Estimating a Dutch value set for the paediatric preference-based CHU-9D using a discrete choice experiment with duration

Objective: This paper presents the development of the Dutch value set for the CHU-9D, a paediatric preference-based measure of quality of life that can be used to generate quality adjusted life years (QALYs).

Methods: A large online survey was conducted using a discrete choice experiment (DCE) including a duration attribute with adult members of the Netherlands general population (n=1,276) who were representative in terms of age, gender, marital status, employment, education and region. Respondents were asked which of two health states they prefer, where each health state was described using the nine dimensions of the CHU-9D (worried, sad, pain, tired, annoyed, school work/homework, sleep, daily routine, able to join in activities) and duration. The data was modelled using conditional logit with robust standard errors to produce utility values for every health state described by the CHU-9D.

Results: The majority of the dimension level coefficients were monotonic, leading to a decrease in utility as severity increases. However there was evidence of some logical inconsistencies particularly for the school work/homework dimension. The value set produced was based on the ordered model and ranges from -0.568 for the worst state to 1 for the best state.

Conclusion: The valuation of the CHU-9D using online DCE with duration with adult members of the Dutch general population was feasible and produced a valid model for use in cost utility analysis. Normative questions are raised around the valuation of paediatric preference-based measures including the appropriate perspective for imagining hypothetical paediatric health states.