Are EQ-5D-Y-3L and EQ-5D-Y-5L Useful Tools to Assess Health Outcomes in Children With Asthma? An Analysis of Child and Parental Carer Reporting

Objective: 

The three-level and five-level child-friendly versions (EQ-5D-Y) are widely employed for assessing health-related quality of life (HRQoL) in children. However, their effectiveness in asthma remains understudied. We aimed to assess their psychometric properties in asthmatic children. 

Methods: 

Seventy-six dyads of patients and their parents completed EQ-5D-Y-5L and EQ-5D-Y-3L, respectively, at two visits. Test-retest reliability and patient-caregiver agreement were assessed using intraclass correlation coefficient (ICC). Known-groups validity was assessed by comparing scores across varying asthma control levels. Responsiveness was assessed in children showing improved overall health and asthma control. 

Results:

ICCs for test-retest reliability of EQ-5D-Y-3L and EQ-5D-Y-5L summary scores ranged from 0.744 to 0.898 (self-report) and 0.525 to 0.767 (proxy-report), indicating satisfactory reliability. As expected, EQ-5D-Y summary scores for both versions were better in well- or partially-controlled patients, with fewer problems reported for each dimension as well. Effect sizes ranged from 0.19 to 1.00 for the self-completed version, from 0.39 to 0.83 for the proxy version, and from 0.26 to 1.40 for EQ VAS in patients showing improvement. Patient-caregiver agreement ranged from moderate to good. 

Conclusion:

The results support the use of the self-complete and proxy versions of both EQ-5D-Y-3L and EQ-5D-Y-5L to assess health outcomes in children with asthma. The self-complete EQ-5D-Y-3L is preferred where possible, but parental carer reports can be used as a reasonable proxy when necessary. The EQ VAS offers a valuable complementary perspective on overall health. Further investigation of the EQ-5D-Y-5L is recommended once a value set becomes available.