EQ-TIPS (Toddler and Infant Populations)

The EuroQol Toddler and Infant Populations (EQ-TIPS ) is a proxy-completed, experimental measure developed by the EuroQol Group to measure and value health in children aged 0-3 years. EuroQol experimental measures are tools which are still under development and may change as work on the instrument proceeds.

The original version of EQ-TIPS (then called the TANDI) was developed in line with the United States Food and Drug Association (FDA) guidelines and published in 2020. ^{1 2}

EQ-TIPS was developed to fill a clear need for a preference-weighted measure of health in the very youngest populations, where a considerable proportion of health care resources are employed. The aim is that it will contribute to optimising decision-making and resource allocation in that age group.

The format used for EQ-TIPS is the same as that used in the EQ-5D-Y and other EQ instruments and consists of 2 parts : the descriptive system and the EQ visual analogue scale (EQ VAS).

The descriptive system currently comprises the following six items: movement, play, pain, social interaction, communication and eating. Work is ongoing to refine these items and their wording. On the 3-level version of EQ-TIPS (the EQ-TIPS-3L), each item has 3 levels of severity corresponding to: no problems, some problems and a lot of problems. The items on the EQ-TIPS-5L have 5 levels of severity corresponding to: no problems, a little bit of a problem, some problems, a lot of problems and extreme problems.

The proxy respondent, typically the parent, is asked to indicate the young child’s health ‘today’ by ticking the box next to the most appropriate statement in each of the six items. The response on each item is defined as a 1-digit number that expresses the level selected for that item, where ‘no problems’ is assigned a ‘1’ and the most extreme level a ‘3’ or a ‘5’ depending on whether the 3-level or 5-level version is used. The single digit response for each of the six items can be combined into a 6-digit number that describes the younger patient’s health state. For example, on the EQ-TIPS 5-level version, the health state 111245 would represent no problems on the items of movement, play, and pain, ‘a little bit of a problem’ with social interaction, a lot of problems’ with communication, and ‘extreme’ problems with eating.

In the future, it is likely that each EQ-TIPS health state will be associated with an EQ value (societal preference weight or utility) which will allow for the calculation of Quality Adjusted Life Years (QALYs) for use in economic evaluations of health-care interventions for this age group. EQ values are derived from EQ value sets and are not currently available for EQ-TIPS but for more information on how value sets are derived and used with EQ instruments, please see the animation .

The final part of EQ-TIPS, the EQ VAS, is used to record the proxy’s view of how good or bad the infant’s health is overall on the day of questionnaire completion. The EQ VAS is a vertical visual analogue scale with endpoints labelled “The best health you can imagine” and “The worst health you can imagine”. The EQ VAS score can be used as a quantitative measure of overall health to complement the results provided by the descriptive system.

References:

1. Verstraete J, Ramma L, Jelsma J. Item generation for a proxy health related quality of life measure in very young children. Health and quality of life outcomes. 2020;18(1):11. ↩︎
2. Verstraete J, Ramma L, Jelsma J. Validity and reliability testing of the Toddler and Infant (TANDI) Health Related Quality of Life instrument for very young children. Journal of Patient-Reported Outcomes. 2020;4(1). ↩︎