Constructing a US Value Set for Child Health States: The PedsUtil Scoring System

The Pediatric Quality of Life Inventory (PedsQL) is a widely used, generic, health-related quality of life instrument validated for children aged 2–18 years. However, because it is not preference weighted, it cannot be directly used to estimate health utilities for economic evaluations. This study constructed a value set for the PedsQL: the PedsUtil scoring system. Preferences for child health states were elicited from US adults using an online discrete choice experiment ( n = 2518) and composite time trade-off survey ( n = 868). Child health states were defined by the seven-dimension PedsUtil health state classification system previously derived from the PedsQL. Discrete choice experiment data were analyzed using a mixed logistic regression and the latent coefficients were anchored onto the quality-adjusted life year scale using composite time trade-off data with a linear mapping approach. Preferences varied with age. Pain was the most important dimension for ages 2–4 years and Social Functioning was most important for ages 5–18 years. Pairwise comparisons confirmed significant preference differences between the youngest and older age groups and these age-related differences were also reflected in composite time trade-off data. Consequently, age-specific scoring systems (2–4 and 5–18 years) and an age-combined scoring system (2–18 years) were developed. Utility ranges for the final scoring systems were 0.368–0.999 for ages 2–4 years, 0.427–0.951 for ages 5–18 years, and 0.410–0.972 for ages 2–18 years combined. The PedsUtil scoring system is the first value set derived for the PedsQL, enabling direct estimation of health utilities from PedsQL responses and facilitating pediatric economic evaluations.