance evaluated on the testing sample. Model performance was evaluated over 100-fold repeated training-testing sample splits. RESULTS For the EQ-5D-3L analysis, the multivariable linear and splines models had the lowest mean square error (MSE) of 0.0415. The SUR model had the lowest mean absolute error (MAE) of 0.136. Model performance was greatest in the mid-range and best health states, and lowest in poor health states. For the EQ-5D-5L analyses, the multivariable linear and splines models had the lowest MSE (0.0241-0.0278) while the SUR models had the lowest MAE (0.105-0.113). CONCLUSION The developed models now allow accurate estimation of the EQ-5D health index when only the OSS responses are available as a measure of patient-reported health outcome.
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Affiliation(s)
- Epaminondas M. Valsamis
- grid.4991.50000 0004 1936 8948Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, OX3 7LD UK
| | - David Beard
- grid.4991.50000 0004 1936 8948Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, OX3 7LD UK
| | - Andrew Carr
- grid.4991.50000 0004 1936 8948Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, OX3 7LD UK
| | - Gary S. Collins
- grid.4991.50000 0004 1936 8948Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Centre for Statistics in Medicine, University of Oxford, Oxford, OX3 7LD UK
| | - Stephen Brealey
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, York Trials Unit, University of York, York, YO10 5DD UK
| | - Amar Rangan
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, York Trials Unit, University of York, York, YO10 5DD UK
| | - Rita Santos
- grid.5685.e0000 0004 1936 9668Centre for Health Economics, University of York, York, YO10 5DD UK
| | - Belen Corbacho
- grid.5685.e0000 0004 1936 9668Department of Health Sciences, York Trials Unit, University of York, York, YO10 5DD UK
| | - Jonathan L. Rees
- grid.4991.50000 0004 1936 8948Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, OX3 7LD UK
| | - Rafael Pinedo-Villanueva
- grid.4991.50000 0004 1936 8948Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, OX3 7LD UK
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Rencz F, Ruzsa G, Bató A, Yang Z, Finch AP, Brodszky V. Value Set for the EQ-5D-Y-3L in Hungary. PHARMACOECONOMICS 2022; 40:205-215. [PMID: 36123448 PMCID: PMC9485017 DOI: 10.1007/s40273-022-01190-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/04/2022] [Indexed: 05/19/2023]
Abstract
BACKGROUND The Hungarian health technology assessment guidelines recommend the use of the EuroQol instrument family in quality-adjusted life-year calculations. However, no national value set exists for the EQ-5D-Y-3L or any other youth-specific instrument. OBJECTIVE This study aims to develop a national value set of the EQ-5D-Y-3L for Hungary based on preferences of the general adult population. METHODS This study followed the international valuation protocol for the EQ-5D-Y-3L. Two independent samples, representative of the Hungarian general adult population in terms of age and sex were recruited to complete online discrete choice experiment (DCE) tasks and composite time trade-off (cTTO) tasks by computer-assisted personal interviews. Adults valued hypothetical EQ-5D-Y-3L health states considering the health of a 10-year-old child. DCE data were modelled using a mixed logit model with random-correlated coefficients. Latent DCE utility estimates were mapped onto mean observed cTTO utilities using ordinary least squares regression. RESULTS Overall, 996 and 200 respondents completed the DCE and cTTO surveys, respectively. For each domain, the value set resulted in larger utility decrements with more severe response levels. The relative importance of domains by level 3 coefficients was as follows: having pain or discomfort > feeling worried, sad or unhappy > mobility > doing usual activities > looking after myself. Overall, 12.3% of all health states had negative utilities in the value set, with the worst health state having the lowest predicted utility of - 0.485. CONCLUSION This study developed a national value set of the EQ-5D-Y-3L for Hungary. The value set enables to evaluate the cost utility of health technologies for children and adolescents based on societal preferences in Hungary.
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Affiliation(s)
- Fanni Rencz
- Department of Health Policy, Corvinus University of Budapest, 8 Fővám tér, 1093, Budapest, Hungary.
| | - Gábor Ruzsa
- Department of Statistics, Corvinus University of Budapest, Budapest, Hungary
- Doctoral School of Psychology, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Alex Bató
- Department of Health Policy, Corvinus University of Budapest, 8 Fővám tér, 1093, Budapest, Hungary
- Károly Rácz Doctoral School of Clinical Medicine, Semmelweis University, Budapest, Hungary
| | - Zhihao Yang
- Health Services Management Department, Guizhou Medical University, Guiyang, China
| | | | - Valentin Brodszky
- Department of Health Policy, Corvinus University of Budapest, 8 Fővám tér, 1093, Budapest, Hungary
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Lin J, Wong CKH, Cheung JPY, Cheung PWH, Luo N. Psychometric performance of proxy-reported EQ-5D youth version 5-level (EQ-5D-Y-5L) in comparison with three-level (EQ-5D-Y-3L) in children and adolescents with scoliosis. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2022; 23:1383-1395. [PMID: 35122171 DOI: 10.1007/s10198-022-01435-z] [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: 08/19/2021] [Accepted: 01/11/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To assess the psychometric performance of proxy-reported EQ-5D-Y-5L (Y-5L) in comparisons with EQ-5D-Y-3L (Y-3L) administered by caregivers of patients with juvenile (JIS) or adolescent idiopathic scoliosis (AIS). METHODS A consecutive sample of caregivers of JIS or AIS patients were recruited. Redistribution property, ceiling effects, and discriminative power were examined. Known-group validity was determined by examining their ability to detect differences across clinical known groups. Test-retest reliability was assessed using intraclass correlation coefficient (ICC) for EQ-VAS score and Gwet's agreement coefficient (GAC) and percentage agreement (PA) for dimension responses. Furthermore, subgroups were analyzed for comparing test-retest reliability. RESULTS A total of 130 caregivers were involved in the study. Consistencies between proxy-reported Y-3L and Y-5L were very high for all dimensions (93.8-99.2%). The ceiling effect in the Y-5L was slightly reduced in four dimensions (AR: 0.8-2.3%) whereas increased in "Having pain/discomfort". Greater informativity was found in the Y-5L than the Y-3L. In known-group comparisons of curvature magnitude, curvature type, and treatment modality, Y-5L and Y-3L dimension scales showed hypothesized results. For example, more full-health responses were found in the mild Cobb angle group (Y-5L: 63.1%; Y-3L: 62.2%) than the severe Cobb angle group (Y-5L: 55.6%, Y-3L: 55.6%). EQ-VAS score exhibited low test-retest reliability (ICC: 0.41), whereas dimension scales of both instruments showed satisfactory test-retest reliability (GAC ≥ 0.7 and PA ≥ 70% for all). In most known groups, hard-to-observe dimensions were more reliable for proxy-reported Y-5L than Y-3L. CONCLUSION Both the proxy-reported Y-5L and Y-3L are valid and reliable instruments for assessing the HRQoL of JIS or AIS patients.
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Affiliation(s)
- Jiaer Lin
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Carlos King Ho Wong
- Department of Family Medicine and Primary Care, LKS Faculty of Medicine, The University of Hong Kong, Rm 1‑01, 1/F, Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong SAR, China.
- Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong SAR, Rm 1-01, 1/F, Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong SAR, China.
| | - Jason Pui Yin Cheung
- Department of Orthopaedics and Traumatology, LKS Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, 5/F Professorial Block, Pokfulam, Hong Kong SAR, China.
| | - Prudence Wing Hang Cheung
- Department of Orthopaedics and Traumatology, LKS Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, 5/F Professorial Block, Pokfulam, Hong Kong SAR, China
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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Guha C, Khalid R, van Zwieten A, Francis A, Hawley CM, Jauré A, Teixeira-Pinto A, Mallard AR, Bernier-Jean A, Johnson DW, Hahn D, Reidlinger D, Pascoe EM, Ryan EG, Mackie F, McCarthy HJ, Craig JC, Varghese J, Kiriwandeniya C, Howard K, Larkins NG, Macauley L, Walker A, Howell M, Irving M, Caldwell PHY, Woodleigh R, Jesudason S, Carter SA, Kennedy SE, Alexander SI, McTaggart S, Wong G. Baseline characteristics of participants in the NAVKIDS 2 trial: a patient navigator program in children with chronic kidney disease. Pediatr Nephrol 2022; 38:1577-1590. [PMID: 36264432 PMCID: PMC9584266 DOI: 10.1007/s00467-022-05772-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 09/16/2022] [Accepted: 09/23/2022] [Indexed: 10/24/2022]
Abstract
BACKGROUND Children with chronic kidney disease (CKD) require multidisciplinary care to meet their complex healthcare needs. Patient navigators are trained non-medical personnel who assist patients and caregivers to overcome barriers to accessing health services through care coordination. This trial aims to determine the effectiveness of a patient navigator program in children with CKD. METHODS The NAVKIDS2 trial is a multi-center, waitlisted, randomized controlled trial of patient navigators in children with CKD conducted at five sites across Australia. Children (0-16 years) with CKD from low socioeconomic status rural or remote areas were randomized to an intervention group or a waitlisted control group (to receive intervention after 6 months). The study primary and secondary endpoints include the self-rated health (SRH) (primary), and utility-based quality of life, progression of kidney dysfunction of the child, SRH, and satisfaction with healthcare of the caregiver at 6 months post-randomization. RESULTS The trial completed recruitment in October 2021 with expected completion of follow-up by October 2022. There were 162 patients enrolled with 80 and 82 patients randomized to the immediate intervention and waitlisted groups, respectively. Fifty-eight (36%) participants were from regional/remote areas, with a median (IQR) age of 9.5 (5.0, 13.0) years, 46% were of European Australian ethnicity, and 65% were male. A total of 109 children (67%) had CKD stages 1-5, 42 (26%) were transplant recipients, and 11 (7%) were receiving dialysis. CONCLUSION The NAVKIDS2 trial is designed to evaluate the effectiveness of patient navigation in children with CKD from families experiencing socioeconomic disadvantage. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Chandana Guha
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Rabia Khalid
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Anita van Zwieten
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Anna Francis
- Child and Adolescent Renal Services, Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
| | - Carmel M Hawley
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia
- Translational Research Institute, Brisbane, QLD, Australia
| | - Allison Jauré
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Armando Teixeira-Pinto
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Alistair R Mallard
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Amelie Bernier-Jean
- CIUSSS du Nord-de-l'Île de Montréal, University of Montréal, Montreal, Canada
| | - David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia
- Translational Research Institute, Brisbane, QLD, Australia
| | - Deirdre Hahn
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
- Department of Nephrology, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Donna Reidlinger
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia
| | - Elaine M Pascoe
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia
| | - Elizabeth G Ryan
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia
- QCIF Facility for Advanced Bioinformatics, Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Fiona Mackie
- Department of Nephrology, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia
| | - Hugh J McCarthy
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
- Department of Nephrology, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Julie Varghese
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia
| | - Charani Kiriwandeniya
- Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia
| | - Kirsten Howard
- Menzies Centre for Health Policy and Economics and Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Nicholas G Larkins
- Department of Nephrology, Perth Children's Hospital, Perth, WA, Australia
- School of Medicine, University of Western Australia, Perth, WA, Australia
| | | | - Amanda Walker
- Department of Nephrology, Royal Children's Hospital, Melbourne, VIC, Australia
- Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Martin Howell
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Michelle Irving
- Menzies Centre for Health Policy, The University of Sydney, Camperdown, Sydney, NSW, 2006, Australia
- Centre for Evidence and Implementation, 33 Lincoln Square South Carlton, Melbourne, VIC, 3053, Australia
| | - Patrina H Y Caldwell
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | | | - Shilpanjali Jesudason
- Central Northern Adelaide Renal and Transplantation Service (CNARTS), Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Simon A Carter
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
- Department of Nephrology, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Sean E Kennedy
- Department of Nephrology, Sydney Children's Hospital, Randwick, Sydney, NSW, Australia
- School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
| | - Stephen I Alexander
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Steven McTaggart
- Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
- The University of Queensland, Brisbane, QLD, Australia
| | - Germaine Wong
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia.
- Department of Renal Medicine, Westmead Hospital, Sydney, NSW, Australia.
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Golicki D, Młyńczak K. Measurement Properties of the EQ-5D-Y: A Systematic Review. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:S1098-3015(22)02001-0. [PMID: 35752534 DOI: 10.1016/j.jval.2022.05.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/16/2022] [Accepted: 05/09/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This study aimed to perform a systematic review of published evidence on the psychometric properties of 3-level version of EQ-5D-Y and 5-level version of EQ-5D-Y (EQ-5D-Y-5L). METHODS A literature search on the MEDLINE, Embase, and EuroQol website (until June 2021) was conducted. Original studies on EQ-5D-Y psychometric properties such as feasibility, distribution properties (ceiling and floor effects), reliability (test-retest, interrater, intermodal), validity (known-groups, convergent), and responsiveness, published as full-text articles in English, were included. Studies on experimental EQ-5D-Y versions were excluded. The following data were pooled using random effects models: missing values, the ceiling effect, and correlations coefficients with other measures. RESULTS A total of 47 studies (inclusive of 7 on EQ-5D-Y-5L) containing data from 45 310 children and 2690 proxy respondents representing 15 countries were included. These studies were characterized as being high quality according to the quality index. The most represented areas were school populations and musculoskeletal diseases and orthopedics. The EQ-5D-Y dimensions, EQ visual analog scale, and EQ index were reported in 89%, 77%, and 26% of studies, respectively. Most articles addressed validity (known-groups, n = 27; convergent, n = 21) and reliability (test-retest and interrater, n = 10 each). Convergent validity studies showed that, where the assessment of the child's functioning at school is required, EQ-5D-Y should be supplemented with other school-specific measures. CONCLUSIONS This systematic review provides a summary of measurement properties and the psychometric performance of 3-level version of EQ-5D-Y and EQ-5D-Y-5L. The existing evidence supports using the EQ-5D-Y descriptive system and EQ visual analog scale in children and adolescent populations. Further research on test-retest reliability and the responsiveness of the EQ-5D-Y index obtained with child-specific value sets is needed.
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Affiliation(s)
- Dominik Golicki
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland.
| | - Katarzyna Młyńczak
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland
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Frakking TT, Waugh J, Carty C, Burmeister A, Marozza A, Hobbins S, Kilah M, David M, Kane L, McCormick S, Carter HE. The effect of different service models on quality of care in the assessment of autism spectrum disorder in children: study protocol for a multi-centre randomised controlled trial. BMC Pediatr 2022; 22:173. [PMID: 35366839 PMCID: PMC8976356 DOI: 10.1186/s12887-022-03244-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background There is significant variability in clinical pathways available in the diagnostic assessment of ASD, including the order and timing of allied health assessments in relation to paediatrician consultations. Allied health professionals in first-contact models are increasingly used to improve the timeliness of healthcare access, whilst complementing medical specialty workforce shortages. Anecdotally, the implementation of allied health first-contact models in paediatrics has improved waitlists and timely access to healthcare. However, no rigorous studies have been conducted to evaluate the outcomes of these models. This study aims to determine the impacts of an allied health first-contact model on health service use and costs and patient quality of life and satisfaction. Methods An open, semi-blinded, multi-centre randomised controlled trial in paediatric outpatient clinics at two Australian metropolitan public hospitals. 56 children (0–16 years) fulfilling the inclusion criteria will be randomised to one of two clinical pathways for assessment of ASD: (1) allied health first-contact or (2) medical first-contact model. Cost outcomes will be collected from both health service and family perspectives. Caregiver-reported outcome measures include: Pediatric Quality of Life Inventory (PedsQL), the EuroQOL Five Dimension Youth Version (EQ-5D-Y), the Autism Family Experience Questionnaire (AFEQ) and Measure of Processes of Care. Discussion Evidence of improvements in service and consumer centric outcomes will help inform the development and implementation of high-value, evidenced based models of care for the assessment of ASD in children. The findings from this study are expected to contribute to the evidence base around the costs and consequences of allied health first contact models for the assessment of children with ASD in the Australian setting. Findings of this study may help to inform the allocation of health care resources while maintaining, or potentially improving, patient and family quality of life and experience of care. These findings may be useful in informing the wider adoption of these models in Australia and internationally, particularly in healthcare settings where medical specialist shortages exist. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR) ACTRN12621001433897. Registered: 25th October, 2021.
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28
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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: 30] [Impact Index Per Article: 15.0] [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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Dawoud D, Lamb A, Moore A, Bregman C, Rupniewska E, Paling T, Wolfram V, Lovett RES, Dent R. Capturing what matters: updating NICE methods guidance on measuring and valuing health. Qual Life Res 2022; 31:2167-2173. [PMID: 35247152 PMCID: PMC9188493 DOI: 10.1007/s11136-022-03101-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2022] [Indexed: 11/26/2022]
Abstract
In July 2019, the National Institute for Health and Care Excellence (NICE) initiated a major review of its health technology evaluation methods to update its methods guide. This update has recently concluded with the publication of its health technology evaluation manual in January 2022. This paper reports the methods and findings of the review in relation to the recommended approach to use for the measurement and valuation of health-related quality of life (HRQoL) in submissions to NICE. Issues related to (i) the methods to use when NICE’s preferred measure (EQ-5D) is not appropriate or not available; (ii) adjusting health state utility values over time to account for age; (iii) measuring and valuing HRQoL in children and young people; and (iv) including carers’ QoL in economic evaluations were included in this review. This commentary summarises the methods used to undertake the review, its findings, and the changes to NICE methods that were proposed based on these findings. It also outlines topics where further research is needed before definitive methods guidance can be issued. The broad proposals described here were subject to a public consultation in 2020 and a further consultation on the updated methods guidance was completed in October 2021 before the publication of the manual in January 2022.
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Affiliation(s)
- Dalia Dawoud
- National Institute for Health and Care Excellence (NICE), Manchester, UK.
| | - Alan Lamb
- National Institute for Health and Care Excellence (NICE), Manchester, UK
| | - Alan Moore
- National Institute for Health and Care Excellence (NICE), Manchester, UK
| | - Caroline Bregman
- National Institute for Health and Care Excellence (NICE), Manchester, UK
| | - Ewa Rupniewska
- National Institute for Health and Care Excellence (NICE), Manchester, UK
| | - Thomas Paling
- National Institute for Health and Care Excellence (NICE), Manchester, UK
| | - Verena Wolfram
- National Institute for Health and Care Excellence (NICE), Manchester, UK
| | | | - Ross Dent
- National Institute for Health and Care Excellence (NICE), Manchester, UK
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Verstraete J, Marthinus Z, Dix-Peek S, Scott D. Measurement properties and responsiveness of the EQ-5D-Y-5L compared to the EQ-5D-Y-3L in children and adolescents receiving acute orthopaedic care. Health Qual Life Outcomes 2022; 20:28. [PMID: 35177084 PMCID: PMC8851798 DOI: 10.1186/s12955-022-01938-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 02/08/2022] [Indexed: 12/16/2022] Open
Abstract
Objective The aim of this study is a head-to-head comparison of the instrument performance and responsiveness of the EQ-5D-Y-3L and the expanded English version of the EQ-5D-Y-5L in children/adolescents receiving acute orthopaedic management in South Africa. Methods Children/adolescents aged 8–15 years completed the EQ-5D-Y-5L, EQ-5D-Y-3L, self-rated health (SRH) question and PedsQL at baseline. The EQ-5D-Y-5L, EQ-5D-Y-3L and SRH question were repeated after 24 and 48 h. Performance of the EQ-5D-Y-5L and EQ-5D-Y-3L was determined by comparing feasibility (missing responses), redistribution of dimensions responses, discriminatory power, concurrent validity, and responsiveness. Results Eighty-three children/adolescents completed baseline measures and seventy-one at all three time-points. Reporting of 11111 decreased by 20% from the EQ-5D-Y-3L to the EQ-5D-Y-5L. Informativity of dimensions improved on average by 0.267 on the EQ-5D-Y-5L with similar evenness. There was a range of 11–27% inconsistent responses when moving from the EQ-5D-Y-3L to the EQ-5D-Y-5L. There was a low to moderate and significant association on the EQ-5D-Y-3L and EQ-5D-Y-5L to similar items on the PedsQL and SRH scores. Percentage change over time was greater for the EQ-5D-Y-5L (range 0–182%) than EQ-5D-Y-3L (range 0–100%) with the largest reduction for both measures between 0 and 48 h. For those who respondents who showed an improved SRH the EQ-5D-Y-5L and EQ-5D-Y-3L showed significant paired differences. Conclusion The English version of the EQ-5D-Y-5L appears to be a valid and responsive extension of the EQ-5D-Y-3L for children receiving acute orthopaedic management. The expanded levels notably reduce the ceiling effect and has greater discriminatory power. Concurrent validity of the EQ-5D-Y-3L and EQ-5D-Y-5L was low to moderate with similar PedsQL items and SRH. The EQ-5D-Y-5L generally showed greater change than the EQ-5D-Y-3L across all dimensions with the greatest change observed for 0–48 h. Responsiveness was comparable across the EQ-5D-Y-3L and EQ-5D-Y-5L for those with improved SRH. Greater sensitivity to change may be observed on comparison of utility scores, once preference-based value sets are available for the EQ-5D-Y-5L.
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Affiliation(s)
- Janine Verstraete
- Department of Paediatrics and Child Health, Division of Pulmonology, Cape Town, South Africa.
| | - Zara Marthinus
- Department of Paediatrics and Child Health, Orthopaedic Surgery, Cape Town, South Africa
| | - Stewart Dix-Peek
- Division of Physiotherapy, Maitland Cottage Hospital, Cape Town, South Africa
| | - Des Scott
- Faculty of Health and Rehabilitation Sciences, Division of Physiotherapy, Cape Town, South Africa
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Fitriana TS, Purba FD, Rahmatika R, Muhaimin R, Sari NM, Bonsel G, Stolk E, Busschbach JJV. Comparing measurement properties of EQ-5D-Y-3L and EQ-5D-Y-5L in paediatric patients. Health Qual Life Outcomes 2021; 19:256. [PMID: 34781978 PMCID: PMC8591892 DOI: 10.1186/s12955-021-01889-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 10/27/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The adult versions EQ-5D-3L and EQ-5D-5L have been extensive compared. This is not the case for the EQ-5D youth versions. The study aim was to compare the measurement properties and responsiveness of EQ-5D-Y-3L and EQ-5D-Y-5L in paediatric patients. METHODS A sample of patients 8-16 years old with different diseases and a wide range of disease severity was asked to complete EQ-5D-Y-3L, EQ-5D-Y-5L, PedsQL Generic Core Scale, and selected, appropriate disease-specific instruments, three times. EQ-5D-Y-3L and EQ-5D-Y-5L were compared in terms of: feasibility, (re-)distribution properties, discriminatory power, convergent validity, test-retest reliability, and responsiveness. RESULTS 286 participating patients suffered from one of the following diseases: major beta-thalassemia, haemophilia, acute lymphoblastic leukaemia, acute illness. Missing responses were comparable between versions of the EQ-5D-Y, suggesting comparable feasibility. The number of patients in the best health state (level profile 11111) was equal in both EQ-5D-Y versions. The projection of EQ-5D-Y-3L scores onto EQ-5D-Y-5L for all dimensions showed that the two additional levels in EQ-5D-Y-5L slightly improved the accuracy of patients in reporting their problems, especially if severe. Convergent validity with PedsQL and disease-specific measures showed that the two EQ-5D-Y versions performed about equally. Test-retest reliability (EQ-5D-Y-3L 0.78 vs EQ-5D-Y-5L 0.84), and sensitivity for detecting health changes, were both better in EQ-5D-Y-5L. CONCLUSIONS Extending the number of levels did not give clear superiority to EQ-5D-Y-5L over EQ-5D-Y-3L based on the criteria assessed in this study. However, increasing the number of levels benefitted EQ-5D-Y performance in the measurement of moderate to severe problems and especially in longitudinal study designs.
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Affiliation(s)
- Titi Sahidah Fitriana
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands.
- Faculty of Psychology, YARSI University, Jakarta, Indonesia.
| | - Fredrick Dermawan Purba
- Department of Developmental Psychology, Faculty of Psychology, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Rina Rahmatika
- Faculty of Psychology, YARSI University, Jakarta, Indonesia
| | - Riski Muhaimin
- Department of Child Health, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Nur Melani Sari
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Gouke Bonsel
- The EuroQol Research Foundation, Rotterdam, The Netherlands
- Department of Public Health, Erasmus MC University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Elly Stolk
- The EuroQol Research Foundation, Rotterdam, The Netherlands
| | - Jan J V Busschbach
- Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands
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Lamb A, Murray A, Lovett R. The Challenges of Measuring and Valuing Quality of Life in Preschool Children: A Retrospective Review of NICE Appraisals. CHILDREN (BASEL, SWITZERLAND) 2021; 8:765. [PMID: 34572196 PMCID: PMC8464668 DOI: 10.3390/children8090765] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/27/2021] [Accepted: 08/27/2021] [Indexed: 11/26/2022]
Abstract
Health technology assessment agencies evaluate interventions across the lifespan. However, there is no consensus about best-practice methods to measure health-related quality of life (HRQoL) in preschool children (<5 years) and data are often scarce. We reviewed methods used to capture the HRQoL of preschool children in past National Institute for Health and Care Excellence (NICE) appraisals to establish whether there is a need for better methods in this area and if so, to identify priority research areas. We identified past NICE appraisals that included preschool children, examining the methods used to generate utility values and whether committees believed these captured HRQoL adequately. Of the 12 appraisals, most used generic HRQoL measures designed for adults. Measures were usually completed by adult patients or clinical experts. Committees frequently commented on limitations in the HRQoL data. While acknowledging that data collection may be challenging, committees would value evidence based on HRQoL data from parents or guardians collected as part of a clinical trial. We identified several research priorities including the psychometric properties of existing measures; the feasibility and validity of valuation studies; and mapping. Progress in these areas will help ensure that the aspects of HRQoL which matter to children and their families are captured in NICE evaluations.
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Affiliation(s)
- Alan Lamb
- Science Policy and Research, National Institute for Health and Care Excellence (NICE), Level 1A, City Tower, Piccadilly, Manchester M1 4BT, UK; (A.M.); (R.L.)
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Psychometric Performance of HRQoL Measures: An Australian Paediatric Multi-Instrument Comparison Study Protocol (P-MIC). CHILDREN-BASEL 2021; 8:children8080714. [PMID: 34438605 PMCID: PMC8393323 DOI: 10.3390/children8080714] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 11/17/2022]
Abstract
Background: There is a lack of psychometric evidence about pediatric health-related quality of life (HRQoL) instruments. Evidence on cost effectiveness, involving the measurement of HRQoL, is used in many countries to make decisions about pharmaceuticals, technologies, and health services for children. Additionally, valid instruments are required to facilitate accurate outcome measurement and clinical decision making. A pediatric multi instrument comparison (P-MIC) study is planned to compare the psychometric performance and measurement characteristics of pediatric HRQoL instruments. Methods: The planned P-MIC study will collect data on approximately 6100 Australian children and adolescents aged 2–18 years via The Royal Children’s Hospital Melbourne and online survey panels. Participants will complete an initial survey, involving the concurrent collection of a range of pediatric HRQoL instruments, followed by a shorter survey 2–8 weeks later, involving the collection of a subset of instruments from the initial survey. Children aged ≥7 years will be asked to self-report HRQoL. Psychometric performance will be assessed at the instrument, domain, and item level. Conclusions: This paper describes the methodology of the planned P-MIC study, including benefits, limitations, and likely challenges. Evidence from this study will guide the choice of HRQoL measures used in clinical trials, economic evaluation, and other applications.
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