Sullivan Trudy A, Wyeth Emma H, Turner Robin M, Hansen Paul, Ombler Franz, Devlin Nancy J, Derrett Sarah
Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, New Zealand.
Value Health. 2025 Jun;28(6):936-944. doi: 10.1016/j.jval.2025.02.013. Epub 2025 Mar 18.
Research into methods for eliciting adolescents' health state preferences has mostly avoided tasks for identifying health states worse than dead, which is required for calculating quality-adjusted life years for economic evaluations. This study investigated the feasibility of eliciting the health state preferences of older adolescents, including for states worse than dead, using the EQ-5D-Y-5L (Y-5L) and EQ-5D-5L (5L), and compared participants' preferences across the 2 instruments.
Two online surveys were created for the Y-5L and 5L, respectively, using the Potentially All Pairwise Rankings of all Possible Alternatives method, a type of adaptive discrete choice experiment, and a binary search algorithm for identifying health states worse than dead. The surveys were completed by 24 adolescents aged 16 to 19 years in 2 think-aloud sessions, with semistructured interviews at the end of each session. Dimension preference weights and rankings for the Y-5L and 5L were compared using intraclass correlation coefficients, Bland-Altman plots, and paired t tests.
The adolescents were capable of valuing health states and identifying states worse than dead. There is no evidence of a difference in mean preference weights between the Y-5L and 5L, and the rankings of dimensions are similar.
Eliciting the health state preferences of older adolescents, including for states worse than dead, is feasible and acceptable. The similarity in Y-5L and 5L mean preference weights suggests that their corresponding value sets, if obtained using the methods used in this study, would be similar. Data quality was enhanced by the surveys being administered in a supportive environment.
对引发青少年健康状态偏好的方法的研究大多避开了识别比死亡更糟的健康状态的任务，而这是经济评估中计算质量调整生命年所必需的。本研究调查了使用EQ-5D-Y-5L（Y-5L）和EQ-5D-5L（5L）引发年龄较大青少年的健康状态偏好（包括比死亡更糟的状态）的可行性，并比较了参与者对这两种工具的偏好。
分别为Y-5L和5L创建了两个在线调查，采用所有可能替代方案的潜在全对全排序方法，这是一种自适应离散选择实验，以及一种用于识别比死亡更糟的健康状态的二分搜索算法。24名年龄在16至19岁的青少年在两次出声思考环节中完成了调查，并在每个环节结束时进行了半结构化访谈。使用组内相关系数、布兰德-奥特曼图和配对t检验比较了Y-5L和5L的维度偏好权重和排序。
青少年能够对健康状态进行估值并识别比死亡更糟的状态。没有证据表明Y-5L和5L之间的平均偏好权重存在差异，且维度排序相似。
引发年龄较大青少年的健康状态偏好（包括比死亡更糟的状态）是可行且可接受的。Y-5L和5L平均偏好权重的相似性表明，如果使用本研究中使用的方法获得其相应的价值集，它们将是相似的。在支持性环境中进行调查提高了数据质量。
