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. 2022 Dec;40(Suppl 2):181-192.
doi: 10.1007/s40273-022-01202-1. Epub 2022 Oct 18.

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

Stefan A Lipman  1 , Brigitte A B Essers  2   3 , Aureliano P Finch  4 , Ayesha Sajjad  5 , Peep F M Stalmeier  6 , Bram Roudijk  4
Affiliations

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

Stefan A Lipman et al. Pharmacoeconomics. 2022 Dec.

Abstract

Background and objectives: EQ-5D-Y-3L health states are commonly valued by asking adults to complete stated preference tasks, 'given their views about a 10-year-old child' (hereafter referred to as proxy 1). The use of this perspective has been a source of debate. In this paper, we investigated an alternative proxy perspective: i.e. adults considered what they think a 10-year old-child would decide for itself (hereafter, proxy 2 (substitute)]. Our main objective was to explore how the outcomes, dispersion and response patterns of a composite time trade-off valuation differ between proxy 1 and proxy 2.

Methods: A team of four trained interviewers completed 402 composite time trade-off interviews following the EQ-5D-Y-3L protocol. Respondents were randomly allocated to value health states in either the proxy 1 or proxy 2 (substitute) perspective. Each respondent valued ten health states with the perspective they were assigned to, as well as one health state with the alternative perspective (33333).

Results: The use of different proxy perspectives yielded differences in EQ-5D-Y-3L valuation. For states in which children had considerable pain and were very worried, sad or unhappy, respondents' valuations were lower in proxy 1 than in proxy 2 (substitute) perspectives, by about 0.2. Within-subject variation across health states was lower for proxy 2 (substitute) than proxy 1 perspectives. Analyses of response patterns suggest that data for proxy 2 (substitute) perspectives were less clustered.

Conclusions: There are systematic differences between composite time trade-off responses given by adults deciding for children and adults considering what children would want for themselves. In addition to warranting further qualitative exploration, such differences contribute to the ongoing normative discussion surrounding the source and perspective used for valuation of child and adolescent health.

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Conflict of interest statement

All authors have received funding from the EuroQol Research Foundation for work outside the scope of this research. Bram Roudijk, Aureliano Finch, Peep Stalmeier and Brigitte Essers are members of the EuroQol Group, and Bram Roudijk and Aureliano Finch are currently employees of EuroQol.

Figures

Fig. 1
Fig. 1
Scatter-density plot for repeated utility measurement (for state 33333). Darker shades reflect higher densities
See this image and copyright information in PMC

References

    1. Kwon J, Kim SW, Ungar WJ, et al. Patterns, trends and methodological associations in the measurement and valuation of childhood health utilities. Qual Life Res. 2019;28(7):1705–1724. doi: 10.1007/s11136-019-02121-z. - DOI - PMC - PubMed
    1. Chen G, Ratcliffe J. A review of the development and application of generic multi-attribute utility instruments for paediatric populations. Pharmacoeconomics. 2015;33(10):1013–1028. doi: 10.1007/s40273-015-0286-7. - DOI - PubMed
    1. Stevens K. Valuation of the child health utility 9D index. Pharmacoeconomics. 2012;30(8):729–747. doi: 10.2165/11599120-000000000-00000. - DOI - PubMed
    1. Ratcliffe J, Chen G, Stevens K, et al. Valuing Child Health Utility 9D health states with young adults: insights from a time trade off study. Appl Health Econ Health Policy. 2015;13(5):485–492. doi: 10.1007/s40258-015-0184-3. - DOI - PubMed
    1. Ravens-Sieberer U, Wille N, Badia X, et al. Feasibility, reliability, and validity of the EQ-5D-Y: results from a multinational study. Qual Life Res. 2010;19(6):887–897. doi: 10.1007/s11136-010-9649-x. - DOI - PMC - PubMed

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