Reyes Nicole, Pan Tianxin, Jones Renee, Dalziel Kim, Devlin Nancy
Child Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
Child Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
Value Health. 2025 Jun 6. doi: 10.1016/j.jval.2025.04.2161.
The EQ-5D-5L is widely used to measure adults' health-related quality of life (HRQoL). The EQ-5D-Y-5L is a corresponding measure adapted for children/adolescents, in principle allowing HRQoL to be measured consistently from childhood to adulthood. However, little is known about how their measurement properties compare. This study investigated the relationship between EQ-5D-Y-5L and EQ-5D-5L in adolescents and compared their psychometric performance.
The Australian Pediatric Multi-Instrument Comparison Study includes a sample of 591 adolescents (aged 12-18) who completed both EQ-5D-5L and EQ-5D-Y-5L. Responses were compared descriptively and HRQoL summarized using the level sum score. Acceptability, feasibility, ceiling effects, convergence, test-retest reliability, and known-group validity were assessed overall and in subgroups defined by special healthcare needs (SHCN), mental health concerns (MHC), and age (12-13, 14-16, and 17-18 years).
Ceiling effects were lower for EQ-5D-Y-5L than EQ-5D-5L. The EQ-5D-Y-5L better differentiated between adolescents with and without SHCN and MHC than EQ-5D-5L, whereas EQ-5D-5L showed better test-retest reliability in adolescents with SHCN and MHC. We found strong correlations between dimensions anticipated to be correlated. EQ-5D-Y-5L identified a higher incidence of self-reported HRQoL problems than EQ-5D-5L both overall and particularly in mental health.
Although both instruments are valid for measuring HRQoL in adolescents aged 12 to 18 years, EQ-5D-Y-5L had some psychometric advantages. The instruments are closely related, but differences in their descriptive systems produce differences in self-reported HRQoL. Results highlight potential discontinuities in HRQoL measured using age-specific instruments, which may be important for their use in economic models that involve transitions between age groups.
EQ-5D-5L被广泛用于测量成年人的健康相关生活质量（HRQoL）。EQ-5D-Y-5L是适用于儿童/青少年的相应测量工具，原则上允许从童年到成年持续测量HRQoL。然而，对于它们的测量属性如何比较知之甚少。本研究调查了青少年中EQ-5D-Y-5L与EQ-5D-5L之间的关系，并比较了它们的心理测量性能。
澳大利亚儿科多仪器比较研究纳入了591名青少年（12至18岁）的样本，他们同时完成了EQ-5D-5L和EQ-5D-Y-5L。对回答进行描述性比较，并使用水平总和分数总结HRQoL。总体上以及在由特殊医疗需求（SHCN）、心理健康问题（MHC）和年龄（12至13岁、14至16岁和17至18岁）定义的亚组中评估可接受性、可行性、天花板效应、收敛性、重测信度和已知组效度。
EQ-5D-Y-5L的天花板效应低于EQ-5D-5L。与EQ-5D-5L相比，EQ-5D-Y-5L在有和没有SHCN及MHC的青少年之间的区分度更好，而EQ-5D-5L在有SHCN和MHC的青少年中显示出更好的重测信度。我们发现预期相关的维度之间存在强相关性。EQ-5D-Y-5L在总体上尤其是在心理健康方面比EQ-5D-5L识别出更高的自我报告HRQoL问题发生率。
虽然这两种工具都可有效测量12至18岁青少年的HRQoL，但EQ-5D-Y-5L具有一些心理测量优势。这两种工具密切相关，但它们描述系统的差异导致自我报告的HRQoL存在差异。结果突出了使用特定年龄工具测量HRQoL时潜在的不连续性，这对于它们在涉及年龄组间转换的经济模型中的应用可能很重要。
