Presentation (CTI)

OBJECTIVES: Economic evaluation of health interventions for children and adolescents presents many challenges in measuring preferences for health-related quality of life (HRQoL) for health technology assessment (HTA) bodies and decision makers. The aim of this study is to perform a scoping review (SR) identifying published studies on methods used to generate utility values for this population and to highlight related issues that can be considered in developing methodological best practices.
METHODS: We performed a SR on Medline, Embase, Econlit and Global Health via the interface Proquest from February 2015 to December 2025. Using recent SLR and HTA appraisals (e.g. HAS, NICE, and PBAC) we extracted a list of variables including methods of utility estimation (e.g. proxy/caregiver rater, preference elicitation, value sets of preferences weights) and the related methodological issues. Data extraction and study assessment were performed independently by the two authors.
RESULTS: From 400 records identified in the initial search, 27 publications were selected. Sixty-three per cent of the selected publications considered preference-based measures (PBMs), such as the EQ-5D-Y-3L or the CHU9D. The more recent methodological developments focused on the EQ-5D-Y-3L. Parents and/or caregivers were proxy raters of child utilities in 44% (12/27) of studies. Discrete Choice Experiment (alone or in association with composite-TTO) was the most used method of elicitation in 48% (13/27) of studies. The main issues related to the estimation of child and adolescents’ utilities were associated with the 1) proxy/caregivers’ perspective, 2) type of HRQoL (generic or specific) instrument and 3) framing of the valuation task.
CONCLUSIONS: Our SR identified the most recent and common HRQoL instruments for children and adolescents and highlighted the issues related to both the elicitation methods used in the generation of utility values for PBMs, as well as the mapping methods of specific disease measures.