Valuing EQ-5D-Y health states using a discrete choice experiment: do adult and adolescent preferences differ?

Mott, D.J., Shah, K.K., Ramos-Goñi, J.M., Devlin, N.J. and Rivero-Arias, O.

Research Paper
July 2019

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One of the challenges with generating an EQ-5D-Y value set is that traditional methods are cognitively demanding and may not be appropriate for younger individuals. However, asking adults to complete a valuation task from the perspective of a child/adolescent presents its own challenges. This Research Paper describes a study examining adolescent and adult responses to a discrete choice experiment (DCE) containing EQ-5D-Y health states in order to determine whether the two groups exhibit different preferences. An online survey was designed containing a DCE, which comprised 15 pairwise choices. A sample of UK adults was asked to consider the health of a 10-year-old child when completing the tasks. In contrast, a sample of UK adolescents (11-17 years) received the same survey and completed the tasks considering their own health. Mixed logit models were estimated for both samples and comparisons were made.
 
The relative importance of the levels attached greatest disutility to level 3 in pain/discomfort (PD3) followed by anxiety/depression (AD3) in both groups. The rank-order of other levels differed, including the third-worst level: mobility (MO3) for adolescents; and usual activities (UA3) for adults. Modelling results indicate that there are significant differences in preferences between the two samples. The paper concludes that adolescents’ preferences differ from those of adults taking the perspective of a child. As the adolescents were capable of completing the DCE, it is important to consider whether their preferences should be considered in decision-making.