Practicality, Validity, and Responsiveness of Using the Proxy Version of the Child Health Utility–9 Dimensions With Children Aged 2 to 5 Years

Sach, Tracey H.; Williams, Hywel C.; Allen, Hilary; Boyle, Robert; Kelleher, Maeve; Brown, Sara; Cork, Mike; Flohr, Carsten; Jay, Nicola; Lartey, Stella; Davies, Charlotte; Lawton, Sandra; Perkin, Michael; Ridd, Matthew; Brooks, Joanne; Tarr, Stella; Wyatt, Laura; Thomas, Kim

Abstract

Objectives
To assess the practicality, validity and responsiveness of proxy CHU-9D in children aged 2-5 years.

Methods
We used data from BEEP, a UK randomised controlled trial testing whether daily emollients in infancy could prevent eczema in high-risk infants. The main parent/carer completed the proxy CHU-9D using developers’ additional guidance for completion in under-5’s and the Patient-Orientated Eczema Measure (POEM) at ages 2, 3, 4 and 5. Practicality was assessed by completion rates. Construct validity assessed if CHU-9D could discriminate between those with/without eczema and between eczema severity levels on POEM. Responsiveness was determined by ability to discriminate between three groups: those whose POEM score, i) deteriorated ≥3 points, ii) change not clinically important (-2.9 to 2.9 points), and iii) improved ≥3 points. Analysis was conducted in STATA 17.

Results
Of 1,394 children participating in BEEP, study questionnaires were completed by 1,212 (87%), 981 (70%), 990 (71%), and 976 (70%) at 2, 3, 4 and 5-years. Of these the CHU-9D was completed by 1,066 (88.0%), 685 (69.8%), 925 (93.4%) and 923 (94.6%) respectively. Mean utility at all timepoints was around 0.934 (range 0.443-1). For construct validity, very small differences on the CHU-9D between known groups were observed(p <0.01). 801 participants had responsiveness data: 13% deteriorated, 72% had non-clinically important change, and 15% improved. Mean utility change (standardised response mean) for these groups was -0.0198 (0.21), 0.0041 (0.05), and 0.0175 (0.21)showing small change and small responsiveness.

Conclusions
Proxy CHU-9D in 2-5 year old children shows potential but further research is needed.

Citation

Sach, T. H., Williams, H. C., Allen, H., Boyle, R., Kelleher, M., Brown, S., Cork, M., Flohr, C., Jay, N., Lartey, S., Davies, C., Lawton, S., Perkin, M., Ridd, M., Brooks, J., Tarr, S., Wyatt, L., & Thomas, K. (2024). Practicality, Validity, and Responsiveness of Using the Proxy Version of the Child Health Utility–9 Dimensions With Children Aged 2 to 5 Years. Value in Health, https://doi.org/10.1016/j.jval.2024.08.010

• Journal Article Type: Article
• Acceptance Date: Aug 19, 2024
• Online Publication Date: Oct 9, 2024
• Publication Date: 2024-10
• Deposit Date: Nov 5, 2024
• Publicly Available Date: Nov 7, 2024
• Journal: Value in Health
• Print ISSN: 1098-3015
• Electronic ISSN: 1524-4733
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1016/j.jval.2024.08.010
• Public URL: https://nottingham-repository.worktribe.com/output/40590175
• Publisher URL: https://www.valueinhealthjournal.com/article/S1098-3015(24)02861-4/fulltext?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1098301524028614%3Fshowall%3Dtrue