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This entirely open-access supplement issue of PharmacoEconomics, supported by the EuroQol Group Association and guest edited by Nancy Devlin and Rosalie Viney, brings together current research on the valuation of the EQ-5D-Y-3L instrument, including multiple value sets.
A lot of methodological research has been ongoing in this area, and a valuation protocol for the instrument was published in 2020. However, as Nancy Devlin et al. nicely summarise, many conceptual and methodological questions remain. One such question is the perspective that should be used in valuation tasks. The current protocol suggests that adults should make choices on behalf of a hypothetical 10-year-old child when completing the tasks. This could be framed very differently, such as by changing the characteristics of the hypothetical ‘reference child’, which may influence results. Stefan Lipman et al. explore the slightly more nuanced issue of the type of proxy perspective that is used. In their study, they compare composite time trade-off (cTTO) responses using the protocol perspective with an alternative proxy perspective where adults are asked to consider what they think a 10-year-old child would decide for themselves. They find systematic differences, providing more food for thought on this issue.
A further question is how to analyse the valuation data once it is collected. The protocol suggests that discrete choice experiment (DCE) data should be ‘anchored’ onto the full-health-to-dead scale using cTTO data. However, there are several different analytical approaches for achieving this, each of which will have different implications for the resulting value sets. In my paper, my co-authors and I describe three potential anchoring approaches, compare them, and summarise how the resulting value sets are likely to differ depending on the method chosen. We suggest that anchoring using one mean cTTO value for the worst health state is likely to be suboptimal. However, given the potential impact of the method used on the resulting value set, we recommend that researchers seek input from relevant stakeholders when commencing valuation studies to help guide their later decisions. On the topic of stakeholder engagement, Jonathan Nazari et al. engaged with a range of stakeholders in a roundtable discussion to obtain their input on the potential approach to take in an EQ-5D-Y-3L valuation study in the United States and reported their findings. The authors were able to cover an impressive amount of ground in one roundtable and concluded that stakeholder engagement of this nature is both useful and important when conducting such studies – so expect to see more in future.
This issue also contains no less than six EQ-5D-Y-3L value sets – for China, Indonesia, Belgium, the Netherlands, Hungary, and Germany – adding to the three published elsewhere (Slovenia, Japan, and Spain). Alongside the benefit of enabling EQ-5D-Y-3L responses to be converted to utilities, most of these studies also contained novel components to aid future research efforts, such as the use of a larger cTTO experimental design (relative to the minimum set outlined in the protocol), an examination of the impact of different anchoring methods, and a subgroup analysis by parental status.
This issue reflects only a portion of the substantial amount of research that has taken place to inform the valuation of the EQ-5D-Y-3L and other instruments aimed at paediatric populations. With even more valuation research ongoing, and with the recent development of the EQ-5D-Y-5L instrument, watch this space!
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