The validity and reliability of the interviewer-administered EQ-5D-Y-3L version in young children

Abstract

Objectives

The aim of this study was to determine the validity and reliability of the EQ-5D-Y-3L interviewer-administered (IA) version in South African children aged 5–7-years compared to 8–10-years.

Methods

Children aged 5–10-years (n = 388) were recruited from healthcare facilities, schools for learners with special educational needs and mainstream schools across four known condition groups: chronic respiratory illnesses, functional disabilities, orthopaedic conditions and the general population. All children completed the EQ-5D-Y-3L IA, Moods and Feelings Questionnaire (MFQ), Faces Pain Scale-Revised (FPS-R) and a functional independence measure (WeeFIM) was completed by the researcher. Cognitive debriefing was done after the EQ-5D-Y-3L IA to determine comprehensibility. Test–retest of the EQ-5D-Y-3L IA was done 48 h later and assessed using Cohen’s kappa (k).

Results

Results from children aged 5–7-years (n = 177) and 8–10-years (n = 211) were included. There were significantly higher reports of problems in the Looking After Myself dimension in the 5–7-year-olds (55%) compared to the 8–10-year-olds (28%) (x² = 31.021; p = 0.000). The younger children took significantly longer to complete the measure (Mann-Whitney U = 8389.5, p < 0.001). Known-group validity was found at dimension level with children receiving orthopaedic management reporting more problems on physical dimensions across both age-groups. Convergent validity between Looking After Myself and WeeFIM items of self-care showed moderate to high correlations for both age-groups with a significantly higher correlation in the 8–10-year-olds for dressing upper (z = 2.24; p = 0.013) and lower body (z = 2.78; p = 0.003) and self-care total (z = 2.01; p = 0.022). There were fair to moderate levels of test-retest reliability across age-groups.

Conclusion

The EQ-5D-Y-3L IA showed acceptable convergent validity and test–retest reliability for measuring health in children aged 5–7-years. There was more report of problems with the dimension of Looking After Myself in the 5–7-year group due to younger children requiring help with dressing, including buttons and shoelaces due to their developmental age, rather than their physical capabilities. Therefore, it may be useful to include examples of age-appropriate dressing tasks. There was further some reported difficulty with thinking about the dimensions in the younger age-group, most notably for Usual Activities which includes a large number of examples. By decreasing the number of examples it may reduce the burden of recall for the younger age-group.