Mihalopoulos, Cathrine, Chen, Gang, Scott, James G., Bucholc, Jessica, Allen, Cassandra, Coghill, David, Jenkins, Peter, Norman, Richard, Ratcliffe, Julie, Richardson, Jeffrey, Stathis, Stephen, and Viney, Rosalie
The objective of this study was to compare the concurrent and construct validity, as well as the sensitivity of 5 multiattribute utility instruments (MAUIs), including the Assessment of Quality of Life-6D (AQoL-6D), EQ-5D-Y, Health Utilities Index (HUI)-2 and HUI-3, and the Child Health Utility 9D, 1 generic pediatric quality of life instrument, with 3 routinely collected outcome measures in Australian mental health services (Strengths and Difficulties Questionnaire, Clinical Global Assessment Scale [CGAS] and the Health of the Nation Outcome Scale for Children and Adolescents) in children and adolescents diagnosed of internalizing (eg, anxiety/depression), externalizing (eg, attention deficit hyperactivity disorder/conduct disorders), and trauma/stress related mental disorders. A cross-sectional survey of measures, including demographic and basic treatment information, in children/adolescents recruited via 5 child and youth mental health services in Queensland and Victoria, Australia. Measures were either proxy or self-report completed, the CGAS and the Health of the Nation Outcome Scale for Children and Adolescents were clinician completed. The sample included 426 participants and had a mean age of 13.7 years (range 7-18 years). Utilities (as calculated from MAUIs) were generally lower in older adolescents and those with internalizing disorders. All MAUIs and self-reported clinical measures significantly correlated with each other (absolute correlation range 0.40-0.90), with the AQoL-6D showing generally higher levels of correlations. Correlations between the MAUIs and clinician/proxy-reported measures were weak, regardless of diagnosis (absolute correlation range 0.09-0.47). Generally, EQ-5D-Y, HUI-2, and AQoL-6D were more sensitive than Child Health Utility 9D and HUI-3 when distinguishing between different severities according to clinician-assessed CGAS (effect size range 0.17-0.84). The study showed that the commonly used MAUIs had good concurrent and construct validity compared with routinely used self-complete measures but poor validity when compared with clinician/proxy-completed measures. These findings generally held across different diagnoses. • Multiattribute utility instruments (MAUIs), such as the EQ-5D-Y, Child Health Utility 9D, Health Utilities Index-2 and -3, and the Assessment of Quality of Life-6D—used to assess quality-adjusted life-years—have not been psychometrically evaluated in children/adolescents with mental disorders. • This study evaluated commonly used MAUIs in children/adolescents with mental disorders and compared them with frequently used non-MAUI outcome measures—both self- and clinician/parent reported. • The MAUIs were found to have good concurrent and construct validity when compared with self-reported outcome measures but poor validity when compared with clinician or parent/guardian-reported measures. • This research raises the question of whether quality-adjusted life-year gains should be exclusively estimated using self-reported measures. [ABSTRACT FROM AUTHOR]