Psychometric Comparison of EQ-5D-Y, CHU-9D, and PedsQL 4.0 in Chinese Children and Adolescents With Functional Dyspepsia: A Multicenter Study

• Published in: Value in health 2023-12, Vol.26 (12), p.1754-1762
• Main Authors: He, Siyu, Chen, Liangjiang, Wang, Pei, Xi, Xiaoyu
• Format: Article
• Language: English
• Subjects: Adolescent; Child; Child Health; Child Health Utility 9D; China; Dyspepsia; East Asian People; EQ-5D Youth version; Female; Humans; Pediatric Quality of Life Inventory 4.0; Psychometric property; Psychometrics; Quality of Life; Reproducibility of Results; Surveys and Questionnaires
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2023.08.007

This study aimed to assess and compare psychometric properties of the 3 health-related quality of life (HRQOL) instruments EQ-5D Youth version (EQ-5D-Y), Child Health Utility 9D (CHU-9D), and Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0) in children and adolescents with functional dyspepsia (FD) in China. A consecutive sample of FD outpatients were recruited from 6 tertiary medical centers in Hangzhou. The patients self-completed the 3 instruments in random order. Their feasibility, acceptability, construct validity (convergent, divergent, and known-group validity), and sensitivity were assessed. Multiple linear regression was used for identifying HRQOL-associated factors. A total of 1100 patients (mean age, 9.2 years; girl, 56.8%) completed the survey with no missing responses. Ceiling effect was quite higher in EQ-5D-Y (60.9%) than CHU-9D (33.8%) and PedsQL 4.0 (1.0%). The EQ-5D-Y and CHU-9D utility scores and PedsQL 4.0 total score were highly correlated (|r| = 0.593-0.661), ex1cept for the EuroQol visual analog scale score. The intraclass correlation coefficient between the 2 utility scores was fair (0.542). Most conceptually similar dimensions among the 3 instruments showed moderate to high correlations (|r| > 0.3) as hypothesized. The difference was statistically significant for the 2 utility scores and PedsQL 4.0 total score in varied severity groups (P < .001), and PedsQL 4.0 total score had higher relative efficiency and effect size values. The child’s age, severity of FD symptoms, and their guardian’s education had significant impact on HRQOL (P < .001). EQ-5D-Y, CHU-9D, and PedsQL 4.0 demonstrated acceptable psychometric properties in Chinese children with FD. PedsQL 4.0 showed superior sensitivity and is recommended. EQ-5D-Y and CHU-9D utility scores were not interchangeable. The measurement properties of EuroQol visual analog scale need to be further explored. •The EQ-5D Youth version, Child Health Utility 9D, and Pediatric Quality of Life Inventory 4.0 are widely used pediatric health-related quality of life (HRQOL) instruments. Nevertheless, no study has yet tested and compared their performance in populations with functional dyspepsia (FD).•This study demonstrated the potential of EQ-5D Youth version, Child Health Utility 9D, and Pediatric Quality of Life Inventory 4.0 in measuring HRQOL in Chinese children and adolescents with FD.•The findings provide insights for choosing appropriate instruments to accurately measure HRQOL in child