Bashir Naazish S, Walters Thomas D, Griffiths Anne M, Otley Anthony, Critch Jeff, Ungar Wendy J
Program of Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.
Division of Gastroenterology, Hepatology and Nutrition, IBD Centre, The Hospital for Sick Children, Toronto, ON, Canada.
J Can Assoc Gastroenterol. 2023 Feb 4;6(2):73-79. doi: 10.1093/jcag/gwac034. eCollection 2023 Apr.
Generic preference-based HRQOL assessments used expressly for economic evaluation have not been examined in pediatric Crohn's disease (CD) and ulcerative colitis (UC). The objective was to further assess the construct validity of preference-based HRQOL measures in pediatric IBD by comparing the Child Health Utility 9 Dimensions (CHU9D) and Health Utilities Index (HUI) to the disease-specific IMPACT-III and to the generic PedsQL in children with CD and with UC.
The CHU9D, HUI, IMPACT-III and/or PedsQL were administered to Canadian children aged 6 to 18 years with CD and UC. CHU9D total and domain utilities were calculated using adult and youth tariffs. HUI total and attribute utilities were determined for the HUI2 and HUI3. Total scores for IMPACT-III and PedsQL were determined. Spearman correlations were calculated between generic preference-based utilities and the IMPACT-III and PedsQL scores.
The questionnaires were administered to 157 children with CD and 73 children with UC. Moderate to strong correlations were observed between the CHU9D, HUI2, HUI3 and the disease-specific IMPACT-III or generic PedsQL. As hypothesized, domains with similar constructs demonstrated stronger correlations, such as the Pain and Well-being domains.
While all questionnaires were moderately correlated with the IMPACT-III and PedsQL questionnaires, the CHU9D using youth tariffs and the HUI3 were most strongly correlated and would be suitable choices to generate health utilities for children with CD or UC for the purpose of economic evaluation of treatments in pediatric IBD.
专门用于经济评估的基于偏好的通用健康相关生活质量(HRQOL)评估尚未在儿童克罗恩病(CD)和溃疡性结肠炎(UC)中进行研究。目的是通过比较儿童健康效用9维度(CHU9D)和健康效用指数(HUI)与特定疾病的IMPACT-III以及CD和UC患儿的通用儿童生活质量量表(PedsQL),进一步评估基于偏好的HRQOL测量在儿童炎症性肠病(IBD)中的结构效度。
对6至18岁患有CD和UC的加拿大儿童进行CHU9D、HUI、IMPACT-III和/或PedsQL评估。CHU9D总分和领域效用使用成人和青少年费率计算。确定HUI2和HUI3的HUI总分和属性效用。确定IMPACT-III和PedsQL的总分。计算基于偏好的通用效用与IMPACT-III和PedsQL分数之间的Spearman相关性。
对157名CD患儿和73名UC患儿进行了问卷调查。观察到CHU9D、HUI2、HUI3与特定疾病的IMPACT-III或通用PedsQL之间存在中度至高度相关性。如假设的那样,具有相似结构的领域表现出更强的相关性,如疼痛和幸福感领域。
虽然所有问卷与IMPACT-III和PedsQL问卷都存在中度相关性,但使用青少年费率的CHU9D和HUI3相关性最强,将是为儿童CD或UC生成健康效用的合适选择,用于儿科IBD治疗的经济评估。