EQ-5D-Y-3L

The child-friendly EQ-5D version, EQ-5D-Y-3L (formerly EQ-5D-Y), was introduced by the EuroQol Group in 2009 as a more comprehensible instrument suitable for children and adolescents. The EQ-5D-Y-3L is based on the EQ-5D-3L and essentially consists of 2 pages: the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS).

Due to the release of a new version of the instrument (EQ-5D-Y-5L) during 2024, which provides five response levels of severity to questions in the descriptive system, we renamed EQ-5D-Y to EQ-5D-Y-3L to help differentiate between the instruments. As the renaming process of the EQ-5D-Y-3L is expected to take a number of months, either name will be found for some time on EuroQol webpages, in scientific publications and legal documents, and EQ-5D versions obtained from EuroQol. Please note that, apart from the name, EQ-5D-Y or EQ-5D-Y-3L, the content of the instrument is identical.

The EQ-5D-Y-3L descriptive system comprises the following five dimensions: mobility, looking after myself, doing usual activities, having pain or discomfort and feeling worried, sad or unhappy. Each dimension has 3 levels: no problems, some problems and a lot of problems. The younger patient is asked to indicate his/her health state by ticking the box next to the most appropriate statement in each of the five dimensions. This decision results in a 1-digit number that expresses the level selected for that dimension. The digits for the five dimensions can be combined into a 5-digit number that describes the younger patient’s health state.
The EQ VAS records the younger patient’s self-rated health on a vertical visual analogue scale where the endpoints are labelled “The best health you can imagine” and “The worst health you can imagine”. The VAS can be used as a quantitative measure of health outcome that reflects the younger patient’s own judgement.

Studies have demonstrated the EQ-5D-Y-3L’s feasibility, validity and reliability.12 EQ-5D-Y-3L is available in more than 150 languages and in various modes of administration.

Main differences between the EQ-5D-Y-3L and the EQ-5D-3L

The EQ-5D-Y-3L descriptive system comprises the same five dimensions as the EQ-5D-3L, but uses more appropriate, child-friendly wording. The most relevant differences with the adult EQ-5D-3L are:

  • The ‘Mobility’ dimension header now includes ‘(walking about)’ to facilitate understanding.
  • The title of the second dimension was changed from ‘Self-Care’ to ‘Looking After Myself’
  • The ‘Usual Activities’ dimension is now more child relevant: the new title, ‘Doing Usual Activities’, is followed by ‘(for example, going to school, hobbies, sports, playing, doing things with family or friends)’.
  • For the fifth dimension, ‘Anxiety/Depression’ was replaced with ‘Feeling Worried, Sad or Unhappy’.
  • The wording of the items representing the highest level of severity were changed in all dimensions, from ‘confined to bed’ to ‘a lot of problems walking about’, in the first dimension, and from ‘being unable to’ to ‘having a lot of problems’ (with washing or dressing myself, or doing usual activities) in the second and third dimensions. In the Pain/Discomfort dimension, the upper (worst) level was changed from ‘I have extreme pain or discomfort’ in the adult 3L version to ‘I have a lot of pain or discomfort’ in the Y version; in the final dimension, the upper level was changed from ‘I am extremely anxious or depressed’ to ‘I am very worried, sad or unhappy’.
  • The wording of the first response level in the Looking after Myself dimension was also changed from ‘I have no problems with self-care’ to ‘I have no problems washing or dressing myself’.

EQ-5D-Y-3L value sets

Following an international methodological research programme led by the EuroQol Group, a protocol has been developed to value EQ-5D-Y-3L health states and create standard value sets for the instrument.2 Using value sets produced with the EuroQol Group’s standardised valuation technology, known as EQ-VT, ensures that results are derived using a tried and tested methodology, which provides robust results and facilitates international comparisons. Once published EQ-5D-Y-3L valuation studies are listed on the EuroQol website.

Comparing the EQ-5D-Y-3L and EQ-5D-Y-5L

A brief comparison of the two EQ-5D youth versions, the EQ-5D-Y-3L and EQ-5D-Y-5L, is provided on the EQ-5D-Y-5L webpage.

References:

  1. Golicki D, Młyńczak K. Measurement Properties of the EQ-5D-Y: A Systematic Review. Value Health. 2022;25:1910-1921. ↩︎
  2. Ramos-Goñi JM, Oppe M, Stolk E, Shah K, Kreimeier S, Rivero-Arias O, Devlin N. International valuation protocol for the EQ-5D-Y-3L. Pharmacoeconomics 2020;38:653–663 ↩︎
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