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Huang L, Devlin N, Chen G, Dalziel K. A happiness approach to valuing health states for children. Soc Sci Med 2024; 348:116802. [PMID: 38537454 DOI: 10.1016/j.socscimed.2024.116802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 04/29/2024]
Abstract
Preference weights are widely used to score generic health states into utility indexes for estimation of quality adjusted life years (QALYs) and to aid health care funding decisions. To date, health state utilities are predominantly derived using stated preference methods based on decision utility. This paper tests an alternative and generates preference weights using experienced utility for children based on the Child Health Utility 9D (CHU9D) descriptive system. We estimate the relative values of the CHU9D health states with regard to experienced utility, where experienced utility is approximated by self-reported happiness. A nationally-representative longitudinal survey was used including 6090 Australian children aged 12-17 years surveyed over 2014-2018. The derived weights were then applied to calculate the utility decrements for a few common child health conditions. We found that the estimated utility decrements are largely similar to those estimated using the published CHU9D Australian adolescent weights based on decision utility, except for pain and depression. A smaller utility decrement for pain and a larger utility decrement for depression were indicated by experienced utility. We contribute to the literature by showing that using experienced utility methods to generate preference weights for health states is possible, and we discuss some important methodological challenges for future studies such as the impracticability of anchoring to 'dead' when utilizing experienced utility.
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Affiliation(s)
- Li Huang
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Nancy Devlin
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, Australia
| | - Kim Dalziel
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
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Bashir NS, Walters TD, Griffiths AM, Otley A, Critch J, Ungar WJ. A comparison of the Child Health Utility 9D and the Health Utilities Index for estimating health utilities in pediatric inflammatory bowel disease. Qual Life Res 2023:10.1007/s11136-023-03409-x. [PMID: 37004628 PMCID: PMC10393835 DOI: 10.1007/s11136-023-03409-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 04/04/2023]
Abstract
PURPOSE Health utilities are challenging to ascertain in children and have not been studied in pediatric Crohn's disease (CD) and ulcerative colitis (UC). The objective was to assess discriminative validity by comparing utilities elicited using the Child Health Utility-9 Dimension (CHU9D) to the Health Utilities Index (HUI) across multiple disease activity scales in pediatric UC and CD. METHODS Preference-based instruments were administered to 188 children with CD and 83 children with UC aged 6 to 18 years. Utilities were calculated using CHU9D adult and youth tariffs, and HUI2 and HUI3 algorithms in children with inactive (quiescent) and active (mild, moderate, and severe) disease. Differences between instruments, tariff sets and disease activity categories and were tested statistically. RESULTS In CD and UC, all instruments detected significantly higher utilities for inactive compared to active disease (p < 0.05). Mean utilities for quiescent disease ranged from 0.810 (SD 0.169) to 0.916 (SD 0.121) in CD and from 0.766 (SD 0.208) to 0.871 (SD 0.186) in UC across instruments. Active disease mean utilities ranged from 0.694 (SD 0.212) to 0.837 (SD 0.168) in CD and from 0.654 (SD 0.226) to 0.800 (SD 0.128) in UC. CONCLUSION CHU9D and HUI discriminated between levels of disease activity in CD and UC regardless of the clinical scale used, with the CHU9D youth tariff most often displaying the lowest utilities for worse health states. Distinct utilities for different IBD disease activity states can be used in health state transition models evaluating the cost-effectiveness of treatments for pediatric CD and UC.
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Affiliation(s)
- Naazish S Bashir
- Program of Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Thomas D Walters
- Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Anne M Griffiths
- Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Anthony Otley
- Departments of Paediatrics and Medicine, Dalhousie University, Halifax, NS, Canada
- Division of Gastroenterology & Nutrition, IWK Health Centre, Halifax, NS, Canada
| | - Jeff Critch
- Department of Pediatrics, Faculty of Medicine, Janeway Children's Health and Rehabilitation Centre, Memorial University, St. John's, NF, Canada
| | - Wendy J Ungar
- Program of Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada.
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Hu J, Zhu L, Bao H, Liu Y, Xing H, Kang Q, Jin C. Utility estimations of different health states of patients with type I, II, and III spinal muscular atrophy in China: A mixed approach study with patient and proxy-reported data. Front Public Health 2022; 10:1054931. [PMID: 36605247 PMCID: PMC9809905 DOI: 10.3389/fpubh.2022.1054931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/11/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Spinal muscular atrophy (SMA) is a rare autosomal-recessive neuromuscular disease. Health state utility values (HSUV) are used in health economic evaluation regarding the desirability of health outcomes such as a certain health state or change in health states over time. There is no utility data of Chinese patients with SMA. Materials and methods Vignettes were developed for 10 pediatric neurologists to value the utility of Chinese patients with Type I SMA. A mixed patient/proxy derived approach using EQ-5D-Y-3L, EQ-5D-3L, and CHU9D was adopted to estimate the HSUV data of patients with Type II and III SMA, including 112 patients and 301 caregivers. Result The utility of Type I SMA patients ranged from 0.19 to 0.72 with the health state improved from "permanent ventilation" to "walking". The utility of children patients with Type II and III SMA derived from EQ-5D-Y-3L ranged from 0.33 to 0.82 while that derived from CHU9D ranged from 0.46 to 0.75. The utility of adult patients with Type II and III SMA measured by EQ-5D-3L ranged from 0.30 to 0.83. Conclusion The better health states the patients with SMA were in, the higher were the HSUV. The utilities derived from population with different age and disease subtypes were not statistically different when patients with SMA were in the same health states. We recommend further studies on the Chinese specific value set for EQ-5D-Y-3L and other PBMs for children to derive more robust utility data.
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Affiliation(s)
- Jiahao Hu
- Shanghai Health Development Research Centre (Shanghai Medical Information Centre), Shanghai, China
| | - Lin Zhu
- Shanghai Health Development Research Centre (Shanghai Medical Information Centre), Shanghai, China
| | - Han Bao
- Institute of Pharmaceutical Economics, Sun Yat-sen University, Guangzhou, China
| | - Yuhan Liu
- Shanghai Health Development Research Centre (Shanghai Medical Information Centre), Shanghai, China
| | - Huanping Xing
- Meier Advocacy & Support Centre for SMA, Beijing, China
| | - Qi Kang
- Shanghai Health Development Research Centre (Shanghai Medical Information Centre), Shanghai, China,*Correspondence: Qi Kang
| | - Chunlin Jin
- Shanghai Health Development Research Centre (Shanghai Medical Information Centre), Shanghai, China,Chunlin Jin
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Thomas HM, Runions KC, Lester L, Lombardi K, Epstein M, Mandzufas J, Barrow T, Ang S, Leahy A, Mullane M, Whelan A, Coffin J, Mitrou F, Zubrick SR, Bowen AC, Gething PW, Cross D. Western Australian adolescent emotional wellbeing during the COVID-19 pandemic in 2020. Child Adolesc Psychiatry Ment Health 2022; 16:4. [PMID: 35027061 PMCID: PMC8756750 DOI: 10.1186/s13034-021-00433-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/13/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The impacts of the COVID-19 pandemic have been vast and are not limited to physical health. Many adolescents have experienced disruptions to daily life, including changes in their school routine and family's financial or emotional security, potentially impacting their emotional wellbeing. In low COVID-19 prevalence settings, the impact of isolation has been mitigated for most young people through continued face-to-face schooling, yet there may still be significant impacts on their wellbeing that could be attributed to the pandemic. METHODS We report on data from 32,849 surveys from Year 7-12 students in 40 schools over two 2020 survey cycles (June/July: 19,240; October: 13,609), drawn from a study of 79 primary and secondary schools across Western Australia, Australia. The Child Health Utility Index (CHU9D) was used to measure difficulties and distress in responding secondary school students only. Using comparable Australian data collected six years prior to the pandemic, the CHU9D was calibrated against the Kessler-10 to establish a reliable threshold for CHU9D-rated distress. RESULTS Compared to 14% of responding 12-18-year-olds in 2013/2014, in both 2020 survey cycles almost 40% of secondary students returned a CHU9D score above a threshold indicative of elevated difficulties and distress. Student distress increased significantly between June and October 2020. Female students, those in older Grades, those with few friendships or perceived poor quality friendships, and those with poor connectedness to school were more likely to score above the threshold. CONCLUSIONS In a large dataset collected during the first year of the COVID-19 pandemic, the proportion of secondary school students with scores indicative of difficulties and distress was substantially higher than a 2013/2014 benchmark, and distress increased as the pandemic progressed, despite the low local prevalence of COVID-19. This may indicate a general decline in social and emotional wellbeing exacerbated by the events of the pandemic. TRIAL REGISTRATION ANZCTRN (ACTRN12620000922976). Retrospectively registered 17/08/2020. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380429&isReview=true .
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Affiliation(s)
- H. M. Thomas
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - K. C. Runions
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - L. Lester
- grid.1012.20000 0004 1936 7910University of Western Australia, Perth, Australia
| | - K. Lombardi
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia ,grid.1038.a0000 0004 0389 4302Edith Cowan University, Perth, Australia
| | - M. Epstein
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - J. Mandzufas
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - T. Barrow
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - S. Ang
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - A. Leahy
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - M. Mullane
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - A. Whelan
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - J. Coffin
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia ,grid.1012.20000 0004 1936 7910University of Western Australia, Perth, Australia
| | - F. Mitrou
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - S. R. Zubrick
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia
| | - A. C. Bowen
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia ,grid.1012.20000 0004 1936 7910University of Western Australia, Perth, Australia ,grid.410667.20000 0004 0625 8600Perth Children’s Hospital, Perth, Australia
| | - P. W. Gething
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia ,grid.1032.00000 0004 0375 4078Curtin University, Perth, Australia
| | - D. Cross
- grid.414659.b0000 0000 8828 1230Telethon Kids Institute, Perth, Australia ,grid.1012.20000 0004 1936 7910University of Western Australia, Perth, Australia
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Palacios-Cartagena RP, Pastor-Cisneros R, Adsuar JC, Pérez-Gómez J, García-Gordillo MÁ, Mendoza-Muñoz M. CHU9D Normative Data in Peruvian Adolescents. J Pers Med 2021; 11:1272. [PMID: 34945744 PMCID: PMC8704949 DOI: 10.3390/jpm11121272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Due to the vulnerability to protective and risk factors during adolescence, there is a growing interest in the study of health-related quality of life (HRQoL) at this stage. The CHU9D is a generic and practical HRQoL instrument that provides values on all dimensions of self-perceived health, in addition to providing utilities and a cost-utility assessment fee, unlike other instruments. This study was conducted with an adolescent population in Peru. The main objective of this article is to report the normative values of the CHU9D questionnaire in Peruvian adolescents. METHODS The CHU9D questionnaire was administered to Peruvian adolescent students. A total of 1229 young people participated in the survey. The CHU9D score was reflected as a function of gender, age, weight, height, and educational level. RESULTS The mean CHU9D utility index for the total sample was 0.890; this rating was significantly better for boys with 0.887 and girls with 0.867. The ceiling effect was higher for male adolescents with 32.6 than for female adolescents. CONCLUSIONS The results of the present study show that adolescents in school show a positive perception of HRQoL. It is also concluded that the CHU9D instrument can be effectively applied to economic evaluations for interventions to improve the quality of life of adolescents.
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Affiliation(s)
- Roxana Paola Palacios-Cartagena
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (R.P.P.-C.); (J.C.A.); (M.M.-M.)
| | - Raquel Pastor-Cisneros
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (R.P.P.-C.); (J.C.A.); (M.M.-M.)
| | - Jose Carmelo Adsuar
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (R.P.P.-C.); (J.C.A.); (M.M.-M.)
| | - Jorge Pérez-Gómez
- Health, Economy, Motricity and Education Research Group (HEME), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain;
| | | | - María Mendoza-Muñoz
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (R.P.P.-C.); (J.C.A.); (M.M.-M.)
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Qiao H, Wang X, Qin Z, Wang N, Zhang N, Xu F. The relationship between health literacy and health-related quality of life among school-aged children in regional China. Health Qual Life Outcomes 2021; 19:262. [PMID: 34823540 PMCID: PMC8620561 DOI: 10.1186/s12955-021-01895-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/16/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives To examine the association between health literacy (HL) and health-related quality of life (HRQoL) among primary and high school students in Nanjing, China. Methods A cross-sectional study was conducted among randomly selected primary (graders 4–6), junior (graders 7–9) and senior (graders 10–12) high school students in 2018 in Nanjing Municipality of China. HRQoL, the outcome variable, was assessed with the validated Chinese version of Child Health Utility 9D (CHU9D) and used as continuous variable, while HL, our independent variable, was measured with the validated Chinese Students’ Health literacy Assessment Scale and treated as categorical variable (“adequate” or “inadequate”) in the analysis. Mixed-effects linear regression models were introduced to calculate mean difference and 95% confidence interval (CI) for examining the association between HL and HRQoL. Results Totally, 4388 of 4498 students completed the survey. Among these responders, the mean score of CHU9D was 0.78 ± 0.17, and the proportion of participants with adequate HL was 85.8% (95% CI = 84.7%, 86.8%). After adjustment for potential confounders and class-level clustering effects, participants who had adequate HL were observed having, on average, an elevated HRQoL score of 0.08 (95% CI = 0.06, 0.11) units compared to their counterparts with inadequate HL. Such a positive HL-HRQoL association was also identified among each stratum of participants’ age, gender and residence. Conclusions HL was positively associated with HRQoL score among primary and high school students in China. It has public health implications that HRQoL may be improved through school-based health literacy intervention among children and adolescents in China.
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Affiliation(s)
- Huifen Qiao
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, 264, Guangzhou Road, 210029, Nanjing, China
| | - Xiaorong Wang
- Department of Pediatric Intensive Care Unit, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Zhenzhen Qin
- Nanjing Municipal Center for Disease Control and Prevention, 2, Zizhulin, Nanjing, 210003, China
| | - Na Wang
- Nanjing Municipal Center for Disease Control and Prevention, 2, Zizhulin, Nanjing, 210003, China
| | - Ning Zhang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, 264, Guangzhou Road, 210029, Nanjing, China.
| | - Fei Xu
- Nanjing Municipal Center for Disease Control and Prevention, 2, Zizhulin, Nanjing, 210003, China. .,Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China.
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Lindvall K, Vaezghasemi M, Feldman I, Ivarsson A, Stevens KJ, Petersen S. Feasibility, reliability and validity of the health-related quality of life instrument Child Health Utility 9D ( CHU9D) among school-aged children and adolescents in Sweden. Health Qual Life Outcomes 2021; 19:193. [PMID: 34344386 PMCID: PMC8336397 DOI: 10.1186/s12955-021-01830-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/26/2021] [Indexed: 11/23/2022] Open
Abstract
Background This study was conducted in a general population of schoolchildren in Sweden, with the aim to assess the psychometric properties of a generic preference-based health related quality of life (HRQoL) instrument, the Swedish Child Health Utility 9D (CHU9D), among schoolchildren aged 7–15 years, and in subgroups aged 7–9, 10–12 and 13–15 years.
Methods In total, 486 school aged children, aged 7–15 years, completed a questionnaire including the CHU9D, the Pediatric quality of life inventory 4.0 (PedsQL), KIDSCREEN-10, questions on general health, long-term illness, and sociodemographic characteristics. Psychometric testing was undertaken of feasibility, internal consistency reliability, test–retest reliability, construct validity, factorial validity, concurrent validity, convergent validity and divergent validity. Results The CHU9D evidenced very few missing values, minimal ceiling, and no floor effects. The instrument achieved satisfactory internal consistency (Cronbach’s Alfa > 0.7) and strong test–retest reliability (r > 0.6). Confirmatory factor analyses supported the proposed one-factor structure of the CHU9D. For child algorithm, RMSEA = 0.05, CFI = 0.95, TLI = 0.94, and SRMR = 0.04. For adult algorithm RMSEA = 0.04, CFI = 0.96, TLI = 0.95, and SRMR = 0.04. The CHU9D utility value correlated moderately or strongly with KIDSCREEN-10 and PedsQL total scores (r > 0.5–0.7). The CHU9D discriminated as anticipated on health and on three of five sociodemographic characteristics (sex, age, and custody arrangement, but not socioeconomic status and ethnic origin). Conclusions This study provides evidence that the Swedish CHU9D is a feasible, reliable and valid measure of preference-based HRQoL in children. The study furthermore suggests that the CHU9D is appropriate for use among children 7–15 years of age in the general population, as well as among subgroups aged 7– 9, 10–12 and 13–15 years.
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Affiliation(s)
- Kristina Lindvall
- Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, Sweden.
| | - Masoud Vaezghasemi
- Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, Sweden
| | - Inna Feldman
- Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, Sweden.,Department of Public Health and Caring Science, Uppsala University, Uppsala, Sweden
| | - Anneli Ivarsson
- Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, Sweden
| | - Katherine J Stevens
- School of Health and Related Research, The University of Sheffield, Sheffield, UK
| | - Solveig Petersen
- Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, Sweden
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Bashir NS, Walters TD, Griffiths AM, Ungar WJ. An Assessment of the Validity and Reliability of the Pediatric Child Health Utility 9D in Children with Inflammatory Bowel Disease. Children (Basel) 2021; 8:343. [PMID: 33925356 DOI: 10.3390/children8050343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/15/2021] [Accepted: 04/23/2021] [Indexed: 12/03/2022]
Abstract
Health utilities relevant to children are lacking, compromising health funding and policy decisions for children. The Child Health Utility 9D (CHU9D) is a recently developed preference-based health utility instrument designed for use in children. The objective was to examine the validity of the CHU9D in a cohort of 285 Canadian children aged 6.5 to 18 years of age with Crohn’s disease (CD) and ulcerative colitis (UC), (collectively inflammatory bowel disease (IBD)). The correlation and agreement between paired CHU9D and Health Utility Index (HUI) assessments were determined with Spearman coefficients and Bland–Altman levels of agreement. Total and domain utilities were calculated for the CHU9D using Australian adult and youth tariffs. Algorithms for HUI2 and HUI3 were used. Domain correlations were determined between domains with expected overlap between instruments. In CD and in UC, correlations between CHU9D, HUI2, and HUI3 utilities ranged between 0.62 to 0.67 and 0.67 to 0.69, respectively (p < 0.05). CHU9D utilities were lower using youth tariffs compared to adult tariffs. A large range in health utilities suggested a heterogeneous quality of life. The CHU9D is a good option for preference-based utility measurement in pediatric IBD. Additional research is required to derive pediatric tariffs to conduct economic evaluation in children.
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Rowen D, Keetharuth AD, Poku E, Wong R, Pennington B, Wailoo A. A Review of the Psychometric Performance of Selected Child and Adolescent Preference-Based Measures Used to Produce Utilities for Child and Adolescent Health. Value Health 2021; 24:443-460. [PMID: 33641779 DOI: 10.1016/j.jval.2020.09.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/08/2020] [Accepted: 09/25/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This review examined the psychometric performance of 4 generic child- and adolescent-specific preference-based measures that can be used to produce utilities for child and adolescent health. METHODS A systematic search was undertaken to identify studies reporting the psychometric performance of the Child Health Utility (CHU9D), EQ-5D-Y (3L or 5L), and Health Utilities Index Mark 2 (HUI2) or Mark 3 (HUI3) in children and/or adolescents. Data were extracted to assess known-group validity, convergent validity, responsiveness, reliability, acceptability, and feasibility. Data were extracted separately for the dimensions and utility index where this was reported. RESULTS The review included 76 studies (CHU9D n = 12, EQ-5D-Y-3L n = 20, HUI2 n = 26,HUI3 n = 43), which varied considerably across conditions and sample size. EQ-5D-Y-3L had the largest amount of evidence of good psychometric performance in proportion to the number of studies examining performance. The majority of the evidence related to EQ-5D-Y-3L was based on dimensions. CHU9D was assessed in fewer studies, but the majority of studies found evidence of good psychometric performance. Evidence for HUI2 and HUI3 was more mixed, but the studies were more limited in sample size and statistical power, which was likely to have affected performance. CONCLUSIONS The heterogeneity of published studies means that the evidence is based on studies across a range of countries, populations and conditions, using different study designs, different languages, different value sets and different statistical techniques. Evidence for CHU9D in particular is based on a limited number of studies. The findings raise concerns about the comparability of self-report and proxy-report responses to generate utility values for children and adolescents.
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Affiliation(s)
- Donna Rowen
- School of Health and Related Research, University of Sheffield, Sheffield, England, UK.
| | - Anju D Keetharuth
- School of Health and Related Research, University of Sheffield, Sheffield, England, UK
| | - Edith Poku
- School of Health and Related Research, University of Sheffield, Sheffield, England, UK
| | - Ruth Wong
- School of Health and Related Research, University of Sheffield, Sheffield, England, UK
| | - Becky Pennington
- School of Health and Related Research, University of Sheffield, Sheffield, England, UK
| | - Allan Wailoo
- School of Health and Related Research, University of Sheffield, Sheffield, England, UK
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Abstract
Objectives The Child Health Utility 9D (CHU9D) currently represents the only preference-based health-related quality-of-life instrument designed exclusively from its inception for application with children. The objective of this study was to examine the construct validity and responsiveness of the proxy-reported (parent) CHU9D in a mental health setting using utility weights derived from an adult and adolescent population, respectively. Methods The discriminant validity and convergent validity were examined using the mental health-specific ‘The Strengths and Difficulties Questionnaire’ (SDQ) and the generic KIDSCREEN-27. Responsiveness was assessed by examining the floor-ceiling effects, the magnitude of change over time, and the ability to differentiate between improvement and no improvement. Results The study included 396 children with mental health problems. CHU9D showed good construct validity, with correlation coefficients ranging between 0.329 and 0.571 for SDQ Impact score and KIDSCREEN-27 Psychological Well-being. CHU9D was able to distinguish between groups of children with different levels of mental health problems (p < 0.001). The absolute magnitudes of the group mean differences were larger using adolescent weights. No evidence of a floor/ceiling effect was found at the baseline. A standardized response mean of 0.634–0.654 was found for the children who experienced clinically significant improvements. CHU9D was able to discriminate between children who experienced positive and no health improvements (p < 0.001). Conclusion This study provides the first evidence on responsiveness for CHU9D in a mental health context. The findings demonstrate that CHU9D is an appropriate HRQOL measure for use in mental health trials. Furthermore, the results show that the preference weights generated from an adolescent population resulted in the larger mean differences between groups. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-02774-9.
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Affiliation(s)
- Rasmus Trap Wolf
- Danish Centre for Health Economics, Department of Public Health, University of Southern Denmark, Odense, Denmark. .,Child and Adolescent Mental Health Centre, Mental Health Services-Capital Region of Denmark, Odense, Denmark.
| | - Julie Ratcliffe
- College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia
| | - Gang Chen
- Centre for Health Economics, Monash University, Melbourne, Australia
| | - Pia Jeppesen
- Child and Adolescent Mental Health Centre, Mental Health Services-Capital Region of Denmark, Odense, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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12
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Petersen KD, Ratcliffe J, Chen G, Serles D, Frøsig CS, Olesen AV. The construct validity of the Child Health Utility 9D-DK instrument. Health Qual Life Outcomes 2019; 17:187. [PMID: 31870369 PMCID: PMC6929354 DOI: 10.1186/s12955-019-1256-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 12/04/2019] [Indexed: 01/08/2023] Open
Abstract
Background Relative to their application with adults there is currently little information about the application of preference-based health-related quality of life (HRQL) instruments among populations of young people. The Child Health Utility 9D (CHU9D) is a paediatric-specific generic preference-based HRQL instrument, recently translated and linguistically validated into Danish (CHU9D-DK). The purpose of this study was to investigate the construct validity of the CHU9D-DK in a sample of Danish high school students. Methods All students attending a Danish High School were invited to participate in a web-based survey in January 2018 (N = 272). The survey included the CHU9D-DK, the young adult version of the Pediatric Quality of Life Inventory™ 4.0 Generic Core Scales (PedsQL), self-reported health status, presence/absence of disability/chronic diseases, life satisfaction, and socio-economic questions. CHU9D-DK utility scores were generated by employing the two scoring algorithms developed from adults in the UK and adolescents in Australia, respectively. Internal consistency, reliability and construct validity of the CHU9D-DK instrument were investigated. Results Two hundred and twenty-eight (84%) students consented to participate and completed the survey. The mean ± (standard deviation) values of the CHU9D-DK utilities were 0.84 (0.11) when the UK adult algorithm was applied and 0.70 (0.22), when the Australian adolescent algorithm was applied. The mean PedsQL score was 82.32 (13.14). The CHU9D-DK showed good internal consistency reliability (Cronbach’s alpha = 0.803). Higher levels of health status and life satisfaction were significantly associated with higher CHU9D-DK utility scores regardless of which scoring algorithm was applied (p-values < 0.001). Students living with a disability/chronic disease exhibited significantly lower utility scores relative to their healthy peers (p-values < 0.05). Higher socio-economic status (approximated by financial situation and frequency of family vacations) was also associated with higher utility scores (p-values < 0.005). Conclusion The CHU9D-DK demonstrated good psychometric performance overall and shows potential as a valid and reliable instrument for assessing the HRQL of Danish young people. Trial registration ClinicalTrials.gov identifier: NCT03391999, Registered 15 October 2017.
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Affiliation(s)
- Karin Dam Petersen
- Department of Business and Management, Faculty of Social Sciences, Aalborg University, Fibigerstræde 11, 9220, Aalborg East, Denmark. .,Institute of Health Economics, Ternevej 31, 8240, Risskov, Denmark.
| | - Julie Ratcliffe
- Health and Social Care Economics Group, College of Nursing and Health Sciences, Flinders University, Sturt North Wing (N206) GPO Box 2100, Adelaide, South Australia, 5001, Australia
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, 900 Dandenong Road, Caulfield East, VIC, 3145, Australia
| | - Dorthe Serles
- Department of Business and Management, Faculty of Social Sciences, Aalborg University, Fibigerstræde 11, 9220, Aalborg East, Denmark.,Vocational Colleges, Østre Boulevard 10, 9600 Aars, Denmark
| | | | - Anne Vingaard Olesen
- Department of Civil Engineering, Faculty of Engineering and Science, Division of Transportation Engineering, Traffic Research Group, Aalborg University, Thomas Manns Vej 23, 9220, Aalborg East, Denmark
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13
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Sweeney R, Chen G, Gold L, Mensah F, Wake M. Mapping PedsQL TM scores onto CHU9D utility scores: estimation, validation and a comparison of alternative instrument versions. Qual Life Res 2019; 29:639-652. [PMID: 31745690 DOI: 10.1007/s11136-019-02357-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND The Paediatric Quality of Life InventoryTM 4.0 Generic Core Scales (PedsQL) is a non-preference based instrument for assessing health related quality of life (HRQoL) in children. Recent papers presented algorithms of parental proxy and short-form versions of the PedsQL onto the validated preference-based Child Health Utility 9D (CHU9D) instrument, to enable conversion of PedsQL scores to quality adjusted life years for use in economic evaluation. However, further research was needed to both validate these algorithms, and assess if use of the full 23-item PedsQL self-report instrument is preferable to other PedsQL versions for mapping onto child self-report CHU9D utilities. OBJECTIVE To develop a mapping algorithm for converting the 23-item PedsQL instrument onto the CHU9D instrument and provide an external validation of two recently published algorithms that might be considered alternatives. METHODS Data from children in the Longitudinal Study of Australian Children (LSAC) were used (N = 1801). Six econometric methods were compared to identify the best algorithms, assessed against a series of goodness-of-fit criteria. The same data and goodness-of-fit criteria were used in the external validation exercise for previously published mapping algorithms. RESULTS The optimal mapping algorithm was identified, which used PedsQL dimension scores to predict the CHU9D utilities. It performed well against standard goodness-of-fit tests. The external validation exercise revealed the recently published alternative algorithms also performed relatively well. CONCLUSION The identified mapping algorithms can be used to facilitate cost-utility analysis in comparable populations when only the PedsQL instrument is available. Results from this population indicate the algorithms identified in this paper are well suited for estimating CHU9D self-report utilities when the full 23-item self-report PedsQL instrument has been used.
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Affiliation(s)
- Rohan Sweeney
- Centre for Health Economics, Monash Business School, Monash University, Caulfield East, Australia.
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Caulfield East, Australia
| | - Lisa Gold
- Deakin Health Economics, School of Health and Social Development, Deakin University, Geelong, Australia
| | - Fiona Mensah
- Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Australia
| | - Melissa Wake
- Murdoch Children's Research Institute, Parkville, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Australia.,Department of Paediatrics and The Liggins Institute, The University of Auckland, Grafton, New Zealand
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14
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Sharma R, Gu Y, Sinha K, Aghdaee M, Parkinson B. Mapping the Strengths and Difficulties Questionnaire onto the Child Health Utility 9D in a large study of children. Qual Life Res 2019; 28:2429-41. [PMID: 31154585 DOI: 10.1007/s11136-019-02220-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2019] [Indexed: 01/19/2023]
Abstract
PURPOSE Non-preference-based measures cannot be used to directly obtain utilities but can be converted to preference-based measures through mapping. The only mapping algorithm for estimating Child Health Utility-9D (CHU9D) utilities from Strengths and Difficulties Questionnaire (SDQ) responses has limitations. This study aimed to develop a more accurate algorithm. METHODS We used a large sample of children (n = 6898), with negligible missing data, from the Longitudinal Study of Australian Children. Exploratory factor analysis (EFA) and Spearman's rank correlation coefficients were used to assess conceptual overlap between SDQ and CHU9D. Direct mapping (involving seven regression methods) and response mapping (involving one regression method) approaches were considered. The final model was selected by ranking the performance of each method by averaging the following across tenfold cross-validation iterations: mean absolute error (MAE), mean squared error (MSE), and MAE and MSE for two subsamples where predicted utility values were < 0.50 (poor health) or > 0.90 (healthy). External validation was conducted using data from the Child and Adolescent Mental Health Services study. RESULTS SDQ and CHU9D were moderately correlated (ρ = - 0.52, p < 0.001). EFA demonstrated that all CHU9D domains were associated with four SDQ subscales. The best-performing model was the Generalized Linear Model with SDQ items and gender as predictors (full sample MAE: 0.1149; MSE: 0.0227). The new algorithm performed well in the external validation. CONCLUSIONS The proposed mapping algorithm can produce robust estimates of CHU9D utilities from SDQ data for economic evaluations. Further research is warranted to assess the applicability of the algorithm among children with severe health problems.
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15
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Aguiar M, Andronis L, Pallan M, Högler W, Frew E. Micronutrient deficiencies and health-related quality of life: the case of children with vitamin D deficiency. Public Health Nutr 2020; 23:1165-72. [PMID: 30744725 DOI: 10.1017/S1368980018003841] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To explore the extent to which micronutrient deficiencies (MND) affect children's health-related quality of life (HRQoL), using vitamin D deficiency (VDD) as a case study. DESIGN Proxy valuation study to estimate the impact of VDD on the HRQoL of younger (0-4 years) and older (>4 years) children. We used the Child Health Utility 9 Dimension (CHU9D) questionnaire to estimate HRQoL for children within six VDD-related health states: 'hypocalcaemic cardiomyopathy', 'hypocalcaemic seizures', 'active rickets', 'bone deformities', 'pain and muscle weakness' and 'subclinical VDD'. SETTING Sampling was not restricted to any particular setting and worldwide experts were recruited. PARTICIPANTS Respondents were paediatric bone experts recruited through network sampling. RESULTS Thirty-eight experts completed the survey. The health state with the largest detrimental impact (mean score (se)) on children's HRQoL was hypocalcaemic cardiomyopathy (0·47 (0·02)), followed by hypocalcaemic seizures (0·50 (0·02)) and active rickets (0·62 (0·02) in young children; 0·57 (0·02) in older children). Asymptomatic VDD had a modest but noticeable negative impact on HRQoL, attributed mostly to tiredness in both age groups and pain in the older paediatric population. CONCLUSIONS Elicitation of HRQoL from clinical experts suggests a negative impact of VDD on HRQoL, even if there is no recognizable clinical manifestation. HRQoL data from populations of patients with MND will inform public health policy decisions. In some settings, routine collection of HRQoL data alongside national nutrition surveys may help capture the full burden of MND and prioritize resources towards effective prevention.
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16
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Yang P, Chen G, Wang P, Zhang K, Deng F, Yang H, Zhuang G. Psychometric evaluation of the Chinese version of the Child Health Utility 9D ( CHU9D-CHN): a school-based study in China. Qual Life Res 2018; 27:1921-1931. [PMID: 29730851 DOI: 10.1007/s11136-018-1864-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2018] [Indexed: 01/07/2023]
Abstract
PURPOSE The Child Health Utility 9D (CHU9D), a new generic preference-based health-related quality of life (HRQoL) instrument, was developed specifically for the application in cost-effectiveness analyses of treatments and interventions for children and adolescents. The main objective of this study was to examine the psychometric property of the Chinese version of CHU9D (CHU9D-CHN) in a large school-based sample in China. METHODS Data were collected using a multi-stage sampling method from third-to-ninth-grade students in Shaanxi Province, China. Participants self-completed a hard-copy questionnaire including the CHU9D-CHN instrument, the Pediatric Quality of Life Inventory™ 4.0 Generic Core Scales (PedsQL), information on socio-demographic characteristics and self-reported health status. The psychometric properties of the CHU9D-CHN, including the internal consistency, 2-week test-retest reliability, convergent and known-groups validity were studied. RESULTS A total of 1912 students participated in the survey. The CHU9D-CHN internal consistency and test-retest reliability were good to excellent with a Cronbach's alpha of 0.77 and an intra-class correlation coefficient of 0.65, respectively. The CHU9D utility scores moderately correlated with the PedsQL total scores (r = .57, P < .001), demonstrating good convergent validity. Difference of the CHU9D utility scores among the different participants with levels of self-reported general health, health services utilisation and left-behind status demonstrated good construct validity. CONCLUSION The findings demonstrated adequate psychometric performance for the CHU9D-CHN. The CHU9D-CHN was a satisfactory, reliable and valid instrument to measure and value HRQoL for children and adolescents in China.
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Affiliation(s)
- Peirong Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No. 76 Yanta Western Road, Xi'an, 710061, Shaanxi, China.,Baoji Center for Disease Control and Prevention, Baoji, Shaanxi, China
| | - Gang Chen
- Centre for Health Economics, Monash University, 15 Innovation Walk, Clayton Campus, Melbourne, VIC, 3800, Australia.
| | - Peng Wang
- College of Foreign Language, Baoji University of Arts and Sciences, Baoji, China
| | - Kejian Zhang
- Baoji Center for Disease Control and Prevention, Baoji, Shaanxi, China
| | - Feng Deng
- Baoji Center for Disease Control and Prevention, Baoji, Shaanxi, China
| | - Haifeng Yang
- Baoji Center for Disease Control and Prevention, Baoji, Shaanxi, China
| | - Guihua Zhuang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, No. 76 Yanta Western Road, Xi'an, 710061, Shaanxi, China.
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Boyer NRS, Miller S, Connolly P, McIntosh E. Paving the way for the use of the SDQ in economic evaluations of school-based population health interventions: an empirical analysis of the external validity of SDQ mapping algorithms to the CHU9D in an educational setting. Qual Life Res 2016; 25:913-23. [PMID: 26747317 PMCID: PMC4830858 DOI: 10.1007/s11136-015-1218-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2015] [Indexed: 11/08/2022]
Abstract
PURPOSE The Strengths and Difficulties Questionnaire (SDQ) is a behavioural screening tool for children. The SDQ is increasingly used as the primary outcome measure in population health interventions involving children, but it is not preference based; therefore, its role in allocative economic evaluation is limited. The Child Health Utility 9D (CHU9D) is a generic preference-based health-related quality of-life measure. This study investigates the applicability of the SDQ outcome measure for use in economic evaluations and examines its relationship with the CHU9D by testing previously published mapping algorithms. The aim of the paper is to explore the feasibility of using the SDQ within economic evaluations of school-based population health interventions. METHODS Data were available from children participating in a cluster randomised controlled trial of the school-based roots of empathy programme in Northern Ireland. Utility was calculated using the original and alternative CHU9D tariffs along with two SDQ mapping algorithms. t tests were performed for pairwise differences in utility values from the preference-based tariffs and mapping algorithms. RESULTS Mean (standard deviation) SDQ total difficulties and prosocial scores were 12 (3.2) and 8.3 (2.1). Utility values obtained from the original tariff, alternative tariff, and mapping algorithms using five and three SDQ subscales were 0.84 (0.11), 0.80 (0.13), 0.84 (0.05), and 0.83 (0.04), respectively. Each method for calculating utility produced statistically significantly different values except the original tariff and five SDQ subscale algorithm. CONCLUSION Initial evidence suggests the SDQ and CHU9D are related in some of their measurement properties. The mapping algorithm using five SDQ subscales was found to be optimal in predicting mean child health utility. Future research valuing changes in the SDQ scores would contribute to this research.
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Affiliation(s)
- Nicole R S Boyer
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK.
| | - Sarah Miller
- Centre for Effective Education, School of Education, Queen's University Belfast, Belfast, BT7 1LN, UK
| | - Paul Connolly
- Centre for Effective Education, School of Education, Queen's University Belfast, Belfast, BT7 1LN, UK
| | - Emma McIntosh
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK
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Chen G, Flynn T, Stevens K, Brazier J, Huynh E, Sawyer M, Roberts R, Ratcliffe J. Assessing the Health-Related Quality of Life of Australian Adolescents: An Empirical Comparison of the Child Health Utility 9D and EQ-5D-Y Instruments. Value Health 2015; 18:432-8. [PMID: 26091597 DOI: 10.1016/j.jval.2015.02.014] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 11/17/2014] [Accepted: 02/14/2015] [Indexed: 05/27/2023]
Abstract
OBJECTIVES To examine the performance of two recently developed preference-based instruments-the Child Health Utility 9D (CHU9D) and the EuroQol five-dimensional questionnaire Youth version (EQ-5D-Y)-in assessing the health-related quality of life (HRQOL) of Australian adolescents. METHODS An online survey including the CHU9D and the EQ-5D-Y, self-reported health status, and a series of sociodemographic questions was developed for administration to a community-based sample of adolescents (aged 11-17 years). Individual responses to both instruments were translated into utilities using scoring algorithms derived from the Australian adult general population. RESULTS A total of 2020 adolescents completed the online survey. The mean ± SD utilities of the CHU9D and the EQ-5D-Y were very similar (0.82 ± 0.13 and 0.83 ± 0.19, respectively), and the intraclass correlation coefficient (0.80) suggested good levels of agreement. Both instruments were able to discriminate according to varying levels of self-reported health status (P < 0.001). Although exhibiting good levels of agreement overall, some wide divergences were apparent at an individual level. CONCLUSIONS The study results are encouraging and illustrate the potential for both the CHU9D and the EQ-5D-Y to be more widely used for measuring and valuing the HRQOL of adolescent populations in Australia and internationally. Generating adolescent-specific scoring algorithms pertaining to each instrument and an empirical comparison of the resulting utilities is a natural next step. More evidence is required from the application of the CHU9D and the EQ-5D-Y in specific patient groups in adolescent health settings to inform the choice of instrument for measuring and valuing the HRQOL for the economic evaluation of adolescent health care treatments and services.
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Affiliation(s)
- Gang Chen
- Flinders Health Economics Group, School of Medicine, Flinders University, Adelaide, Australia.
| | - Terry Flynn
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Katherine Stevens
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - John Brazier
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Elisabeth Huynh
- Institute for Choice, School of Business, University of South Australia, Adelaide, Australia
| | - Michael Sawyer
- Discipline of Paediatrics, University of Adelaide, Adelaide, Australia
| | - Rachel Roberts
- School of Psychology, University of Adelaide, Adelaide, Australia
| | - Julie Ratcliffe
- Flinders Health Economics Group, School of Medicine, Flinders University, Adelaide, Australia
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