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Measuring preference-based quality of life in children aged 6–7 years: a comparison of the performance of the CHU-9D and EQ-5D-Y—the WAVES Pilot Study

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To examine the performance of the child health utility 9D (CHU-9D) and EuroQol 5D-youth (EQ-5D-Y) in children aged 6–7 years.


The CHU-9D and EQ-5D-Y were interviewer-administered to 160 children aged 6–7 years at six schools across the West Midlands. Missing values, time taken to complete instruments and interviewer ratings were recorded to assess feasibility/acceptability. Construct validity was assessed by testing convergent validity hypotheses. Reliability was examined via a test–retest of a sub-sample. Psychometric properties were further examined by exploring distributions of utility scores, qualitative notes and design of the questionnaires.


No missing responses were recorded with over 80% of children’s understanding being rated as good/excellent for both questionnaires. The average completion time for both instruments was less than 3 minutes, demonstrating excellent feasibility/acceptability. Evidence of construct validity was recorded with 12 of the 13 convergent hypotheses being supported. Test–retest reliability was relatively poor for both instruments with weighted kappa coefficients ranging from fair to moderate.


Children aged 6–7 years can feasibly complete utility instruments when interviewer-administered. The reliability of the instruments is of concern and requires further study. With respect to content validity and other psychometric properties, the CHU-9D is favoured to the EQ-5D-Y. Until the EuroQol group produces tariff values for the EQ-5D-Y, we recommend that the EQ-5D-Y is not used for utility elicitation in this age group.

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This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme (project number 06/85/11). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health.

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Correspondence to Alastair G. Canaway.

Additional information

This study is conducted on behalf of the WAVES investigators. The full details are given in ‘Appendix’.



WAVES trial investigators

University of Birmingham:

Peymane Adab (Chief Investigator), Tim Barrett (Professor of Paediatrics), KK Cheng (Professor of Epidemiology) Amanda Daley (NIHR Senior Research Fellow), Jon Deeks (Professor of Health Statistics), Joan Duda (Professor of Sport and Exercise Psychology), Emma Frew (Senior lecturer in Health Economics), Paramjit Gill (Clinical Reader in Primary Care Research), Miranda Pallan (Clinical Research Fellow), Jayne Parry (Professor of Policy and Health).

Cambridge MRC Epidemiology Unit:

Ulf Ekelund (Programme Leader for Physical Activity Epidemiology Programme).

University of Leeds:

Janet Cade (Professor of Nutritional Epidemiology and Public Health).

The University of Edinburgh:

Raj Bhopal (Bruce and John Usher Chair in Public Health).

Trial collaborators

Birmingham East and North PCT:

Eleanor McGee (Public Health Nutrition Lead).

Birmingham local education authority:

Sandra Passmore (Personal, Social and Health Education Advisor).

WAVES trial management group

Emma Lancashire (trial co-ordinator), Miranda Pallan, Peymane Adab (chair).

WAVES research team:

Behnoush Aranjani, Jo Clark, Tania Griffin, Kiya Kelleher, Emma Lancashire (trial co-ordinator), Alastair Canaway, Karla Hemming.

Trial steering committee:

Peymane Adab, John Bennett, Kelvin Jordan (chair), Karla Hemming, Louise Longworth, Peter Whincup.

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Canaway, A.G., Frew, E.J. Measuring preference-based quality of life in children aged 6–7 years: a comparison of the performance of the CHU-9D and EQ-5D-Y—the WAVES Pilot Study. Qual Life Res 22, 173–183 (2013).

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