OBJECTIVES:

Valuing children’s health states for use in economic evaluations is important globally, and particularly so for jurisdictions where cost-utility analysis is the preferred analysis for decision making. However, there remains debate about the approaches to elicitation of values. The main objectives of this paper were to identify and describe methods used to value children’s health states and determine the specific considerations required when using the methods.

METHODS:

We undertook a systematic search of electronic databases to identify studies published in English since 1990 that used preference elicitation methods to value child and adolescent (under 18 years-of-age) health states. Eligibility criteria comprised valuation studies for child-specific patient-reported outcome measures (PROMs) and child health states defined in other ways, and methodological studies of valuation approaches with or without a value set algorithm.

RESULTS:

We identified 77 eligible studies. Data were extracted for country, aims, condition (general population or clinically specific), sample size, age, perspective and source of values. Studies were evaluated using narrative synthesis methods and classified into three groups: 1) comparing elicitation methods (n=30); 2) comparing perspectives (n=23); and 3) no comparisons presented (n=26). The studies varied considerably in methods and reporting. Methods included time trade-off, standard gamble, visual analogue scale, rating/ranking, discrete choice experiments, best worst scaling and willingness to pay. Perspectives included adults’ own values, adults valuing a child (own, other, hypothetical), and child/adolescent valuing own or another child.

CONCLUSIONS:

Differences in reporting limited about which methods are most suitable for eliciting preferences for children’s health; however, there was some evidence that children gave lower values to health states than either adults’ values for comparable states from their own perspective or adult/parents’ values for children. Challenges in analysing the data suggests that reporting guidelines are required to improve reporting consistency.