Health-related quality of life measurement and valuation in young children

Summary Health-related quality of life is a critical input to many health funding decisions for children around the world. However little is known about performance and validation of instruments for young children. This research will progress measurement and valuation in order to inform health policy decision making.

Project Details

The PhD student will contribute to a funded MRFF grant on health-related quality of life measurement and valuation for children (The QUOKKA project).

There are few measures available to estimate quality adjusted life years (QALYs) for children, particularly for younger children. There is currently no generic multi-attribute utility instrument (MAUI) that is designed or recommended for children under 4 years of age aside from a very recent infant measure which is only suitable for infants aged 0-2 years. although some instruments are under development. This compromises the ability to inform efficient allocation of health care resources across age groups, which is critical considering that younger children are greater consumers of health care services. For example, children aged 0-4 have been reported as the greatest absolute number of emergency department presentations compared to every other age group. Gaps in evidence about utilities for pediatric patient reported outcomes have been noted by Health Technology Assessment bodies. For example, in Australia the Pharmaceutical Benefits Advisory Committee (PBAC) and Medical Services Advisory Committee (MSAC) have noted that they want to facilitate and promote greater use of paediatric PROs in cost effectiveness evidence. In the UK, NICE has established a working group to address the same issue. Literature reviews have identified the very weak evidence upon which pediatric utilities are currently based. The gap in research regarding use of MAUIs for children under 4 years of age is problematic for paediatric clinical research. For example, at present a clinical trial of asthma/wheezing would currently exclude children aged 2-4 from data collection using the EQ-5D-Y resulting in missing data for these children

The PhD student will work closely with supervisors and international collaborators and will focus on young children - an area with a distinct lack of research. They will review existing data psychometric properties for exisitng MAUIs for young children, they will measure a subsample of children below the age of 5 years who are administered side by side measures. They will produce a scoring algorithm for a HRQoL instrument for young children which is currently lacking.