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Psychometric Properties of Generic Preference-Weighted Measures for Children and Adolescents: A Systematic Review

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Abstract

Introduction

Preference-weighted measures (PWMs)—also referred to as preference-based measures in the literature—of health status/health-related quality of life plays an essential role in estimating quality-adjusted life-years (QALY) for use in economic evaluations of healthcare products and interventions. However, as PWMs are first and foremost intended to accurately reflect respondent health status, they should ideally demonstrate good psychometric properties for the population in question. This study aimed to systematically review published evidence on the measurement properties of commonly used PWMs for children and adolescents.

Methods

Three electronic databases (PubMed, Medline, and PsycINFO) were searched for articles assessing the psychometric properties (content validity, construct validity—including convergent validity and known-group validity, test-retest reliability, and responsiveness) of the PWMs of interest (AQoL-6D, CHU9D, HUI2, HUI3, and EQ-5D-Y). The COsensus-based Standards for the selection of health Measurement INstruments methodology (COSMIN) guidelines were used to assess (a) the methodological quality of the studies included and (b) the psychometric performance of the instruments covered. Data were analysed overall as well as by population (country and disease group) and perspective (self-report or proxy-report). The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42021277296).

Results

In total, 53 articles were included in this systematic review. Health Utilities Index (HUI) was tested only in patient populations, CHU9D was most frequently tested in general population samples, while EQ-5D-Y was tested in both populations. Overall, there was high-quality evidence supporting sufficient construct validity for all instruments except AQoL-6D. Evidence supporting test-retest and responsiveness was scarce. There was high-quality evidence supporting sufficient responsiveness of HUI2 and HUI3, and inconsistent test-retest reliability of CHU9D and EQ-5D-Y. Evidence for content validity was minimal and therefore not extracted and synthesized for any PWMs.

Conclusion

This review provides updated evidence on the measurement properties of existing generic PWMs for children and adolescents. High-quality evidence for all relevant psychometric properties and across a range of populations was not available for any of the instruments included, indicating that further work is needed in this direction. This study has identified some of the most noticeable evidence gaps for each of the individual measures. Users can use this information to guide their decision on the choice of PWM to administer.

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Authors and Affiliations

  1. Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore

    Rachel Lee-Yin Tan, Sonia Zhi Yi Soh, Le Ann Chen & Nan Luo

  2. Office of Health Economics, 105 Victoria Street, London, SW1E 6QT, UK

    Michael Herdman

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  1. Rachel Lee-Yin Tan
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Correspondence to Nan Luo.

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Author contribution

Concept and design: NL, MH. Acquisition of data: RL-YT, SZS, LAC. Analysis and interpretation of data: RL-YT, SZS, LAC, NL. Drafting of the manuscript: RL-YT, NL. Critical revision of the paper for important intellectual content: RL-YT, NL, MH. Administrative, technical, or logistic support: RL-YT, SZS, LAC, NL. Supervision: NL.

Funding

This study was partially funded by the EuroQol Research Foundation (Grant no. EQ Project 232-2020RA).

Data availability

Data generated for the current study are included in this published article (and its supplementary files). They are also available from the corresponding author on reasonable request.

Conflict of interest

Luo and Herdman are members of the EuroQol Research Foundation. All other authors declare no conflicts of interest.

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Tan, R.LY., Soh, S.Z.Y., Chen, L.A. et al. Psychometric Properties of Generic Preference-Weighted Measures for Children and Adolescents: A Systematic Review. PharmacoEconomics 41, 155–174 (2023). https://doi.org/10.1007/s40273-022-01205-y

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