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How do Health State Values Differ When Respondents Consider Adults Versus Children Living in Those States? A
Ashwini De Silva1, Alexander van Heusden2, Zhongyu Lang3
1Melbourne Health Economics, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia. ashwini.desilva@student.unimelb.edu.au.
Pharmacoeconomics
|April 22, 2025
Summary
Adults valuing child health states show significant differences compared to other perspectives, influenced by health severity and valuation methods. These findings highlight the need for refined valuation tools for child health-related quality of life.
Area of Science:
- Health Economics
- Quality of Life Research
- Pediatric Health Outcomes
Background:
- Valuing child health-related quality of life (HRQoL) is complex, with potential discrepancies arising from different perspectives (child, adolescent, adult) and valuation methods.
- Existing research suggests inconsistent findings regarding willingness to trade length-of-life for quality-of-life in pediatric populations.
- Understanding these perspective-based differences is crucial for accurate HRQoL assessments in children.
Purpose of the Study:
- To systematically review how different perspectives (child, adolescent, adult; self vs. other) influence the valuation of child HRQoL.
- To assess differences in willingness to trade and the relative importance of health dimensions across perspectives.
- To identify factors influencing these valuation discrepancies.
Main Methods:
- Systematic review following PRISMA guidelines, searching Ovid MEDLINE, Embase, and EconLit up to November 2024.
- Inclusion of studies comparing different perspectives and valuation instruments for child HRQoL.
- Multi-level meta-regression to analyze factors impacting mean differences between perspectives.
Main Results:
- 24 studies (2004-2024) were included, utilizing various preference elicitation and valuation methods; EQ-5D-Y-3L was common.
- Adults valuing child health states showed significant differences influenced by health state severity and valuation method.
- Qualitative findings suggest emotional responses and difficulty imagining child illness contribute to valuation differences.
Conclusions:
- Differences in mean values for severe child health states are evident when adults provide valuations from different perspectives.
- Health state severity and valuation methodology are key determinants of these valuation differences.
- Further research is needed to optimize preference elicitation and anchoring methods for child HRQoL valuation.
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