Valuation of Child-Health-Related Quality of Life by Child Age and Problem Duration Using a Novel Method

In the United States, the valuation of health-related quality of life (HRQoL) on a quality-adjusted life-years scale has been criticized because of its discriminatory aspects. Therefore, in this EuroQol 5-Dimension Youth version, 3-Level (EQ-5D-Y-3L) valuation study, we assess the value of child HRQoL on a novel "experience" scale, which ranges from 0 ("no experience"/unconscious) to 1 ("experience full health"), and test whether value depends on the child's age and the duration of the problems.

In Spring 2024, 2577 US adults were assigned to 1 of 16 arms that differed only in the child's age and problem duration. Each participant completed a discrete choice experiment with 5 paired comparisons and 20 kaizen tasks. Using this stated preference evidence, we estimated a conditional logit model for each arm and tested for differences in EQ-5D-Y-3L values.

In each arm, all 10 incremental differences in levels were positive (P value < .05) with the highest value on alleviating a child's pain and discomfort. Child age affected the value of self-care, such as relieving "problems taking a bath or showering by myself or getting dressed by myself." The results did not indicate any differences in main effects by problem duration. The value of the worst EQ-5D-Y-3L profile (33333) relative to being "in a coma" differed by child age and problem duration, ranging from 0.202 to -0.346 across 16 arms (P value < .05).

In the United States, the value of relieving problems with self-care depends on a child's age, possibly due to perceived differences in developmental norms.