Assessing the Psychometric Performance of the Experimental EQ-TIPS V20 in Assessing the Health-Related Quality of Life of Stunted Children in Laos
Author(s)
Jia Jia Lee, MPH1, Maikhone Vilakhamxay, MSc2, Sanyalack Saysanasongkham, MD3, Mayfong Mayxay, MD, PhD4, Nattiya Kapol, PhD5, Yot Teerawattananon, PhD, MD6, Janine Verstraete, PhD7, Michael Herdman, MSc8, Nan Luo, PhD1.
1National University of Singapore, Singapore, Singapore, 2University of Health Sciences, Vientiane, Lao People's Democratic Republic, 3National Children's Hospital, Vientiane, Lao People's Democratic Republic, 4Ministry of Health, Vientiane, Lao People's Democratic Republic, 5Silpakorn University, Nakhon Pathom, Thailand, 6Health Intervention & Technology Assessment, Nouthaburi, Thailand, 7University of Cape Town, Cape Town, South Africa, 8Office of Health Economics, London, United Kingdom.
1National University of Singapore, Singapore, Singapore, 2University of Health Sciences, Vientiane, Lao People's Democratic Republic, 3National Children's Hospital, Vientiane, Lao People's Democratic Republic, 4Ministry of Health, Vientiane, Lao People's Democratic Republic, 5Silpakorn University, Nakhon Pathom, Thailand, 6Health Intervention & Technology Assessment, Nouthaburi, Thailand, 7University of Cape Town, Cape Town, South Africa, 8Office of Health Economics, London, United Kingdom.
OBJECTIVES: The experimental EQ-TIPS (v2.0) comprises six dimensions and a visual analogue scale (VAS) to assess infant and toddler health-related quality of life. We evaluated its psychometric properties among caregivers of stunted children aged 0-36 months in Laos, a country with Southeast Asia’s highest under-five mortality rate.
METHODS: Stunted children’s caregivers visiting emergency department (ED) in Laos for any health problems self-completed EQ-TIPS thrice: ED visit (TP1), during hospitalization (TP2), and three months post-discharge (TP3). Clinicians assessed patient’s symptoms. Conveniently sampled healthy nursery children’s caregivers self-completed EQ-TIPS once. For assessing known-groups validity, we compared EQ-TIPS level sum score (LSS), VAS, and dimensions between stunted children differing in symptom count (1-3/>3), vitamin deficiency (yes/no), and against healthy children. Cohen’s d and Cliff’s delta were calculated to evaluate effect sizes (ES). Responsiveness to improvement was assessed using standardized effect sizes (SES), standardized response mean (SRM) and Cliff’s delta across timepoints.
RESULTS: We included 200 caregivers (100 stunted; 100 healthy), mostly mothers (66.7%). Child’s full health (“111111”) was reported for 1% of stunted and 61% of healthy children. LSS supported all three known-groups hypotheses (ES: 0.10-1.44, negligible-large); VAS supported two (ES: 0.22-3.98, small-large). Movement (delta: 0.03-0.11, all negligible) and play (delta: 0.05-0.88, negligible-large) dimensions supported all hypotheses. Other dimensions supported two hypotheses each: pain (delta: 0.09-0.64, negligible-large), relationship (delta: 0.01-0.05, all negligible), communications (delta: 0.03-0.13, all negligible), eating (delta: 0.00-0.78, negligible-large). LSS demonstrated small to large responsiveness across timepoints (SES: -0.22 - -1.60; SRM: -0.20 - -1.38). SES/SRM for VAS was large at all intervals (SES: 1.20-1.75; SRM: 0.92-2.73). For all dimensions, the patients improved significantly from TP1 to TP3 (delta: 0.08-0.83, negligible-large). Dimensional improvements between TP2-TP3 were negligible for all dimensions, except eating (delta: 0.24 small).
CONCLUSIONS: EQ-TIPS demonstrated substantial construct validity and responsiveness to improvement in stunted Laotian children.
METHODS: Stunted children’s caregivers visiting emergency department (ED) in Laos for any health problems self-completed EQ-TIPS thrice: ED visit (TP1), during hospitalization (TP2), and three months post-discharge (TP3). Clinicians assessed patient’s symptoms. Conveniently sampled healthy nursery children’s caregivers self-completed EQ-TIPS once. For assessing known-groups validity, we compared EQ-TIPS level sum score (LSS), VAS, and dimensions between stunted children differing in symptom count (1-3/>3), vitamin deficiency (yes/no), and against healthy children. Cohen’s d and Cliff’s delta were calculated to evaluate effect sizes (ES). Responsiveness to improvement was assessed using standardized effect sizes (SES), standardized response mean (SRM) and Cliff’s delta across timepoints.
RESULTS: We included 200 caregivers (100 stunted; 100 healthy), mostly mothers (66.7%). Child’s full health (“111111”) was reported for 1% of stunted and 61% of healthy children. LSS supported all three known-groups hypotheses (ES: 0.10-1.44, negligible-large); VAS supported two (ES: 0.22-3.98, small-large). Movement (delta: 0.03-0.11, all negligible) and play (delta: 0.05-0.88, negligible-large) dimensions supported all hypotheses. Other dimensions supported two hypotheses each: pain (delta: 0.09-0.64, negligible-large), relationship (delta: 0.01-0.05, all negligible), communications (delta: 0.03-0.13, all negligible), eating (delta: 0.00-0.78, negligible-large). LSS demonstrated small to large responsiveness across timepoints (SES: -0.22 - -1.60; SRM: -0.20 - -1.38). SES/SRM for VAS was large at all intervals (SES: 1.20-1.75; SRM: 0.92-2.73). For all dimensions, the patients improved significantly from TP1 to TP3 (delta: 0.08-0.83, negligible-large). Dimensional improvements between TP2-TP3 were negligible for all dimensions, except eating (delta: 0.24 small).
CONCLUSIONS: EQ-TIPS demonstrated substantial construct validity and responsiveness to improvement in stunted Laotian children.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
MSR41
Topic
Methodological & Statistical Research
Topic Subcategory
PRO & Related Methods, Survey Methods
Disease
Pediatrics