Department of Paediatrics, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Centre, Rotterdam, The Netherlands.
Eur J Health Econ. 2024 Nov;25(8):1361-1370. doi: 10.1007/s10198-024-01669-z. Epub 2024 Feb 14.
The psychometric properties of the EQ-5D-Y have not been widely tested in severely ill children. The aim of this study was to assess and compare the validity and responsiveness of the EQ-5D-Y-3L and EQ-5D-Y-5L in paediatric inpatients with haematological malignancies and caregivers. Respondents completed the interviewer-administered self-complete or proxy version of the EQ-5D-Y-3L and EQ-5D-Y-5L and an overall health assessment twice on different days. Known-groups validity was assessed by comparing patients who differed in overall health and Eastern Cooperative Oncology Group (ECOG) performance. Responsiveness to worsened health was assessed using standardised effect size (SES) for patients with worsened ECOG grade, self-reported rating, or chemotherapy initiation. Ninety-six dyads completed the baseline questionnaires. A smaller proportion of patients reported "no problems" on the EQ-5D-Y-5L compared to EQ-5D-Y-3L for most of the five dimensions. Patients in poor health reported more problems in all dimensions and had higher EQ-5D-Y-5L level sum score, lower EQ VAS and EQ-5D-Y-3L index scores (Cohen's d ES: 0.32-1.38 for patients; 0.50-2.05 for caregivers). There was a mild to good responsiveness to worsened health condition based on ECOG (SES: 0.14-0.61 for patients; 0.40-0.96 for caregivers), suggesting the proxy version was slightly responsive than the self-complete version of both instruments. The results demonstrated validity and responsiveness for both the self-complete and proxy versions of the EQ-5D-Y-3L and EQ-5D-Y-5L. The proxy and 5-level versions of the instrument were more sensitive than the self-complete and 3-level versions in this patient group.
EQ-5D-Y 的心理测量特性尚未在重病儿童中得到广泛测试。本研究旨在评估和比较 EQ-5D-Y-3L 和 EQ-5D-Y-5L 在血液恶性肿瘤患儿及其照顾者中的有效性和反应性。受访者在不同的日子里两次完成了访谈者管理的自我完成或代理版本的 EQ-5D-Y-3L 和 EQ-5D-Y-5L 以及总体健康评估。通过比较总体健康状况和东部合作肿瘤学组(ECOG)表现不同的患者来评估已知群体的有效性。通过使用 ECOG 等级恶化、自我报告评分或化疗开始的患者的标准化效应大小(SES)来评估对健康恶化的反应性。96 对 dyads 完成了基线问卷。与 EQ-5D-Y-3L 相比,大多数情况下,更多的患者在 EQ-5D-Y-5L 上报告“无问题”。健康状况较差的患者在所有维度上报告的问题更多,EQ-5D-Y-5L 水平总分更高,EQ VAS 和 EQ-5D-Y-3L 指数得分更低(患者的 Cohen's d ES:0.32-1.38;照顾者的 0.50-2.05)。根据 ECOG,对健康状况恶化有轻微到良好的反应性(患者的 SES:0.14-0.61;照顾者的 0.40-0.96),这表明代理版本比两种仪器的自我完成版本稍微敏感。结果表明,EQ-5D-Y-3L 和 EQ-5D-Y-5L 的自我完成和代理版本均具有有效性和反应性。在这个患者群体中,与自我完成和 3 级版本相比,仪器的代理和 5 级版本更敏感。