Development of a Preference Weighting System for the Parent-Proxy Child Chronic Cough Quality-of-Life Instrument

Area of Science:

• Health Economics
• Pediatric Health
• Quality of Life Research

Background:

• Chronic cough in children is a common healthcare concern in Australia.
• It significantly impacts parental quality of life and incurs societal costs.
• Existing economic evaluations often overlook the spillover effects on parents/carers.

Purpose of the Study:

• To develop and validate a novel method for estimating health utility spillover in Australian parents of children with chronic cough.
• To integrate parental well-being into economic assessments of pediatric chronic cough interventions.

Main Methods:

• A discrete choice experiment (DCE) was employed using hypothetical health states derived from the Parent-Proxy Child Cough Quality of Life questionnaire.
• Data were analyzed using a garbage-class multinomial logit model (GCL).
• Visual analog scale (VAS) scores were obtained and mapped to DCE utilities, rescaled to a 0-1 health utility scale for Quality-Adjusted Life-Year (QALY) estimation.

Main Results:

• The study surveyed 550 Australian parents, representative of the general population.
• Parental concerns regarding their child's ability to lead a normal life emerged as the most significant factor in the GCL analysis.
• The developed scoring algorithm yielded utility values ranging from 0.21 to 1 (full health).

Conclusions:

• A new, validated method for quantifying health utility spillover in parents of children with chronic cough has been established for the Australian context.
• The study highlights the utility of the GCL model for identifying non-trading behaviors and the effectiveness of VAS-anchoring for preference elicitation.
• An R package and shiny app are available for practical application of the developed method, facilitating the estimation of spillover utility scores.