EuroQol 5-Dimension 5-Level Youth Version as a Measure of Health-Related Quality of Life in Pediatric Patients: A Review

Abstract

Measuring health-related quality of life (HRQoL) is increasingly important in pediatric clinical research, pharmacotherapy, health technology assessment, and patient-centered care. The EuroQol 5-Dimension 5-Level Youth Version (EQ-5D-Y-5L) is a youth-specific, generic, preference-based health-status instrument that describes health across five dimensions: mobility, looking after myself, doing usual activities, having pain or discomfort, and feeling worried, sad, or unhappy, using five response levels, together with a visual analogue scale. This review summarizes the development of the EQ-5D-Y-5L and critically examines evidence on feasibility, content validity, reliability, construct validity, informativity, responsiveness, proxy reporting, cross-cultural adaptation, and emerging valuation research. The available evidence indicates that the five-level instrument is understandable to children and adolescents and generally provides greater descriptive discrimination than the three-level version. Head-to-head studies have reported reduced ceiling effects and improved informativity with the 5-Level Youth Version (Y-5L), although performance varies by population, reporter, and outcome. Evidence in intellectual disability, juvenile idiopathic arthritis, scoliosis, psychiatric care, and cardiovascular disease supports construct validity, while reliability and responsiveness remain less consistent across settings. Valuation is an active methodological area, and emerging adolescent and adult preference studies indicate that perspective and age may influence stated preferences. The EQ-5D-Y-5L is therefore a useful generic pediatric HRQoL measure, but selection should be guided by the clinical population, purpose of measurement, reporter, and availability of appropriate value sets.