Valuation of the Child Health Utility 9D Index

The aim of this study was to test the feasibility of estimating preference weights for all health states defined by the Child Health Utility 9D (CHU9D), a new generic measure of health-related quality of life for children aged 7-11 years. The estimation of preference weights will allow the calculation of QALYs for use in paediatric economic evaluation.

Valuation interviews were undertaken with 300 members of the UK adult general population to obtain preference weights for a sample of the health states in the CHU9D descriptive system. Both standard gamble and ranking valuation methods were used. Regression modelling was undertaken to estimate models that could predict a value for every health state defined by the system. A range of models were tested and were evaluated based on their predictive performance.

Models estimated on the standard gamble data performed better than the rank model. All models had a few inconsistencies or insignificant levels and so further modelling was done to estimate a parsimonious consistent regression model using the general-to-specific approach, by combining inconsistent levels and removing non-significant levels. The final preferred model was an ordinary least squares (OLS) model. All the coefficients in this model were significant, there were no inconsistencies and the model had the best predictive performance and a low mean absolute error.

This research has demonstrated it is feasible to value the CHU9D descriptive system, and preference weights for each health state can be generated to allow the calculation of QALYs. The CHU9D can now be used in the economic evaluation of paediatric healthcare interventions. Further research is needed to investigate the impact of children's preferences for the health states and what methods could be used to obtain these preferences.