Abstract

Objectives

During consultations on development of the EuroQol 5-Dimension Youth version (EQ-5D-Y) value set, Canadian stakeholders recommended that preferences be directly elicited from children and adolescents using discrete choice experiments (DCEs). Our objective was to assess the feasibility of eliciting health state preferences from adolescents using DCE.

Methods

A convergent parallel mixed-methods study was conducted among a purposive sample of Canadian youth (13-18 years). First, the participants completed an online survey with the EQ-5D-Y-5L, 13 DCE tasks using EQ-5D-Y-5L health states (all participants), and 3 DCE with duration (15-18 years only). Then, they engaged in a focus group discussion. Quantitative data on DCE feasibility (incompletion, speeding, flatlining, and violation of dominant choice task) were analyzed using descriptive statistics. Qualitative focus group data were analyzed using content analysis. Qualitative and quantitative data were integrated using a joint display.

Results

A total of 36 adolescents (n = 6 per focus group) participated. The average time to complete DCE tasks was 7 minutes (range 3-12). No incomplete tasks, speeding, flatlining, or wrong answers to the dominant choice task were observed. All participants reported understanding the instructions and had minimal issues with engagement or use of the online survey. Most issues were differences in interpretation because of the presentation of information, participants’ abilities to conceptualize and/or differentiate between health states or framing of DCE tasks.

Conclusions

Although the use of DCE is feasible among adolescents, participants’ experience completing the DCEs varied in ways that could affect their responses to the valuation tasks. These findings will inform the EQ-5D-Y-5L valuation study in Canada.