Valuation of child health-related quality of life by child age and problem duration using a novel method

Journal article

Objectives
In the U.S., the valuation of health-related quality of life (HRQoL) on a quality-adjusted life years scale has been criticized due to its discriminatory aspects. Therefore, in this EQ-5D-Y-3L valuation study, we assess the value of child HRQoL on a novel "experience" scale, which ranges from 0 ("no experience"/unconscious) to 1 ("experience full health"), and test whether value depends on the child's age and the duration of the problems.
Methods
In Spring 2024, 2,577 U.S. adults were assigned to one of 16 arms that differed only in the child's age and problem duration. Each participant completed a discrete choice experiment (DCE) with five paired comparisons and 20 kaizen tasks. Using this stated preference evidence, we estimated a conditional logit model for each arm and tested for differences in EQ-5D-Y-3L values.
Results
In each arm, all 10 incremental differences in levels were positive (p-value < 0.05) with the highest value on alleviating a child's pain and discomfort. Child age affected the value of self-care, such as relieving "problems taking a bath or showering by myself or getting dressed by myself". The results didn't indicate any differences in main effects by problem duration. The value of the worst EQ-5D-Y-3L profile (33333) relative to being "in a coma" differed by child age and problem duration, ranging from 0.202 to -0.346 across 16 arms (p-value < 0.05).
Conclusion
In the U.S., the value of relieving problems with self-care depends on a child's age, possibly due to perceived differences in developmental norms.

Authors: Jumamyradov, M; Craig, BM; Jakubczyk, M; Rivero-Arias, O

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Elsevier
• Journal: Value in Health
• Place of publication: United States
• Publication date: 2026-07-14
• Acceptance date: 2026-06-17
• DOI: 10.1016/j.jval.2026.06.011
• EISSN: 1524-4733
• ISSN: 1098-3015
• Pmid: 42447980
• Language: English
• Keywords: quality-adjusted life years; Inflation Reduction Act; discrete choice experiments; kaizen task; EQ-5D-Y-3L