Related Experiment Video
Updated: Jun 14, 2026
Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
Published on: April 12, 2021
Psychometric Properties of Multiattribute Utility Instruments in Pediatric Solid Organ Transplantation and Related
Mónica Padilla-Lamadrid1, Carlos Durantez-Fernández2, María J Pascau3
1Pediatric Intensive Care Unit, La Paz University Hospital, Madrid, Spain.
Objectives:
This study aimed to systematically review the psychometric properties of multiattribute utility instruments (MAUIs) used in pediatric solid organ transplant populations.
Methods:
Studies reporting psychometric properties of MAUIs in pediatric solid organ transplant recipients were peer-reviewed. Searches were conducted in PubMed, Scopus, Web of Science, CINAHL, and ProQuest between May and June 2025. Methodological quality was evaluated using the Consensus-Based Standards for the Selection of Health Measurement Instruments Risk-of-Bias checklist. Reliability and interrater and intrarater agreement were assessed using the intraclass correlation coefficient or kappa statistic (κ). Construct validity and responsiveness were evaluated based on the confirmation of previous established hypotheses. Evidence was synthesized according to Grading of Recommendations Assessment, Development, and Evaluation approach.
Results:
A total of 15 studies were analyzed, identifying 7 MAUIs. Overall, the psychometric evidence was indirect because few studies explicitly aimed to evaluate psychometric properties. The most frequently used instruments were HUI2 and HUI3; however, their psychometric performance was inconsistent. Content validity was only explored for 16D and 17D instruments. Evidence related to EQ-5D-Y-3L focused on its dimensions and visual analog scale scores, with no studies assessing utility scores. The 16D instrument demonstrated good convergent validity with Pediatric Quality-of-Life Inventory, whereas findings for the Child Health Utility Instrument-9, HUI2, and HUI3 were insufficient. Data on interpretability were also inconsistent.
Conclusions:
None of the instruments used in pediatric transplant populations demonstrated better psychometric properties than others, which may be related to variability and sample size indirect nature of the evidence. Significant gaps remain in the implementation of these instruments and in the use of value set utility scores, particularly in clinically complex populations and among toddlers or infants.
