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Comparative Study
. 2025 Aug;28(8):1231-1240.
doi: 10.1016/j.jval.2025.04.2161. Epub 2025 Jun 6.

Understanding the Transition Between Age-Specific Measures of Health-Related Quality of Life: Evidence on the Relationship Between and Comparative Performance of the EQ-5D-Y-5L and EQ-5D-5L

Nicole Reyes  1 , Tianxin Pan  2 , Renee Jones  3 , Kim Dalziel  3 , Nancy Devlin  2 ; Quality Of Life in Kids: Key evidence to strengthen decisions in Australia (QUOKKA) project team
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Free article
Comparative Study

Understanding the Transition Between Age-Specific Measures of Health-Related Quality of Life: Evidence on the Relationship Between and Comparative Performance of the EQ-5D-Y-5L and EQ-5D-5L

Nicole Reyes et al. Value Health. 2025 Aug.
Free article

Abstract

Objectives: The EQ-5D-5L is widely used to measure adults' health-related quality of life (HRQoL). The EQ-5D-Y-5L is a corresponding measure adapted for children/adolescents, in principle allowing HRQoL to be measured consistently from childhood to adulthood. However, little is known about how their measurement properties compare. This study investigated the relationship between EQ-5D-Y-5L and EQ-5D-5L in adolescents and compared their psychometric performance.

Methods: The Australian Pediatric Multi-Instrument Comparison Study includes a sample of 591 adolescents (aged 12-18) who completed both EQ-5D-5L and EQ-5D-Y-5L. Responses were compared descriptively and HRQoL summarized using the level sum score. Acceptability, feasibility, ceiling effects, convergence, test-retest reliability, and known-group validity were assessed overall and in subgroups defined by special healthcare needs (SHCN), mental health concerns (MHC), and age (12-13, 14-16, and 17-18 years).

Results: Ceiling effects were lower for EQ-5D-Y-5L than EQ-5D-5L. The EQ-5D-Y-5L better differentiated between adolescents with and without SHCN and MHC than EQ-5D-5L, whereas EQ-5D-5L showed better test-retest reliability in adolescents with SHCN and MHC. We found strong correlations between dimensions anticipated to be correlated. EQ-5D-Y-5L identified a higher incidence of self-reported HRQoL problems than EQ-5D-5L both overall and particularly in mental health.

Conclusions: Although both instruments are valid for measuring HRQoL in adolescents aged 12 to 18 years, EQ-5D-Y-5L had some psychometric advantages. The instruments are closely related, but differences in their descriptive systems produce differences in self-reported HRQoL. Results highlight potential discontinuities in HRQoL measured using age-specific instruments, which may be important for their use in economic models that involve transitions between age groups.

Keywords: Adolescents; Australia; Child health; EQ-5D-5L; EQ-5D-Y-5L; Pediatrics; health-related quality of life; psychometric performance.

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Conflict of interest statement

Author Disclosures Author disclosure forms can be accessed below in the Supplemental Material section. Dr Devlin is an editor for Value in Health and had no role in the peer-review process of this article. Views expressed in this article are those of the authors and are not necessarily those of the EuroQol Research Foundation or the Australian Government Medical Research Futures Fund.

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