Assessment of children’s own health status using visual analogue scale and descriptive system of the EQ-5D-Y: linkage between two systems

ObjectivesThe objective of the study is to derive a scoring system for the EQ-5D child-friendly version (EQ-5D-Y) from a population-based sample of children based on their own health state assessments on the descriptive system and the visual analogue scale (VAS).MethodsWe used data from the 2008 and 2010 Raising Healthy Eating and Active Living Kids in Alberta surveys of grade five students aged primarily 10–11 years and their parents in the Canadian province of Alberta. We applied a random split sample approach. Two-thirds of the sample (modeling sample) was used for the estimation of the EQ-5D-Y VAS. The remaining one-third sample (validation sample) was used for the examination of the prediction accuracy of the estimation model. Multilevel linear regression was used to estimate EQ-5D-Y VAS score and produce EQ-5D-Y index values from the children’s self-rated states described in the EQ-5D-Y and the accompanying VAS values.ResultsThe mean EQ-5D-Y VAS-based index value was 0.891 (SD 0.133) in the modeling sample and 0.885 (SD 0.134) in the validation sample. The own VAS-based index generally showed logical consistency, with lower values for health states that were logically worse. There was no statistically significant difference between the observed and the predicted VAS values in this sample.ConclusionsThis study elicited a value set for health states defined by the EQ-5D-Y that is based on respondents’ own VAS ratings from a large representative sample of Canadian children. Future study is needed to validate this type of value set among different age groups of children.

[1]  G. Torrance Measurement of health state utilities for economic appraisal. , 1986, Journal of health economics.

[2]  Grazyna Adamiak,et al.  Methods for the economic evaluation of health care programmes, 3rd ed , 2006 .

[3]  P. Veugelers,et al.  Sociodemographic and neighbourhood determinants of health-related quality of life among grade-five students in Canada , 2010, Quality of Life Research.

[4]  R. Rabin,et al.  EQ-SD: a measure of health status from the EuroQol Group , 2001, Annals of medicine.

[5]  X. Badia,et al.  Feasibility, validity and test–retest reliability of scaling methods for health states: The visual analogue scale and the time trade-off , 1999, Quality of Life Research.

[6]  P. Dolan,et al.  Modeling valuations for EuroQol health states. , 1997, Medical care.

[7]  P. Stalmeier,et al.  The Dutch tariff: results and arguments for an effective design for national EQ-5D valuation studies. , 2006, Health economics.

[8]  Wendy J. Ungar,et al.  Challenges in Health State Valuation in Paediatric Economic Evaluation , 2011, PharmacoEconomics.

[9]  G. Torrance Preferences for health outcomes and cost-utility analysis. , 1997, The American journal of managed care.

[10]  David Parkin,et al.  Is there a case for using visual analogue scale valuations in cost-utility analysis? , 2006, Health economics.

[11]  J. Coast,et al.  Quality-Adjusted Life-Years Lack Quality in Pediatric Care: A Critical Review of Published Cost-Utility Studies in Child Health , 2005, Pediatrics.

[12]  Stephen Joel Coons,et al.  US Valuation of the EQ-5D Health States: Development and Testing of the D1 Valuation Model , 2005, Medical care.

[13]  R. S. Tedlow New And Improved , 1990 .

[14]  P. Hansen,et al.  A ‘new and improved’ EQ-5D valuation questionnaire? , 2005, The European Journal of Health Economics.

[15]  Jacob Cohen Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[16]  Mark L. Greenberg,et al.  Health-related quality of life (HRQL) scores reported from parents and their children with chronic illness differed depending on utility elicitation method. , 2004, Journal of clinical epidemiology.

[17]  N. Ikegami,et al.  Estimating an EQ-5D population value set: the case of Japan. , 2002, Health economics.

[18]  R. Keren,et al.  Measuring Health Preferences for Use in Cost-Utility and Cost-Benefit Analyses of Interventions in Children , 2012, PharmacoEconomics.

[19]  V. Irazola,et al.  Argentine valuation of the EQ-5D health states. , 2009, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[20]  M. Neary,et al.  Estimation of minimally important differences in EQ-5D utility and VAS scores in cancer , 2010, Health and Quality of Life Outcomes.

[21]  J. Busschbach,et al.  Performance of the EuroQol in children with imperforate anus , 2004, Quality of Life Research.

[22]  G. Guyatt,et al.  Minimum skills required by children to complete health-related quality of life instruments for asthma: comparison of measurement properties. , 1997, The European respiratory journal.

[23]  G. Guyatt,et al.  Measurement of health status. Ascertaining the minimal clinically important difference. , 1989, Controlled clinical trials.

[24]  Aki Tsuchiya,et al.  A single European currency for EQ-5D health states , 2003, The European Journal of Health Economics, formerly: HEPAC.

[25]  G. Norman,et al.  Interpretation of Changes in Health-related Quality of Life: The Remarkable Universality of Half a Standard Deviation , 2003, Medical care.

[26]  Jeffrey A. Johnson,et al.  Valuation of EuroQOL (EQ-5D) Health States in an Adult US Sample , 1998, PharmacoEconomics.

[27]  A. Norinder,et al.  The weighting exercise for the Swedish version of the EuroQol. , 1999, Health economics.

[28]  P. Hansen,et al.  A "new and improved" EQ-5D valuation questionnaire? Results from a pilot study. , 2005, The European journal of health economics : HEPAC : health economics in prevention and care.

[29]  M. Svartengren,et al.  Testing a Swedish child-friendly pilot version of the EQ-5D instrument--initial results. , 2011, European journal of public health.

[30]  H. Sintonen,et al.  Comparison of Finnish and U.S.-based Visual Analog Scale Valuations of the EQ-5D Measure , 2000, Medical decision making : an international journal of the Society for Medical Decision Making.

[31]  G. Bonsel,et al.  Feasibility, reliability, and validity of the EQ-5D-Y: results from a multinational study , 2010, Quality of Life Research.

[32]  R. Epstein,et al.  Interpretation of quality of life changes , 1993, Quality of Life Research.

[33]  John E. Brazier,et al.  Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D , 2005, Quality of Life Research.

[34]  Michael Herdman,et al.  Development of the EQ-5D-Y: a child-friendly version of the EQ-5D , 2010, Quality of Life Research.

[35]  G. Samsa,et al.  Determining Clinically Important Differences in Health Status Measures , 1999, PharmacoEconomics.

[36]  P. Veugelers,et al.  From "best practice" to "next practice": the effectiveness of school-based health promotion in improving healthy eating and physical activity and preventing childhood obesity , 2012, International Journal of Behavioral Nutrition and Physical Activity.

[37]  M. Drummond,et al.  Health Care Technology: Effectiveness, Efficiency and Public Policy@@@Methods for the Economic Evaluation of Health Care Programmes , 1988 .

[38]  P. Lachenbruch Statistical Power Analysis for the Behavioral Sciences (2nd ed.) , 1989 .

[39]  E. Wouters,et al.  Using EQ-5D in children with asthma, rheumatic disorders, diabetes, and speech/language and/or hearing disorders , 2009, International Journal of Technology Assessment in Health Care.

[40]  P. Veugelers,et al.  Geographic Differences in Childhood Overweight, Physical Activity, Nutrition and Neighbourhood Facilities: Implications for Prevention , 2010, Canadian journal of public health = Revue canadienne de sante publique.

[41]  S. Petrou Methodological issues raised by preference-based approaches to measuring the health status of children. , 2003, Health economics.