Assessing the Health-Related Quality of Life of Children With Asthma or Eczema by a Proxy: Does Assessment Perspective Matter?

IF 6 2区医学 Q1 ECONOMICS

Value in Health Pub Date : 2025-07-18 DOI:10.1016/j.jval.2025.07.004

Jia Jia Lee, Rachel Lee-Yin Tan, Jian Yi Soh, Elizabeth Huiwen Tham, Anne Eng Neo Goh, Zai Ru Cheng, Nisha Suyien Chandran, Siyun Lucinda Tan, Michael Herdman, Nan Luo

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引用次数: 0

Abstract

Objectives: We compared the measurement properties of 2 proxy versions (proxy-proxy perspective, P1 and proxy-patient perspective, P2) of EQ-5D-Y-3L (Y-3L) and EQ-5D-Y-5L (Y-5L) for assessing the health-related quality of life (HRQoL) of pediatric patients with asthma or eczema.

Methods: We recruited pediatric patients with asthma or eczema and their parents or legal guardians from 2 tertiary hospitals in Singapore. Patients completed Y-3L, Y-5L, and a disease-specific HRQoL questionnaire. Proxies completed either P1 or P2 version of Y-3L and Y-5L. Asthma control and eczema severity were assessed by clinicians. A subset of patient-proxy dyads was reassessed (follow-up duration: 101.3 ± 63.6 days). The known-groups validity, responsiveness to improvement, and patient-proxy agreement of both proxy versions were assessed using the Y-3L index score (3L-Index), Y-5L level sum score (5L-LSS), and EQ visual analog scale scores.

Results: We surveyed 328 child-proxy dyads (P1: 154 dyads; P2: 174 dyads). P2 (47.1%-56.3%) exhibited lower ceiling effects than P1 (53.9%-60.4%). All P1-derived scores differed as expected between Global Initiative for Asthma- or Validated Investigator Global Assessment for Atopic Dermatitis-defined known groups but not all P2-derived scores differed as expected. P1/P2 standardized effect size based on improvement in P1/P2-generated scores was 0.48/0.21 for 3L-Index and 0.28/0.42 for 5L-LSS. Patient-proxy agreement was low for all proxy versions (Intraclass correlation coefficient, ICC: 0.22-0.42). Proxies reported better HRQoL than patients regardless of the version used.

Conclusions: Neither proxy version of the 2 EQ-5D-Y questionnaires displayed a clear superiority, suggesting that assessment perspective may not affect proxy-reported HRQoL of children with asthma or eczema. Researchers and clinicians should select the proxy perspective based on the purpose of evaluation.

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评估哮喘或湿疹儿童健康相关生活质量（HRQoL）：评估视角重要吗？

目的：比较EQ-5D-Y-3L （Y-3L）和EQ-5D-Y-5L （Y-5L）评估儿童哮喘或湿疹患者健康相关生活质量（HRQoL）的两个代理版本（proxy-proxy视角，P1和proxy-patient视角，P2）的测量特性。方法：我们从新加坡的两家三级医院招募儿童哮喘/湿疹患者及其父母/法定监护人。患者完成Y-3L、Y-5L和疾病特异性健康相关生活质量（HRQoL）问卷调查。代理完成了Y-3L和Y-5L的P1或P2版本。临床医生评估哮喘控制和湿疹严重程度。重新评估一组患者代理组（随访时间：101.3±63.6天）。采用Y-3L指数评分（3L-Index）、Y-5L水平总评分（5L-LSS）和EQ VAS评分评估两种代理版本的已知组效度、改善反应性和患者-代理协议。结果：我们调查了328对儿童代理夫妇(P1: 154对；P2: 174对)。P2（47.1% ~ 56.3%）的天花板效应低于P1（53.90% ~ 60.39%）。在GINA或viga - ad定义的已知组中，所有p1衍生评分均存在预期差异，但并非所有p2衍生评分均存在预期差异。基于P1/P2生成评分改善的P1/P2标准化效应量3L-Index为0.48/0.21,5L-LSS为0.28/0.42。所有代理版本的患者-代理协议都很低（ICC: 0.22-0.42）。无论使用何种版本，代理报告的HRQoL都优于患者。结论：两份EQ-5D-Y问卷的代理版本均未显示出明显的优势，提示评估视角可能不会影响代理报告的哮喘或湿疹患儿HRQoL。研究人员和临床医生应根据评估的目的选择代理视角。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Value in Health 医学-卫生保健

CiteScore

6.90

自引率

6.70%

发文量

3064

审稿时长

3-8 weeks

期刊介绍： Value in Health contains original research articles for pharmacoeconomics, health economics, and outcomes research (clinical, economic, and patient-reported outcomes/preference-based research), as well as conceptual and health policy articles that provide valuable information for health care decision-makers as well as the research community. As the official journal of ISPOR, Value in Health provides a forum for researchers, as well as health care decision-makers to translate outcomes research into health care decisions.