A two-step procedure to generate utilities for the Infant health-related Quality of life Instrument (IQI)

Abstract

Background Because of a lack of preference-based health-related quality of life (HRQoL) instruments suitable for infants aged 0-12 months, we previously developed the Infant QoL Instrument (IQI). The present study aimed to generate an algorithm to estimate utilities for the IQI. Methods Via an online survey, respondents from the general population and primary caregivers from China-Hong Kong, the UK, and the USA were presented 10 discrete choice scenarios based on the IQI classification system. An additional sample of respondents from the general population were also asked if they considered the examined health states to be worse than death. Coefficients for the IQI item levels were obtained with a conditional logit model based on the responses of the primary caregivers for IQI states only. These coefficients were then normalized using the rank-ordered logit model based on the responses from the general population who assessed "death" as a choice option. In this way, the values were rescaled from full health (1.0) to death (0.0), and consequently, they became suitable for the computation of quality-adjusted life years. Results The total sample consisted of 1409 members of the general population and 1229 primary caregivers. Results indicated that, out of the 7 IQI items ("sleeping," "feeding," "breathing," "stooling/poo," "mood," "skin," and "interaction"), "breathing" had the highest impact on the HRQoL of infants. Moreover, except for "stooling," all item levels were statistically significant. The general population sample considered none of the health states as worse than death. The utility value for the worst health state was 0.015 (State 4444444).

Valuation Survey of EQ-5D-Y Based on the International Common Protocol: Development of a Value Set in Japan

“…Moreover, unbundling DCE and cTTO allows researchers to exercise choice over how and to whom these tasks are administered, which facilitates experimentation and enables quick dissemination of new results into the protocol, if required. 12,13 Most other variations among approaches to generate utilities for different instruments appear to be entirely commonplace, with the exception of choices about perspective. Adult health states can usually be valued by adults themselves, but it may not be possible to elicit values from children.…”

“…Moreover, unbundling DCE and cTTO allows researchers to exercise choice over how and to whom these tasks are administered, which facilitates experimentation and enables quick dissemination of new results into the protocol, if required. 12 , 13 …”

“…In the Australian CHU9D valuation survey, 14 , 15 the AQoL 3 and the 16-Dimension (16D) 16 health states were valued by adolescents for themselves. However, values were elicited from the general population for a child (i.e., from proxies) in the valuation of IQI 13 and in pilot work concerning EQ-5D-Y. 7 The latter approach has now also been adopted in the EQ-5D-Y valuation protocol, to be consistent with the taxpayer perspective, and because it was clear that the tasks could not be administered with children.…”

Using a novel concept to measure outcomes in solid organ recipients provided promising results

“…In the second task, the respondent's health state, as defined in the first task (the reference state), was compared with some slightly different hypothetical health states. Based on our previous experience in other studies, we concluded that six is the optimal number for the hypothetical health states in the second task [24]. The respondents were informed that the health states presented in the second task were those of another patient with the same health status, with the exception of two alternating health items.…”

An overview of the time trade-off method: concept, foundation, and the evaluation of distorting factors in putting a value on health

“…Therefore, an attractive alternative is to combine two methods. Recently, a two-step procedure was developed for a preference-based health instrument for infants (Infant Quality of life Instrument: IQI) [134]. Coefficients for the levels were obtained from a DCE.…”