Tan Rachel Lee-Yin, Soh Jian Yi, Tham Elizabeth Huiwen, Goh Anne Eng Neo, Koh Mark Jean Aan, Chandran Nisha Suyien, Ho Madeline Sheun Ling, Tan Lucinda Siyun, Herdman Michael, Luo Nan
Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Khoo Teck Puat - National University Children's Medical Institute, National University Health System, Singapore; Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Value Health. 2025 Aug 6. doi: 10.1016/j.jval.2025.07.021.
This study evaluated and compared the psychometric properties (ceiling effects, construct validity, and responsiveness) of EQ-5D-Y-3L (Y-3L), EQ-5D-Y-5L (Y-5L), and child health utility 9D (CHU9D) in pediatric patients with eczema.
Patients completed the Y-3L, Y-5L, CHU9D, and the Child Dermatology Life Quality Index and were followed up during their next visit. Clinicians assessed patients' skin status using the Validated Investigator Global Assessment scale for Atopic Dermatitis. Ceiling effects of the 3 instruments were compared. Convergent validity was assessed using correlation with the Child Dermatology Life Quality Index; known-group validity was evaluated using F-statistics; and responsiveness was assessed using standardized effect sizes (SESs) among patients reporting improved health.
A total of 164 patients (mean age: 12.2 years; female: 47.6%) participated in the study. Of those, 67 patients (mean age:11.9; female: 53.8%) completed the follow-up survey. The ceiling effects of Y-3L, Y-5L, and CHU9D were 34.8%, 28.7%, and 9.8%, respectively. All known-group hypotheses, defined by the Validated Investigator Global Assessment scale for Atopic Dermatitis and scratching frequency, were met, with Y-5L showing the strongest performance in discriminating between patients based on symptom severity. Convergent validity was met in 70.0%, 70.0%, and 83.3% of hypotheses tested for Y-3L, Y-5L, and CHU9D, respectively. CHU9D (SES = 0.53) was relatively more responsive to change than Y-3L (SES= 0.18) or Y-5L (SES = 0.43).
Y-3L and Y-5L were more sensitive to clinical outcome differences, whereas CHU9D appeared to be more responsive to self-rated health improvement. Further research using clinical measures and more diverse eczema patient samples is needed to confirm these findings and support evidence-based instrument selection.
本研究评估并比较了EQ-5D-Y-3L（Y-3L）、EQ-5D-Y-5L（Y-5L）和儿童健康效用9D（CHU9D）在小儿湿疹患者中的心理测量特性（天花板效应、结构效度和反应度）。
患者完成了Y-3L、Y-5L、CHU9D以及儿童皮肤病生活质量指数的测评，并在下次就诊时接受随访。临床医生使用特异性皮炎验证研究者整体评估量表评估患者的皮肤状况。比较了这三种工具的天花板效应。通过与儿童皮肤病生活质量指数的相关性评估收敛效度；使用F统计量评估已知组效度；并在报告健康状况改善的患者中使用标准化效应量（SESs）评估反应度。
共有164名患者（平均年龄：12.2岁；女性：47.6%）参与了研究。其中，67名患者（平均年龄：11.9岁；女性：53.8%）完成了随访调查。Y-3L、Y-5L和CHU9D的天花板效应分别为34.8%、28.7%和9.8%。所有由特异性皮炎验证研究者整体评估量表和瘙痒频率定义的已知组假设均得到满足，Y-5L在根据症状严重程度区分患者方面表现最强。Y-3L、Y-5L和CHU9D分别有70.0%、70.0%和83.3%的测试假设满足收敛效度。CHU9D（SES = 0.53）比Y-3L（SES = 0.18）或Y-5L（SES = 0.43）对变化的反应相对更敏感。
Y-3L和Y-5L对临床结局差异更敏感，而CHU9D似乎对自评健康改善更敏感。需要使用临床测量方法和更多样化的湿疹患者样本进行进一步研究，以证实这些发现并支持基于证据的工具选择。
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