Constructing a US Value Set for Child Health States: The PedsUtil Scoring System
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Published on: March 14, 2018
Ellen Kim DeLuca1,2, Kim Dalziel3, Angela M Rose4
1Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, USA. ellen.kim@childrens.harvard.edu.
Background And Objective:
The Pediatric Quality of Life Inventory (PedsQL) is a widely used, generic, health-related quality of life instrument validated for children aged 2-18 years. However, because it is not preference weighted, it cannot be directly used to estimate health utilities for economic evaluations. This study constructed a value set for the PedsQL: the PedsUtil scoring system.
Methods:
Preferences for child health states were elicited from US adults using an online discrete choice experiment (n = 2518) and composite time trade-off survey (n = 868). Child health states were defined by the seven-dimension PedsUtil health state classification system previously derived from the PedsQL. Discrete choice experiment data were analyzed using a mixed logistic regression and the latent coefficients were anchored onto the quality-adjusted life year scale using composite time trade-off data with a linear mapping approach.
Results:
Preferences varied with age. Pain was the most important dimension for ages 2-4 years and Social Functioning was most important for ages 5-18 years. Pairwise comparisons confirmed significant preference differences between the youngest and older age groups and these age-related differences were also reflected in composite time trade-off data. Consequently, age-specific scoring systems (2-4 and 5-18 years) and an age-combined scoring system (2-18 years) were developed. Utility ranges for the final scoring systems were 0.368-0.999 for ages 2-4 years, 0.427-0.951 for ages 5-18 years, and 0.410-0.972 for ages 2-18 years combined.
Conclusions:
The PedsUtil scoring system is the first value set derived for the PedsQL, enabling direct estimation of health utilities from PedsQL responses and facilitating pediatric economic evaluations.
