Comparisons of Preferences Toward EQ-5D-Y-3L Health States Between Adult Own and Child Perspectives

Objectives: The international valuation protocol for EQ-5D-Y-3L recommends elicitation of utilities using adults’ preference for a hypothetical 10-year-old child. Published studies have reported preference difference in adults when valuing for a child and valuing for themselves. This study aimed to obtain EQ-5D-Y-3L preferences in Hong Kong and understand the preference difference between the adult own perspective and the child perspective.

Methods: We recruited 1000 and 200 adults in Hong Kong to value EQ-5D-Y-3L health states using discrete choice experiment and composite time trade-off (cTTO), respectively. Discrete choice experiment respondents were randomized to complete tasks from either adult own perspective or child perspective. cTTO respondents completed valuation from the child perspective. Relative attribute importance scores were compared between perspectives. Utility values were obtained by anchoring on the worst health state for both perspectives.

Results: Both perspectives had similar relative attribute importance scores, rankings of dimensions, rescaled coefficients, and elicited values. Rank order of 5 dimensions, from highest to lowest importance, was “having pain or discomfort,” “doing usual activities,” “feeling worried, sad, or unhappy,” “mobility,” and “looking after myself” for both perspectives. The most important and least important dimensions were consistent with published EQ-5D-Y-3L value sets.

Conclusions: This study revealed no remarkable difference in the relative preference for EQ-5D-Y-3L health states between the adult own and child perspectives in Hong Kong, offering insights to the development of the EQ-5D-Y-5L valuation protocol. Future research may explore the effect of perspectives on preferences elicited by cTTO in Asia.