Abstract

Objectives

There is limited evidence on the relative performance of generic preference-weighted health-related quality-of-life instruments designed for pediatric patients. This study aimed to compare the psychometric properties of EQ-5D-Y-3L (Y-3L), EQ-5D-Y-5L (Y-5L), and CHU9D in patients with asthma.

Methods

Patients diagnosed with asthma, aged between 8 to 18 years old, completed the Y-3L, Y-5L, CHU9D, and the PROMIS Asthma Impact Scale Short Form (PAIS-SF). Patients’ asthma control was assessed using the Global Initiative for Asthma classification. Patients were followed up with a single item on change in health, Y-3L, Y-5L, and CHU9D in a subsequent clinic visit. Ceiling effects of the instruments were compared. Convergent validity and known-groups validity were assessed using hypothesis testing. Responsiveness was assessed using mean change scores and standardized effect size (SES).

Results

A total of 164 pediatric patients (mean age:11.9; female: 31.7%) participated in the study, with 93 patients completing the follow-up survey. The ceiling effects of Y-3L, Y-5L, and CHU9D, were 54.9%, 53.7%, and 19.5%, respectively. Almost all convergent and known-group validity hypotheses tested for the 3 instruments, based on the PROMIS Asthma Impact Scale Short Form and Global Initiative for Asthma, were met. Y-5L best discriminated between relevant known groups, whereas CHU9D showed better responsiveness (SES = 0.43 in children reporting improvement), compared with Y-3L (SES = 0.16) and Y-5L (SES = 0.17).

Conclusions

Although the EQ-5D-Y instruments demonstrated stronger construct validity, their responsiveness appeared to be limited and inferior to the CHU9D in the study sample. Further research in more clinically diverse asthma populations is needed to inform instrument selection.