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
{"title":"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？","authors":"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","doi":"10.1016/j.jval.2025.07.004","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0000,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Assessing the Health-Related Quality of Life of Children With Asthma or Eczema by a Proxy: Does Assessment Perspective Matter?\",\"authors\":\"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\",\"doi\":\"10.1016/j.jval.2025.07.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":23508,\"journal\":{\"name\":\"Value in Health\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":6.0000,\"publicationDate\":\"2025-07-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Value in Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jval.2025.07.004\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ECONOMICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Value in Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jval.2025.07.004","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ECONOMICS","Score":null,"Total":0}
Assessing the Health-Related Quality of Life of Children With Asthma or Eczema by a Proxy: Does Assessment Perspective Matter?
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.
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.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
