马拉维健康和患病儿童及青少年的 EQ-5D-Y-3L 和 EQ-5D-Y-5L 奇切瓦语版本的心理测量性能。
Psychometric performance of the Chichewa versions of the EQ-5D-Y-3L and EQ-5D-Y-5L among healthy and sick children and adolescents in Malawi.
机构信息
Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Chipatala Avenue, P.O. Box 30096, Chichiri, Blantyre 3, Malawi.
Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
出版信息
J Patient Rep Outcomes. 2023 Mar 9;7(1):22. doi: 10.1186/s41687-023-00560-4.
OBJECTIVES
The EuroQol Group has developed an extended version of the EQ-5D-Y-3L with five response levels for each of its five dimensions (EQ-5D-Y-5L). The psychometric performance has been reported in several studies for the EQ-5D-Y-3L but not for the EQ-5D-Y-5L. This study aimed to psychometrically evaluate the EQ-5D-Y-3L and EQ-5D-Y-5L Chichewa (Malawi) versions.
METHODS
The EQ-5D-Y-3L, EQ-5D-Y-5L and PedsQL™ 4.0 Chichewa versions were administered to children and adolescents aged 8-17 years in Blantyre, Malawi. Both of the EQ-5D-Y versions were evaluated for missing data, floor/ceiling effects, and validity (convergent, discriminant, known-group and empirical).
RESULTS
A total of 289 participants (95 healthy, and 194 chronic and acute) self-completed the questionnaires. There was little problem with missing data (< 5%) except in children aged 8-12 years particularly for the EQ-5D-Y-5L. Ceiling effects was generally reduced in moving from the EQ-5D-Y-3L to the EQ-5D-Y-5L. For both EQ-5D-Y-3L and EQ-5D-Y-5L, convergent validity tested with PedsQL™ 4.0 was found to be satisfactory (correlation ≥ 0.4) at scale level but mixed at dimension /sub-scale level. There was evidence of discriminant validity (p > 0.05) with respect to gender and age, but not for school grade (p < 0.05). For empirical validity, the EQ-5D-Y-5L was 31-91% less efficient than the EQ-5D-Y-3L at detecting differences in health status using external measures.
CONCLUSIONS
Both versions of the EQ-5D-Y-3L and EQ-5D-Y-5L had issues with missing data in younger children. Convergent validity, discriminant validity with respect to gender and age, and known-group validity of either measures were also met for use among children and adolescents in this population, although with some limitations (discriminant validity by grade and empirical validity). The EQ-5D-Y-3L seems particularly suited for use in younger children (8-12 years) and the EQ-5D-Y-5L in adolescents (13-17 years). However, further psychometric testing is required for test re-test reliability and responsiveness that could not be carried out in this study due to COVID-19 restrictions.
目的
欧洲质量生活组开发了 EQ-5D-Y-3L 的扩展版本，其中每个维度有五个反应水平（EQ-5D-Y-5L）。EQ-5D-Y-3L 的心理测量性能已在多项研究中报告，但 EQ-5D-Y-5L 则没有。本研究旨在对 EQ-5D-Y-3L 和 EQ-5D-Y-5L 奇切瓦语（马拉维）版本进行心理测量评估。
方法
在马拉维布兰太尔，8-17 岁的儿童和青少年完成了 EQ-5D-Y-3L、EQ-5D-Y-5L 和 PedsQL™ 4.0 奇切瓦语版本的测试。两个 EQ-5D-Y 版本都评估了缺失数据、地板/天花板效应和有效性（收敛性、区分性、已知组和经验性）。
结果
共有 289 名参与者（95 名健康，194 名慢性和急性）自行完成了问卷。除了 8-12 岁的儿童，特别是 EQ-5D-Y-5L，缺失数据问题很少（<5%）。从 EQ-5D-Y-3L 到 EQ-5D-Y-5L，天花板效应通常会降低。对于 EQ-5D-Y-3L 和 EQ-5D-Y-5L，与 PedsQL™ 4.0 的收敛效度在量表水平上被发现是令人满意的（相关性≥0.4），但在维度/子量表水平上则混合。有证据表明区分效度（p>0.05）与性别和年龄有关，但与年级（p<0.05）无关。对于经验有效性，使用外部措施，EQ-5D-Y-5L 在检测健康状况差异方面的效率比 EQ-5D-Y-3L 低 31-91%。
结论
EQ-5D-Y-3L 和 EQ-5D-Y-5L 的两个版本在年幼的儿童中都存在缺失数据的问题。在该人群中，这两种方法的收敛效度、性别和年龄的区分效度以及已知组的有效性也得到了满足，尽管存在一些限制（年级的区分效度和经验有效性）。EQ-5D-Y-3L 似乎特别适合用于年龄较小的儿童（8-12 岁），EQ-5D-Y-5L 适合用于青少年（13-17 岁）。然而，由于 COVID-19 限制，本研究无法进行测试重测可靠性和反应性的进一步心理测量测试。
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