Psychometric Properties of Child Health Utility 9D (CHU9D) Proxy Version Administered to Parents and Caregivers of Children Aged 2–4 Years Compared with Pediatric Quality of Life Inventory™ (PedsQL)

This study examines the psychometric properties of the Child Health Utility 9D (CHU9D) proxy version administered to parents/caregivers of 2–4-year-old Australian children compared with Pediatric Quality of Life Inventory™ version 4.0 (PedsQL).

Data collected in 2021/2022 from parents/caregivers of 2–4-year-olds from the Australian pediatric multi-instrument comparison study were used. Feasibility, ceiling/floor effects, test–retest reliability, convergent validity, known-group validity, and responsiveness were assessed.

A total of 842 caregivers completed the survey at baseline, with 513 completing the follow-up survey. The CHU9D did not demonstrate ceiling effects in the sample with special health care needs, with only 6% of respondents reporting best levels for all nine dimensions. CHU9D correlated with PedsQL moderately-to-strongly between comparable items (correlation coefficients 0.34–0.70). CHU9D was able to differentiate between groups with known health differences with moderate-to-large effect sizes (Cohen’s d 0.58–2.03). Moderate test–retest reliability was found for CHU9D in those reporting no health change at a 2-day follow-up (ICC 0.52). A standard response mean (SRM) of 0.25–0.44 was found for children with changes in general health and a SRM of 0.72–0.82 for children who reported worsened health when developing new illnesses, indicating small-to-large responsiveness according to different definitions of health changes. Compared with PedsQL, CHU9D had similar known-group validity and responsiveness and slightly poorer test–retest reliability.

The CHU9D was found to be valid and reliable to measure health-related quality-of-life in children aged 2–4 years, although with relatively low test–retest reliability in some dimensions. Further development and validation work is warranted.