Application Of Chinese EQ-5D-Y In Children With Hematological Malignancies

Objective: Health utility is an important quota of health outcome evaluation in pharmacoeconomics.The measurement of health utility based on EQ-5D has been widely used in pharmacoeconomic evaluation of adult-related diseases,but the application of EQ-5D in childhood diseases is still in elementary stage.This study investigated the feasibility,reliability,validity of the two Chinese version of EQ-5D-Youth(3LY and 5LY)in evaluating health utility in children with hematological malignancies,the differences between the two versions and the agreement between children and caregivers.Methods: A face-to-face EQ-5D-Y questionnaire survey was conducted among 72 children with hematological malignancies and their caregivers.The correlation between the scales and ECOG,self-rated health(SRH)was analyzed.Test-retest reliability and the agreement between children and caregivers were assessed using Gwet's AC and ICC.Redistribution properties and discriminatory power performed in the two scales were analyzed.Results: The average age of 72 children was 10.4±2.2 years,of which 66.7% were boys,the average VAS was 86.0 ± 15.3.The overall rate of inconsistency of redistribution from 3LY to 5LY was 5.0%.The Shannon index H'of every dimension of 5LY was higher than that of 3LY,showing that 5LY had higher information discrimination power.There was significant statistical difference between the groups according to the condition classification(p<0.05).Both 3LY and 5LY of children and caregivers showed moderate or good agreement(AC > 0.4),the VAS test-retest reliability of children was very good(ICC = 0.895),while the VAS test-retest of caregivers was good(ICC = 0.651).EQ-VAS was moderately correlated with ECOG and SRH(r=-0.443).The dimension “feeling worried/sad/unhappy” of 3LY and 5LY had low correlation with ECOG(r < 0.29),the other dimensions of the two scales were moderately or strongly correlated with ECOG(r>0.3).The “self-care” and “Feeling worried/sad/unhappy” of 3LY were moderately correlated with SRH(0.3<r<0.49),the “Pain/discomfort” and “Feeling worried/sad/unhappy” of 5LY were moderately correlated with SRH(0.3<r<0.49),and the “mobility” of 5LY was lowly correlated with SRH(r=0.264).The dimensions of 3LY and 5LY between children and their caregivers had moderate or high agreement.(AC > 0.4),with their VAS had fair agreement.(ICC=0.517)Conclusion: 3LY and 5LY had certain feasibility,reliability and validity in evaluating the quality of life of children with hematological malignancies.5LY had higher information discrimination power.The inconsistency of redistribution from 3LY to 5LY was low.The agreement of EQ-5D-Y between children and their caregivers showing good consistency.