A head-to-head comparison of the psychometric properties of the EQ-5D-Y-3L, EQ-5D-Y-5L, and CHU9D in children with asthma.

Objectives: There is limited evidence on the relative performance of generic preference-weighted health-related quality of life instruments designed for paediatric patients. This study aimed to compare the psychometric properties of EQ-5D-Y-3L (Y-3L), EQ-5D-Y-5L (Y-5L), and CHU9D in patients with asthma.

Methods: Patients diagnosed with asthma, aged between 8-18 years old completed the Y-3L, Y-5L, CHU9D, and the PROMIS Asthma Impact Scale Short Form (PAIS-SF). Patients' asthma control was assessed using the Global Initiative for Asthma (GINA) classification. Patients were followed up with a single item on change in health, Y-3L, Y-5L, and CHU9D in a subsequent clinic visit. Ceiling effects of the instruments were compared. Convergent validity and known-groups validity were assessed using hypothesis testing. Responsiveness was assessed using mean change scores and Standardized Effect Size (SES).

Results: A total of 164 paediatric patients (mean age:11.9; female: 31.7%) participated in the study, with 93 patients completing the follow-up survey. The ceiling effects of Y-3L, Y-5L, and CHU9D, were 54.9%, 53.7%, and 19.5%, respectively. Almost all convergent and known-group validity hypotheses tested for the three instruments, based on PAIS-SF and GINA, were met. Y-5L best discriminated between relevant known groups, while CHU9D showed better responsiveness (SES= 0.43 in children reporting improvement), compared to Y-3L (SES= 0.16), and Y-5L (SES= 0.17).

Conclusion: While the EQ-5D-Y instruments demonstrated stronger construct validity, their responsiveness appeared to be limited and inferior to the CHU9D in the study sample. Further research in more clinically diverse asthma populations is needed to inform instrument selection.