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Psychometric performance of proxy-reported EQ-5D youth version 5-level (EQ-5D-Y-5L) in comparison with three-level (EQ-5D-Y-3L) in children and adolescents with scoliosis

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Abstract

Objectives

To assess the psychometric performance of proxy-reported EQ-5D-Y-5L (Y-5L) in comparisons with EQ-5D-Y-3L (Y-3L) administered by caregivers of patients with juvenile (JIS) or adolescent idiopathic scoliosis (AIS).

Methods

A consecutive sample of caregivers of JIS or AIS patients were recruited. Redistribution property, ceiling effects, and discriminative power were examined. Known-group validity was determined by examining their ability to detect differences across clinical known groups. Test–retest reliability was assessed using intraclass correlation coefficient (ICC) for EQ-VAS score and Gwet’s agreement coefficient (GAC) and percentage agreement (PA) for dimension responses. Furthermore, subgroups were analyzed for comparing test–retest reliability.

Results

A total of 130 caregivers were involved in the study. Consistencies between proxy-reported Y-3L and Y-5L were very high for all dimensions (93.8–99.2%). The ceiling effect in the Y-5L was slightly reduced in four dimensions (AR: 0.8–2.3%) whereas increased in “Having pain/discomfort”. Greater informativity was found in the Y-5L than the Y-3L. In known-group comparisons of curvature magnitude, curvature type, and treatment modality, Y-5L and Y-3L dimension scales showed hypothesized results. For example, more full-health responses were found in the mild Cobb angle group (Y-5L: 63.1%; Y-3L: 62.2%) than the severe Cobb angle group (Y-5L: 55.6%, Y-3L: 55.6%). EQ-VAS score exhibited low test–retest reliability (ICC: 0.41), whereas dimension scales of both instruments showed satisfactory test–retest reliability (GAC ≥ 0.7 and PA ≥ 70% for all). In most known groups, hard-to-observe dimensions were more reliable for proxy-reported Y-5L than Y-3L.

Conclusion

Both the proxy-reported Y-5L and Y-3L are valid and reliable instruments for assessing the HRQoL of JIS or AIS patients.

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Funding

This study was supported by the EuroQol Research Foundation (Grant number: 20190250) and the General Research Fund of the Research Grants Council #17156416 and #17119518.

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Authors and Affiliations

  1. Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China

    Jiaer Lin

  2. Department of Family Medicine and Primary Care, LKS Faculty of Medicine, The University of Hong Kong, Rm 1‑01, 1/F, Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong SAR, China

    Carlos King Ho Wong

  3. Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong SAR, Rm 1-01, 1/F, Jockey Club Building for Interdisciplinary Research, 5 Sassoon Road, Pokfulam, Hong Kong SAR, China

    Carlos King Ho Wong

  4. Department of Orthopaedics and Traumatology, LKS Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, 5/F Professorial Block, Pokfulam, Hong Kong SAR, China

    Jason Pui Yin Cheung & Prudence Wing Hang Cheung

  5. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

    Nan Luo

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  1. Jiaer Lin
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  2. Carlos King Ho Wong
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Correspondence to Carlos King Ho Wong or Jason Pui Yin Cheung.

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Lin, J., Wong, C.K.H., Cheung, J.P.Y. et al. Psychometric performance of proxy-reported EQ-5D youth version 5-level (EQ-5D-Y-5L) in comparison with three-level (EQ-5D-Y-3L) in children and adolescents with scoliosis. Eur J Health Econ 23, 1383–1395 (2022). https://doi.org/10.1007/s10198-022-01435-z

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