Comparing Adolescent and Adult Preferences for EQ-5D-Y-3L Health States in Hong Kong

The EuroQol EQ-5D-Y-3L valuation protocol suggests eliciting adult preferences from the perspective of a 10-year-old child. However, further research on whether it is feasible to elicit adolescent preferences for EQ-5D-Y-3L health states and how adolescent preferences compare with adult preferences is needed. This study aimed to compare preferences for EQ-5D-Y-3L health states and survey response behaviors between adolescents and adults in the general population of Hong Kong.

Cross-sectional face-to-face surveys were conducted between December 2018 and July 2023 with adolescents and adults in Hong Kong. Discrete choice experiments (DCEs) were used to elicit adolescent preferences from their own perspective and adult preferences from a 10-year-old child's perspective for EQ-5D-Y-3L health states. Mixed logit models estimated the relative importance attribute levels for comparison between adolescents and adults using separate models for each group or a pooled model combining responses. Survey response behaviors were also analyzed by comparing the dominant task responses and feedback to DCE tasks between adolescents and adults.

DCE responses from 776 adolescents aged 12 to 17 years and 1001 adults were used in the analysis after exclusions. For both groups, the most important dimension was pain/discomfort, followed by worried/sad/unhappy, usual activities, mobility, and self-care. Adolescents placed greater importance on mobility and self-care, while valuing pain/discomfort and usual activities less. Significant differences in relative importance of levels across all dimensions between the 2 groups were observed.

Adolescents showed different preference weightings compared with adults but reported greater challenges in completing the DCE tasks. These findings suggest that including adolescents in the valuation of EQ-5D-Y-3L health state is feasible; however, data provided by this group can be of lower data quality than adults.