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Valuation of the EQ-5D-Y-5L Using DCE Methods That Account for Nonlinear Time Preferences.

Alice Yu1, Bram Roudijk2, Peiwen Jiang1

  • 1Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney.

Medical Decision Making : an International Journal of the Society for Medical Decision Making
|January 13, 2026
PubMed
Summary
This summary is machine-generated.

Nonlinear discrete choice experiment (DCE) methods are suitable for valuing the EQ-5D-Y-5L pediatric instrument. Adults valuing health states for a 10-year-old showed nonlinear time preferences, impacting valuations differently than when valuing for themselves.

Keywords:
EQ-5D-Y-5Ldiscrete choice experimentnonlinear time preferencespediatric HRQoLvaluation study

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Area of Science:

  • Health Economics
  • Psychometrics
  • Quality of Life Research

Background:

  • Discrete choice experiment (DCE) methods modeling nonlinear time preferences have been validated for adult EQ-5D instruments.
  • Application and feasibility of these nonlinear DCE methods for pediatric EQ-5D-Y instruments remain unexplored.
  • Understanding how respondent perspective (self vs. child) influences valuation of pediatric health states is crucial.

Purpose of the Study:

  • To assess the feasibility of using nonlinear DCE methods for valuing the EQ-5D-Y-5L instrument.
  • To investigate the impact of respondent perspective (self vs. 10-year-old) on health state valuations.
  • To explore nonlinear time preferences in the context of pediatric health-related quality of life (HRQoL).

Main Methods:

  • An online survey administered to a representative Australian adult general population sample.
  • 15 DCE split triplet tasks were used, with respondents assigned to value health states from either a 'self' or '10-year-old' perspective.
  • Bayesian efficient design updated DCE tasks, with data analyzed using correlated mixed logit models incorporating exponential discounting.

Main Results:

  • Nonlinear modeling revealed evidence of time discounting in both 'self' (17%) and '10-year-old' (15%) perspectives.
  • Pain and discomfort avoidance were prioritized in both perspectives; however, worry, sadness, and unhappiness were more important when valuing for a 10-year-old.
  • Sensitivity analysis indicated nonparents identified more health states as worse than dead when imagining a 10-year-old compared to themselves.

Conclusions:

  • This study demonstrates the suitability of nonlinear DCE methods for valuing the EQ-5D-Y-5L, representing a novel approach in pediatric HRQoL research.
  • Nonlinear modeling offers advantages over traditional time tradeoff methods for valuing child HRQoL.
  • Future research should explore the applicability of nonlinear modeling for other pediatric HRQoL instruments.