EQ-5D-Y-5L

EQ-5D-Y-5L is a new version of the EuroQol Group’s original instrument for children and adolescents, the EQ-5D-Y-3L (formerly EQ-5D-Y). This new version uses the same child-friendly wording as the original instrument, and covers the same five dimensions of health but has five levels of response in each dimension instead of the original three, thereby providing respondents with a wider range of options to describe their health. The EQ-5D-Y-5L was launched as an approved EuroQol Group instrument in September 2024.

The EQ-5D-Y-5L comprises two parts, a descriptive system and the EQ visual analogue scale (EQ VAS).

The descriptive system covers five dimensions of health (hence EQ-5D): ‘Mobility’, ‘Looking After Myself’, ‘Doing Usual Activities’, ‘Having Pain or Discomfort’ and ‘Feeling Worried, Sad or Unhappy’. Each dimension has five statements describing different levels of problem, or severity, within that dimension (so, for example, ‘No problems with walking about’, or ‘A lot of problems washing or dressing myself’), and respondents are asked to select the statement in each dimension which best describes their health on the day they complete the questionnaire. Responses in each dimension can be coded as a 1-digit number ranging from 1 (no problems) to 5 (extreme problems, or cannot do). The digits for the five dimensions can then be combined into a 5-digit number, or profile, that describes the young person’s health state. For example, the code 11234 describes a health state where there are no problems with walking about (mobility) or looking after myself, a little bit of a problem with doing usual activities, some pain or discomfort, and feeling really worried, sad or unhappy.

The EQ VAS records the young person’s overall current health on a vertical visual analogue scale which ranges between 0 at the lower point of the scale and 100 at the top of the scale. These 0 and 100 endpoints are labelled “The worst health you can imagine” and “The best health you can imagine”, respectively. The EQ VAS can be used as a quantitative measure of self-rated overall health that complements the results on the descriptive system.

The EQ-5D-Y-5L is designed for use as a self-report, self-complete measure in respondents between the ages of 8 and 15 years, i.e. children and adolescents in that age range should complete the measure on their own whenever possible. If self-completion is not feasible for any reason, interviewer-administered versions of the instrument can be used; if self-report is not feasible, proxy versions are available for completion by parents or other caregivers. Interviewer and proxy versions are also options for use in children between the ages of 4 and 8 years.

EQ-5D-Y-5L is currently available in a number of languages and various modes of administration. New translations can be produced on request by submitting a new registration. Note: new translations are managed by the EuroQol office and, in general, translation costs are covered by the user requesting a translation.

*Educational materials (animation, slide set and infographic) that provide useful information on the EQ-5D-Y-5L are available here.

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

  • Measurement properties: Multiple studies in several countries and clinical populations have demonstrated that the EQ-5D-Y-5L is a valid, reliable, and responsive measure of HRQoL – and found that the EQ-5D-Y-5L performed at least as well as, and on occasions better than, the EQ-5D-Y-3L. 1

  • Similarity between youth and adult versions: The level structure in the descriptive systems of the EQ-5D-Y-5L and the adult EQ-5D-5L are quite similar, unlike the EQ-5D-Y-3L and EQ-5D-3L, where the differences in wording are greater. For comparisons between paediatric and adult populations, or in longitudinal studies when participants transition from adolescence to adulthood (and therefore will need to transition between instruments), it may therefore be preferable to use the EQ-5D-Y-5L and the EQ-5D-5L, rather than the EQ-5D-Y-3L and EQ-5D-3L.

  • Availability of value sets: Value sets are available for use with the EQ-5D-Y-3L in several countries but are not currently available for the EQ-5D-Y-5L. The EuroQol Group is developing a protocol for the valuation of EQ-5D-Y-5L health states as well as a crosswalk function which will allow users to link individual responses on the EQ-5D-Y-5L descriptive system with existing value sets for the EQ-5D-Y-3L.

References:

  1. Cheng LJ, Kreimeier S, Chen LA, Herdman M, Luo N. Head-to-head comparisons of the measurement properties of the three-level and five-level versions of the EQ-5D-Y: a systematic review. Oral presentation at the ISOQOL Annual Conference, 2023, Calgary, Canada. ↩︎
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