A Comparison of the Psychometric Properties of the EQ-5D-Y-3L and EQ-5D-Y-5L Among Adolescents Aged 10-18 in China
Author(s)
Chang Luo, MS, Shitong Xie, PhD.
Tianjin University, Tianjin, China.
Tianjin University, Tianjin, China.
OBJECTIVES: To compare the psychometric properties between EQ-5D-Y-3L (Y-3L) and EQ-5D-Y-5L (Y-5L) in Chinese adolescents.
METHODS: A sample of adolescents aged 10-18 years was recruited from 11 schools across various geographical regions in China. Respondents were asked to complete an online questionnaire including Y-3L, Y-5L, CHU-9D, and socio-demographics. A subsample retested after two weeks. The ceiling/floor effects were assessed by examining the percentage in the best/worst health states. The discriminative power was evaluated using the Shannon index (H’) and evenness index (J’). The test-retest reliability was assessed by examining Gwet’s agreement coefficient (AC) for responses over a two-week period. The convergent validity was examined using Spearman’s rank correlation with CHU-9D. The known-groups validity was determined by using F-statistics, Scheffe post hoc tests and effect sizes (ES). The response consistency of two instruments was evaluated. Inconsistency was described as a Y-3L response that is at least two levels away from the equivalent Y-5L response.
RESULTS: A total of 4,873 adolescents (50.01% male, age 15.3±1.4 years) were included. Y-3L demonstrated a higher ceiling effect (64.8% vs. 58.3%). Floor effect was not found. “Feeling worried/sad/unhappy” had the highest discriminative power in both instruments (Y-3L: H’=0.96, J’=0.61; Y-5L: H’=1.38, J’=0.59). Test-retest reliability was excellent (AC>0.8) for most dimensions but lower for "pain/discomfort" (Y-3L: 0.735; Y-5L: 0.737) and "feeling worried/sad/unhappy" (Y-3L: 0.693; Y-5L: 0.627). The convergent validity with the correlative dimension in CHU-9D was acceptable (Spearman’s correlation Y-3L: 0.2332-0.5505; Y-5L: 0.2566-0.6132). Both instruments effectively differentiated groups based on sleep, exercise, family harmony, smoking, and alcohol habits (all P<0.001; ES Y-3L: 0.390-1.814, Y-5L: 0.385-2.017). Response consistency was highest for “looking after myself” (99.20%) and lowest for “feeling worried/sad/unhappy” (95.07%).
CONCLUSIONS: Both Y-3L and Y-5L demonstrated acceptable psychometric properties in Chinese adolescents. These findings support the Y-5L as a robust instrument for health utility assessment in Chinese adolescents.
METHODS: A sample of adolescents aged 10-18 years was recruited from 11 schools across various geographical regions in China. Respondents were asked to complete an online questionnaire including Y-3L, Y-5L, CHU-9D, and socio-demographics. A subsample retested after two weeks. The ceiling/floor effects were assessed by examining the percentage in the best/worst health states. The discriminative power was evaluated using the Shannon index (H’) and evenness index (J’). The test-retest reliability was assessed by examining Gwet’s agreement coefficient (AC) for responses over a two-week period. The convergent validity was examined using Spearman’s rank correlation with CHU-9D. The known-groups validity was determined by using F-statistics, Scheffe post hoc tests and effect sizes (ES). The response consistency of two instruments was evaluated. Inconsistency was described as a Y-3L response that is at least two levels away from the equivalent Y-5L response.
RESULTS: A total of 4,873 adolescents (50.01% male, age 15.3±1.4 years) were included. Y-3L demonstrated a higher ceiling effect (64.8% vs. 58.3%). Floor effect was not found. “Feeling worried/sad/unhappy” had the highest discriminative power in both instruments (Y-3L: H’=0.96, J’=0.61; Y-5L: H’=1.38, J’=0.59). Test-retest reliability was excellent (AC>0.8) for most dimensions but lower for "pain/discomfort" (Y-3L: 0.735; Y-5L: 0.737) and "feeling worried/sad/unhappy" (Y-3L: 0.693; Y-5L: 0.627). The convergent validity with the correlative dimension in CHU-9D was acceptable (Spearman’s correlation Y-3L: 0.2332-0.5505; Y-5L: 0.2566-0.6132). Both instruments effectively differentiated groups based on sleep, exercise, family harmony, smoking, and alcohol habits (all P<0.001; ES Y-3L: 0.390-1.814, Y-5L: 0.385-2.017). Response consistency was highest for “looking after myself” (99.20%) and lowest for “feeling worried/sad/unhappy” (95.07%).
CONCLUSIONS: Both Y-3L and Y-5L demonstrated acceptable psychometric properties in Chinese adolescents. These findings support the Y-5L as a robust instrument for health utility assessment in Chinese adolescents.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR3
Topic
Patient-Centered Research
Topic Subcategory
Health State Utilities, Instrument Development, Validation, & Translation, Patient-reported Outcomes & Quality of Life Outcomes
Disease
No Additional Disease & Conditions/Specialized Treatment Areas