1
|
Weerasuriya SR, Hettiarachchi RM, Kularatna S, Rohde A, Arrow P, Jamieson L, Tonmukayakul U, Senanayake S. Comparison of the Early Childhood Oral Health Impact Scale (ECOHIS-4D) and Child Health Utility Index (CHU-9D) in children with oral diseases. Community Dent Oral Epidemiol 2024; 52:224-231. [PMID: 37811777 DOI: 10.1111/cdoe.12917] [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] [Received: 03/08/2023] [Revised: 08/09/2023] [Accepted: 09/25/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE Accurate assessment of child oral health is important for guiding economic evaluations and informing healthcare decision-making. Early Childhood Oral Health Impact Scale (ECOHIS-4D) is a preference-based instrument that measures the oral health-related quality of life of young children. The aim of this study was to compare the utility scores of ECOHIS-4D and Child Health Utility Index (CHU-9D), against an oral health indicator to evaluate which utility score corresponds better with the oral health indicator. METHOD The ECOHIS-4D and CHU-9D were applied to 314 parent/child dyads from preschools in a primary healthcare setting in Perth, Western Australia. Four parameters were used to assess which instrument corresponds better with the oral health indicator (decayed, missing and filled teeth score-dmft score): (i) discrimination, the ability to discriminate between different clinical severity groups, (ii) external responsiveness, how much the utility values relate to the changes in dmft scores, (iii) correlation, the association between the two instruments and the related dimensions and (iv) differences in the utility values across the two instruments. RESULTS Most participants (81%) were 2-6 years old, and nearly 50% had a dmft score <3. ECOHIS-4D demonstrated a superior ability to differentiate between dmft severity groups and respond to changes in dmft scores. A significant weak correlation was observed between dmft and ECOHIS-4D (-0.26, 95%, CI -0.36 to -0.15) compared to a non-significant very poor correlation between dmft and CHU-9D (0.01, 95% CI -0.12 to 0.10). The utility scores of the two instruments had relatively good agreement towards good health and weak agreement towards poor health. CONCLUSIONS ECOHIS-4D, the oral health-specific instrument, is more sensitive in assessing children's oral health-related quality of life than the generic CHU-9D. Thus, ECOHIS-4D is more appropriate for utility estimates in economic evaluations of oral health-related interventions and resource allocation decision-making.
Collapse
Affiliation(s)
- Sucharitha R Weerasuriya
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Ruvini M Hettiarachchi
- Centre for the Business and Economics of Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Sanjeewa Kularatna
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Alexia Rohde
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Peter Arrow
- Adelaide Dental School, The University of Adelaide, South Australia, Adelaide, Australia
| | - Lisa Jamieson
- Adelaide Dental School, The University of Adelaide, South Australia, Adelaide, Australia
| | - Utsana Tonmukayakul
- Institute for Health Transformation, Deakin Health Economics, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
| | - Sameera Senanayake
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| |
Collapse
|
2
|
Hettiarachchi RM, Arrow P, Senanayake S, Carter H, Brain D, Norman R, Tonmukayawul U, Jamieson L, Kularatna S. Developing an Australian utility value set for the Early Childhood Oral Health Impact Scale-4D (ECOHIS-4D) using a discrete choice experiment. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2023; 24:1285-1296. [PMID: 36394684 PMCID: PMC10533628 DOI: 10.1007/s10198-022-01542-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Preference-based quality of life measures (PBMs) are used to generate quality-adjusted life years (QALYs) in economic evaluations. A PBM consists of (1) a health state classification system and (2) a utility value set that allows the instrument responses to be converted to QALYs. A new, oral health-specific classification system, the Early Childhood Oral Health Impact Scale-4D (ECOHIS-4D) has recently been developed. The aim of this study was to generate an Australian utility value set for the ECOHIS-4D. METHODS A discrete choice experiment with duration (DCETTO) was used as the preference elicitation technique. An online survey was administered to a representative sample of Australian adults over 18 years. Respondents were given 14 choice tasks (10 tasks from the DCE design of 50 choice sets blocked into five blocks, 2 practice tasks, a repeated and a dominant task). Data were analyzed using the conditional logit model. RESULTS A total of 1201 respondents from the Australian general population completed the survey. Of them, 69% (n = 829) perceived their oral health status to be good, very good, or excellent. The estimated coefficients from the conditional logit models were in the expected directions and were statistically significant (p < 0.001). The utility values for health states defined by the ECOHIS-4D ranged from 0.0376 to 1.0000. CONCLUSIONS This newly developed utility value set will enable the calculation of utility values for economic evaluations of interventions related to oral diseases such as dental caries among young children. This will facilitate more effective resource allocation for oral health services.
Collapse
Affiliation(s)
- Ruvini M Hettiarachchi
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
| | - Peter Arrow
- Australian Research Centre for Population Oral Health, Adelaide Health and Medical Sciences, University of Adelaide, Adelaide, Australia
- Health Department Western Australia, Dental Health Services, Western Australia, Australia
- Dental School, University of Western Australia, Perth, Australia
| | - Sameera Senanayake
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Hannah Carter
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - David Brain
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Richard Norman
- School of Population Health, Curtin University, Perth, Australia
| | - Utsana Tonmukayawul
- Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Victoria, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Sanjeewa Kularatna
- Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| |
Collapse
|
3
|
Brusco NK, Danchin M, Watts JJ, Jos C, Loughnan M, Williams T, Ratcliffe J, Hoq M, Tosif S, Kaufman J. Parent-Reported Child and Parent Quality of Life during COVID-19 Testing at an Australian Paediatric Hospital Outpatient Clinic: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:2555. [PMID: 37761750 PMCID: PMC10530877 DOI: 10.3390/healthcare11182555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/04/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Globally, we have seen a drop in adult and child quality of life (QOL) during the COVID-19 pandemic. However, little is known about adult or child QOL during the height of the pandemic in Australia and the impact of government-imposed restrictions, specifically attending school on-site versus home schooling. Our study aimed to establish if QOL in children and parents presenting to a Respiratory Infection Clinic in Victoria, Australia, for COVID-19 PCR testing differed from pre-pandemic population norms. We also explored whether on-site versus home schooling further impacted QOL. Following the child's test and prior to receiving results, consenting parents of children aged 6 to 17 years old completed the Child Health Utility 9 Dimension (CHU9D) instrument on their child's behalf. Parents of children aged birth to five years completed the EuroQOL 5-Dimension 5-Level (EQ-5D-5L) instrument on their own behalf (cross-sectional study). Data analyses utilised quantile regression, adjusting for the child's age, COVID-19 symptoms, gender and chronic health conditions. From July 2020 to November 2021, 2025 parents completed the CHU9D; the mean age for children was 8.41 years (±3.63 SD), and 48.4 per cent were female (n = 980/2025). In the same time period, 5751 parents completed the EQ-5D-5L; the mean age for children was 2.78 years (±1.74 SD), and 52.2 per cent were female (n = 3002/5751). Results showed that QOL scores were lower than pre-pandemic norms for 68 per cent of the CHU9D group and 60 per cent of the EQ-5D-5L group. Comparing periods of on-site to home schooling, there was no difference between the median QOL scores for both CHU9D (0.017, 95% CI -0.05 to 0.01) and EQ-5D-5L (0.000, 95% CI -0.002 to 0.002). Our large-scale study found that while QOL was reduced for children and parents at the point of COVID-19 testing during the pandemic, differing levels of government-imposed restrictions did not further impact QOL. These unique insights will inform decision-making in relation to COVID-19 and future pandemics.
Collapse
Affiliation(s)
- Natasha K. Brusco
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Frankston 3199, Australia
| | - Margie Danchin
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (M.D.); (M.L.); (T.W.); (J.K.)
- Department of General Medicine, The Royal Children’s Hospital, Melbourne 3052, Australia;
- Department of Paediatrics, School of Population and Global Health, The University of Melbourne, Melbourne 3052, Australia
| | - Jennifer J. Watts
- School of Health and Social Development, Deakin University, Burwood 3125, Australia;
| | - Carol Jos
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (M.D.); (M.L.); (T.W.); (J.K.)
| | - Myles Loughnan
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (M.D.); (M.L.); (T.W.); (J.K.)
- Department of General Medicine, The Royal Children’s Hospital, Melbourne 3052, Australia;
| | - Tria Williams
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (M.D.); (M.L.); (T.W.); (J.K.)
- Infection and Immunity, Murdoch Children’s Research Institute, Melbourne 3052, Australia
| | - Julie Ratcliffe
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, Adelaide 5001, Australia;
| | - Monsurul Hoq
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Melbourne 3052, Australia;
- RCH National Child Health Poll, The Royal Children’s Hospital, Melbourne 3052, Australia
| | - Shidan Tosif
- Department of General Medicine, The Royal Children’s Hospital, Melbourne 3052, Australia;
- Infection and Immunity, Murdoch Children’s Research Institute, Melbourne 3052, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne 3052, Australia
| | - Jessica Kaufman
- Vaccine Uptake Group, Murdoch Children’s Research Institute, Melbourne 3052, Australia; (M.D.); (M.L.); (T.W.); (J.K.)
- Department of Paediatrics, The University of Melbourne, Melbourne 3052, Australia
| |
Collapse
|
4
|
Duman S, Inceoglu F. The caries impacts and experiences questionnaire for Turkish children by age groups'. BMC Oral Health 2023; 23:592. [PMID: 37620864 PMCID: PMC10463882 DOI: 10.1186/s12903-023-03321-3] [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: 04/05/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND The Caries Impacts and Experiences Questionnaire for Children (CARIES-QC) assess children's effects of dental caries on their quality of life. This study aimed to determine the scale's Turkish version (CARIES-QC/T) validity and reliability according to age groups and to create the scale that is specific to selected age groups. METHODS Children were divided up into 3 age groups (5-7, 8-10 and 11-14 ages). Explanatory factor analysis (EFA) was used in the concept validation process. Confirmatory factor analysis (CFA) was used for cross-cultural validity. For each group, test-retest analyses were performed on 20 children. Inter-question correlation and Cronbach's alpha were used to examine internal consistency. RESULTS A total of 360 children (mean age; 9.04, 56.1% girls,) 120 children in each group, participated in the study. Questions 7 and 12 for the 5-7 age group, Questions 4 and 7 for the 8-10 and 11-14 age groups were excluded from the analysis (according to EFA results; factor loads < 0.30). Three modified CARIES-QC/T scales structures with a total of 10 questions were developed for the age groups of 5-7, 8-10, and 11-14. CONCLUSIONS Some questions on the Caries-QC/T scale should be eliminated, it was found when it was evaluated for age specificity. Although the results of the Caries-QC scale studies to be carried out in different societies and age groups vary, the high sample size in this study and the statistically strong results showed that the Caries-QC/T scale forms that we adapted could be used by the specified age groups.
Collapse
Affiliation(s)
- Sacide Duman
- Department of Paediatric Dentistry, Faculty of Dentistry, Inonu University, Malatya, 44280, Turkey.
| | - Feyza Inceoglu
- Department of Biostatistics, Faculty of Medicine, Malatya Turgut Ozal University, Malatya, Turkey
| |
Collapse
|
5
|
Khanna D, Khadka J, Mpundu-Kaambwa C, Lay K, Russo R, Ratcliffe J. Are We Agreed? Self- Versus Proxy-Reporting of Paediatric Health-Related Quality of Life (HRQoL) Using Generic Preference-Based Measures: A Systematic Review and Meta-Analysis. PHARMACOECONOMICS 2022; 40:1043-1067. [PMID: 35997957 PMCID: PMC9550745 DOI: 10.1007/s40273-022-01177-z] [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: 07/11/2022] [Indexed: 05/25/2023]
Abstract
OBJECTIVE The aim of this study was to examine the level of agreement between self- and proxy-reporting of health-related quality of life (HRQoL) in children (under 18 years of age) using generic preference-based measures. METHODS A systematic review of primary studies that reported agreement statistics for self and proxy assessments of overall and/or dimension-level paediatric HRQoL using generic preference-based measures was conducted. Where available, data on intraclass correlation coefficients (ICCs) were extracted to summarise overall agreement levels, and Cohen's kappa was used to describe agreement across domains. A meta-analysis was also performed to synthesise studies and estimate the level of agreement between self- and proxy-reported paediatric overall and domain-level HRQoL. RESULTS Of the 30 studies included, 25 reported inter-rater agreement for overall utilities, while 17 reported domain-specific agreement. Seven generic preference-based measures were identified as having been applied: Health Utilities Index (HUI) Mark 2 and 3, EQ-5D measures, Child Health Utility 9 Dimensions (CHU9D), and the Quality of Well-Being (QWB) scale. A total of 45 dyad samples were included, with a total pooled sample of 3084 children and 3300 proxies. Most of the identified studies reported a poor inter-rater agreement for the overall HRQoL using ICCs. In contrast to more observable HRQoL domains relating to physical health and functioning, the inter-rater agreement was low for psychosocial-related domains, e.g., 'emotion' and 'cognition' attributes of both HUI2 and HUI3, and 'feeling worried, sad, or unhappy' and 'having pain or discomfort' domains of the EQ-5D. Parents demonstrated a higher level of agreement with children relative to health professionals. Child self- and proxy-reports of HRQoL showed lower agreement in cancer-related studies than in non-cancer-related studies. The overall ICC from the meta-analysis was estimated to be 0.49 (95% confidence interval 0.34-0.61) with poor inter-rater agreement. CONCLUSION This study provides evidence from a systematic review of studies reporting dyad assessments to demonstrate the discrepancies in inter-rater agreement between child and proxy reporting of overall and domain-level paediatric HRQoL using generic preference-based measures. Further research to drive the inclusion of children in self-reporting their own HRQoL wherever possible and limiting the reliance on proxy reporting of children's HRQoL is warranted.
Collapse
Affiliation(s)
- Diana Khanna
- Health and Social Care Economics Group, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA Australia
| | - Jyoti Khadka
- Health and Social Care Economics Group, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA Australia
- Registry of Senior Australians, Healthy Ageing Research Consortium, South Australian Health and Medical Research Institute, Adelaide, SA Australia
| | - Christine Mpundu-Kaambwa
- Health and Social Care Economics Group, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA Australia
| | - Kiri Lay
- Health and Social Care Economics Group, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA Australia
| | - Remo Russo
- Department of Paediatric Rehabilitation, Women’s and Children’s Hospital, Adelaide, SA Australia
- Faculty of Health Sciences, School of Medicine, Flinders University, Adelaide, SA Australia
| | - Julie Ratcliffe
- Health and Social Care Economics Group, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA Australia
| | | |
Collapse
|
6
|
Vermaire JH, Kalf SM, Schuller AA. Oral health and oral health behaviour of adolescents with mild or borderline intellectual disabilities compared with a national representative sample of 17-year-olds in the Netherlands. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 34:615-623. [PMID: 33169895 PMCID: PMC7894337 DOI: 10.1111/jar.12829] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/17/2020] [Accepted: 10/17/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND People with intellectual disabilities have worse health outcomes compared to their peers without. However, regarding oral health parameters, recent systematic reviews reported conflicting evidence. The aim was to assess whether adolescents with MBID differ from their peers in oral health and oral health behaviour. METHODS Ninety seven adolescents with MBID participated in this comparative study. Outcomes were compared to data of 17-year-old Dutch adolescents (n = 581) from a national epidemiological study on oral health and oral health behaviour. RESULTS Adolescents with MBID showed worse oral health outcomes and poorer oral hygiene than their peers from the general population. Furthermore, they visit the dentist less regularly, brush less frequently, eat main-dishes less frequently and have higher levels of dental anxiety. CONCLUSION Adolescents with MBID have poorer oral health and show worse oral health-promoting behaviours than their peers in the general population. Targeted interventions to reach this vulnerable group are necessary.
Collapse
Affiliation(s)
- Jan Hendrik Vermaire
- TNO Child Health - Oral Health Division, Leiden, The Netherlands.,Centre for Dentistry and Oral Hygiene, University Medical Centre Groningen, Groningen, The Netherlands
| | - Sonja M Kalf
- SBT, Centre for Special Care Dentistry, Amsterdam, The Netherlands
| | - Annemarie A Schuller
- TNO Child Health - Oral Health Division, Leiden, The Netherlands.,Centre for Dentistry and Oral Hygiene, University Medical Centre Groningen, Groningen, The Netherlands
| |
Collapse
|