Measurement properties and responsiveness of the EQ-5D-Y-5L compared to the EQ-5D-Y-3L in children and adolescents receiving acute orthopaedic care

Janine Verstraete,Stewart Dix-Peek,Des Scott,Zara Marthinus

doi:10.1186/s12955-022-01938-6

Janine Verstraete, Stewart Dix-Peek + Show 2 more

Open Access

https://doi.org/10.1186/s12955-022-01938-6

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Abstract

ObjectiveThe aim of this study is a head-to-head comparison of the instrument performance and responsiveness of the EQ-5D-Y-3L and the expanded English version of the EQ-5D-Y-5L in children/adolescents receiving acute orthopaedic management in South Africa.MethodsChildren/adolescents aged 8–15 years completed the EQ-5D-Y-5L, EQ-5D-Y-3L, self-rated health (SRH) question and PedsQL at baseline. The EQ-5D-Y-5L, EQ-5D-Y-3L and SRH question were repeated after 24 and 48 h. Performance of the EQ-5D-Y-5L and EQ-5D-Y-3L was determined by comparing feasibility (missing responses), redistribution of dimensions responses, discriminatory power, concurrent validity, and responsiveness.ResultsEighty-three children/adolescents completed baseline measures and seventy-one at all three time-points. Reporting of 11111 decreased by 20% from the EQ-5D-Y-3L to the EQ-5D-Y-5L. Informativity of dimensions improved on average by 0.267 on the EQ-5D-Y-5L with similar evenness. There was a range of 11–27% inconsistent responses when moving from the EQ-5D-Y-3L to the EQ-5D-Y-5L. There was a low to moderate and significant association on the EQ-5D-Y-3L and EQ-5D-Y-5L to similar items on the PedsQL and SRH scores. Percentage change over time was greater for the EQ-5D-Y-5L (range 0–182%) than EQ-5D-Y-3L (range 0–100%) with the largest reduction for both measures between 0 and 48 h. For those who respondents who showed an improved SRH the EQ-5D-Y-5L and EQ-5D-Y-3L showed significant paired differences.ConclusionThe English version of the EQ-5D-Y-5L appears to be a valid and responsive extension of the EQ-5D-Y-3L for children receiving acute orthopaedic management. The expanded levels notably reduce the ceiling effect and has greater discriminatory power. Concurrent validity of the EQ-5D-Y-3L and EQ-5D-Y-5L was low to moderate with similar PedsQL items and SRH. The EQ-5D-Y-5L generally showed greater change than the EQ-5D-Y-3L across all dimensions with the greatest change observed for 0–48 h. Responsiveness was comparable across the EQ-5D-Y-3L and EQ-5D-Y-5L for those with improved SRH. Greater sensitivity to change may be observed on comparison of utility scores, once preference-based value sets are available for the EQ-5D-Y-5L.

Highlights

The measurement of self-reported health in children and adolescents has been used increasingly in population health surveys, clinical trials and for studies of routine health care [1]
A total of 92 children/adolescents needing acute orthopaedic management were eligible for recruitment, nine caregivers were uncontactable to obtain informed consent
Seventyeight completed the measures at 24 h and 71 at 48 h, the other participants were discharged before completion of repeat measures

Summary

Introduction

The measurement of self-reported health in children and adolescents has been used increasingly in population health surveys, clinical trials and for studies of routine health care [1]. The EQ-5D-Y has been widely used to measure and value health in younger populations aged 8–15 years [2]. In the 18 years following its development it was reported to have been registered for use in 586 studies [1], which has likely increased as it is available in over 50 language versions across multiple modes of completion. The original youth version, EQ-5D-Y-3L, describes health on three levels (no problems, some problems and a lot of problems) which results in 243 (35) health states [2, 5]. The response options of the youth version, EQ-5D-Y, were recently expanded to five levels [no/not, a little bit, some/quiet, a lot/really, cannot/extreme(ly)], resulting in 3125 (55) health states [6]. Expanding the response option on the EQ-5D-Y-3L has generally shown improved performance in general population and patient populations with decreased ceiling effect when compared to the expanded five level version, EQ-5D-Y-5L[7,8,9,10,11,12,13,14,15]

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