Evidence map›Paper›PMID 40252155›Full record

SynthesisApplied health economics and health policy2025

Measurement Properties of the EQ-5D Instruments in Children and Adolescents: A Systematic Review.

Caique de Melo do Espirito Santo, Verônica Souza Santos, Alessandro Chiarotto, Gisela Cristiane Miyamoto, Tiê P Yamato

Abstract readSystematic Review
In one paragraph

Synthesis in Applied health economics and health policy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Caique de Melo do Espirito SantoMaster's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno, 448/475, Tatuapé, São Paulo, 03071 - 000, Brazil.ORCID 0000-0002-1175-2211
Verônica Souza SantosMaster's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno, 448/475, Tatuapé, São Paulo, 03071 - 000, Brazil.ORCID 0000-0002-1433-818X
Alessandro ChiarottoDepartment of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.ORCID 0000-0003-2350-9945
Gisela Cristiane MiyamotoMaster's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno, 448/475, Tatuapé, São Paulo, 03071 - 000, Brazil.ORCID 0000-0002-6826-4278
Tiê P YamatoMaster's and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, Rua Cesário Galeno, 448/475, Tatuapé, São Paulo, 03071 - 000, Brazil. tie.yamato@sydney.edu.au.ORCID 0000-0002-5228-1292

Funding

Fundação de Amparo à Pesquisa do Estado de São Paulo 2017/17484-1Fundação de Amparo à Pesquisa do Estado de São Paulo 2019/12049-0Fundação de Amparo à Pesquisa do Estado de São Paulo 2021/08776-4
6 · The paper itself

Abstract

backgroundThe EQ-5D instruments have been widely used to measure health-related quality of life (HRQoL) in child and adolescent populations, especially the EQ-5D-Y-3L and EQ-5D-Y-5L (beta version). Although not specifically designed for younger users, the adult versions (EQ-5D-3L and EQ-5D-5L) are also used in these populations. While the measurement properties of these instruments have been evaluated in children and adolescents, no systematic review to date has employed a rigorous method to assess risk of bias. Additionally, quality criteria for good measurement properties and certainty of evidence have not been thoroughly evaluated. The aim of this study was to summarize and critically appraise the evidence on the measurement properties of all EQ-5D instruments in children and adolescents.

methodsWe conducted electronic searches on MEDLINE, EMBASE, CINAHL, EconLit, National Health Service Economic Evaluation Database (NHS-EED), and Health Technology Assessment (HTA) databases up to May 2024. We included studies measuring HRQoL using either the self-reported or proxy-reported version of the EQ-5D instruments-EQ-5D-3L, EQ-5D-5L, EQ-5D-Y-3L, and EQ-5D-Y-5L-using the descriptive system, visual analogue scale, and/or utility score in children and adolescents up to 19 years of age, and that tested at least one measurement property (e.g., reliability). The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology was followed to assess risk of bias, to score results for measurement properties, and to perform an evidence synthesis using a modified Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach.

resultsFrom 3586 records identified through the search, 65 studies were included in this systematic review. We found moderate certainty of evidence of sufficient comprehensibility and comprehensiveness of the EQ-5D-Y-3L and EQ-5D-Y-5L. Furthermore, we found very low certainty of evidence of inconsistent relevance for the EQ-5D-Y-3L, whereas the EQ-5D-Y-5L had sufficient relevance. Almost all the measurement properties (reliability, hypothesis testing for construct validity, and responsiveness) considering all the EQ-5D versions ranged from moderate certainty of evidence of insufficient results to very low certainty of evidence of insufficient results.

conclusionThere is moderate certainty of evidence that the EQ-5D-Y-3L and EQ-5D-Y-5L have sufficient content validity. Both instruments can be recommended to measure HRQoL in children and adolescents aged 8-15 years. However, most of the measurement properties across all EQ-5D versions showed insufficient results, with certainty of evidence ranging from moderate to very low due to inconsistency and doubtful to inadequate risk of bias. Therefore, further research is needed to improve the methodological quality of studies on EQ-5D instruments for children and adolescents. SYSTEMATIC REVIEW REGISTRATION: International prospective register of systematic reviews (PROSPERO): CRD42020218382 and Open Science Framework: https://osf.io/r8kt9/ .

Indexed as

Health StatusQuality of LifeAdolescentChildHumansPsychometricsReproducibility of ResultsSurveys and Questionnaires

Identifiers

PMID40252155
PMCPMC12364749

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.