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A Qualitative Investigation to Develop an Adapted Version of the EQ-5D-Y-3L for Use in Children Aged 2-4 Years
Kim Dalziel1, Alexander van Heusden2, Janani Sarvananthar2
1Health Economics Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia; Health Services group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Insights
Researchers adapted the EQ-5D-Y-3L for children aged 2-4 years, enhancing its relevance and ease of use for assessing health-related quality of life in young children.
Area of Science:
- Pediatric Health Outcomes Research
- Health-Related Quality of Life Measurement
- Instrument Adaptation and Validation
Background:
- Limited availability of preference-weighted health-related quality-of-life (HRQoL) measures for children under five.
- Young children represent a significant demographic utilizing healthcare services.
Purpose of the Study:
- To evaluate the appropriateness of the EQ-5D-Y-3L for children aged 2 to 4 years.
- To co-produce a suitable adaptation of the EQ-5D-Y-3L with parents.
Main Methods:
- Purposive sampling of parents of children aged 2-4 years at a children's research institute and hospital.
- Online focus groups with parents of healthy children and children with moderate to severe health conditions.
- Thematic analysis of transcribed feedback to guide adaptations, followed by piloting and refinement.
Main Results:
- Parents found the adapted EQ-5D-Y-3L generally acceptable and provided examples illustrating domain relevance across age and health status.
- Suggested wording changes, such as 'walking about' to 'movement,' improved instrument applicability for this age group.
- The adapted instrument demonstrated improved relevance and ease of completion for 2-4 year olds.
Conclusions:
- The adapted EQ-5D-Y-3L shows enhanced relevance and usability for assessing the health-related quality of life in 2-4 year olds.
- Further research is necessary to rigorously evaluate the acceptability, reliability, and validity of the adapted instrument.
Objectives:
Few preference-weighted health-related quality-of-life measures exist for children under 5 years of age. Young children are substantial consumers of healthcare services. This project aims to assess EQ-5D-Y-3L's appropriateness in children aged 2 to 4 years and to coproduce with parents a suitable adaptation.
Methods:
Purposive sampling at the Murdoch Children's Research Institute and Royal Children's Hospital was used to recruit parents or carers of children aged 2 to 4 years in Australia. Online focus groups were conducted consisting of 13 parents of healthy children, and 6 parents of children with moderate to severe health conditions. Parents provided feedback on each dimension of the proxy EQ-5D-Y-3L. Recordings were transcribed and thematic analysis was conducted. Qualitative findings guided the design of adaptations to the instrument. The adaptations were piloted to obtain feedback and refined to improve language translatability and comparability with other EuroQol instruments.
Results:
The adapted EQ-5D-Y-3L was considered generally acceptable by the parents. Parents provided a wide range of examples of how each domain related to their children, with varied examples provided across ages 2 to 4 years and health status. Additional or alternative wording was suggested by parents to improve the applicability of the instrument to this age group. One example of this was the change of the domain wording "walking about" to "movement"-ID5:"In this age group, movement is more important than walking."
Conclusions:
The adapted EQ-5D-Y-3L has improved relevance for 2-4-year olds and appears easy to complete. Further testing of the adapted instrument is required to evaluate acceptability, reliability, and validity.
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