EQ-TIPS (Toddler and Infant Populations)
The EuroQol Toddler and Infant Populations (EQ-TIPS) is a generic, proxy-reported health-related quality of life instrument for children under the age of 4. EQ-TIPS was developed to fill a need for a preference-weighted measure of health-related quality of life in the very youngest populations. The original version of EQ-TIPS (then called the TANDI) was developed in South Africa. Starting from TANDI, the EQ-TIPS was developed iteratively through gradual refinement within a large multinational programme of work. This supports its global relevance and its use alongside EQ-5D instruments to measure and value health-related quality of life across the lifespan. It is intended for use as an outcome measure and to support cost-effectiveness analyses and health technology assessment once preference-weighted values are developed.
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 (EV3.0) currently comprises the following seven items: movement, eating or drinking, sleep, pain, managing emotions, interacting with others and play. Work is ongoing to refine and test these items. 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 1112345 would represent no problems on the items of movement, eating or drinking, and sleep, ‘a little bit of’ with pain, ‘some problems’ with managing emotions, ‘a lot of problems’ interacting with others and ‘extreme’ problems with playing. The final part of EQ-TIPS, the EQ VAS, is used to record the proxy’s view of how good or bad the child’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.
The EQ-TIPS is currently available as an Experimental instrument and is expected to be launched as an Approved instrument in the next 2 to 3 years.
References:
- 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.
- 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).