Appropriateness of self- and caregiver reports in measuring health utility in Thai pediatric cancer patients
DOI:
https://doi.org/10.69898/jhtm.35.2025.279411Keywords:
EQ-5D-Y-3L questionnaire, Health utility scores, Agreement, Pediatric Cancer PatientsAbstract
Abstract:
Background: The EQ-5D-Y-3L is a standardized instrument used to assess health utility in pediatric populations for health economic evaluations. However, no studies have examined the agreement between, or the appropriateness of choosing, self- and proxy-report versions in Thai pediatric cancer patients. Objective: This study aimed to examine the agreement between self- and proxy-report versions of the EQ-5D-Y-3L, evaluate their appropriateness across respondent types and assess known-groups validity based on ECOG performance status. Materials and methods: A cross-sectional analytic study was conducted among 109 Thai pediatric cancer patients aged ≥ 8 years and their caregivers at King Chulalongkorn Memorial Hospital (March–April 2025). Agreement of health utility scores from the Thai EQ-5D-Y-3L (self- and proxy-report version 1) was assessed, along with known-groups validity based on ECOG status and ceiling/floor effects. Results: Overall, EQ-5D-Y-3L scores showed moderate agreement (ICC = 0.52). Agreement was higher among children aged 8-11 years (ICC = 0.68) compared to those aged 12-17 years (ICC = 0.35). The dimensions of mobility and looking after myself showed moderate agreement, with weighted kappa values of 0.52 and 0.58, respectively, while other dimensions and EQ-VAS scores showed poor agreement. A large effect size was observed for known-groups validity based on ECOG performance status, particularly in proxy reports, which yielded values comparable to or greater than self-reports, along with lower ceiling effects across all age groups. Conclusion: Proxy-report versions of the EQ-5D-Y-3L are appropriate for assessing health utility in Thai pediatric cancer patients, demonstrating larger effect sizes in known-groups validity based on ECOG status and lower ceiling effects in most subgroups compared to self-reports.
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