Adolescent valuation of CARIES-QC-U: a child-centred preference-based measure of dental caries

J Sagabiel,H J Rogers,D Rowen,H D Rodd,Z Marshman

doi:10.1186/s12955-022-01918-w

Abstract

ObjectivesThis study develops an adolescent value set for a child-centred dental caries-specific measure of oral health-related quality of life (OHRQoL) based upon CARIES-QC (Caries Impacts and Experiences Questionnaire for Children). This study develops a new approach to valuing child health by eliciting adolescent preferences and anchoring these onto the 1–0 full health-dead QALY (quality adjusted life year) scale using ordinal adult preferences.MethodsTwo online surveys were created to elicit preferences for the CARIES-QC classification system. The first comprised best–worst scaling (BWS) tasks for completion by adolescents aged 11–16 years. The second comprised discrete choice experiment tasks with a duration attribute (DCETTO) for completion by adults aged over 18 years. Preferences were modelled using the conditional logit model. Mapping regressions anchored the adolescent BWS data onto the QALY scale using adult DCETTO values, since the BWS survey data alone cannot generate anchored values.Results723 adolescents completed the BWS survey and 626 adults completed the DCETTO survey. The samples were representative of UK adolescent and adult populations. Fully consistent and robust models were produced for both BWS and DCETTO data. BWS preferences were mapped onto DCETTO values, resulting utility estimates for each health state defined by the classification system.ConclusionThis is the first measure with predetermined scoring based on preferences to be developed specifically for use in child oral health research, and uses a novel technique to generate a value set using adolescent preferences. The estimates can be used to generate QALYs in economic evaluations of interventions to improve children’s oral health.

Highlights

Dental caries, known as tooth decay, is the most common chronic condition to affect children globally
This paper describes the adolescent valuation of a classification system for a preference-based measure (PBM) based upon CARIES-QC, to enable this measure to be used to generate Quality adjusted life year (QALY) for use in cost-effectiveness analyses
The decision to select CARIES-QC as the basis from which to derive a classification system for this PBM was taken after a critical review of alternative measures of paediatric oral health-related quality of life (OHRQoL), of which many were not developed to capture the impacts of caries and may lack the psychometric properties to detect changes in caries status arising from an intervention [20]

Summary

Introduction

Known as tooth decay, is the most common chronic condition to affect children globally. It causes significant negative impacts on the lives of children and young people, including pain, local infection and in some cases may lead to emergency hospitalisation due to spread of the infection and systemic illness. Dental caries is a largely preventable disease, there are a range of different programmes available to reduce the prevalence in children. Within child oral health research, this paucity of economic evaluations could be attributed to the lack of a suitable instrument to measure Quality Adjusted Life Years (QALYs). QALYs measure the benefit of a healthcare intervention, combining the quality and length of life gained to produce a single index.

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