A two-step procedure to generate utilities for the Infant health-related Quality of life Instrument (IQI)

Paul F M Krabbe; Ruslan Jabrayilov; Patrick Detzel; Livia Dainelli; Karin M Vermeulen; Antoinette D I van Asselt

doi:10.1371/journal.pone.0230852

A two-step procedure to generate utilities for the Infant health-related Quality of life Instrument (IQI)

PLoS One. 2020 Apr 3;15(4):e0230852. doi: 10.1371/journal.pone.0230852. eCollection 2020.

Authors

Paul F M Krabbe¹, Ruslan Jabrayilov¹, Patrick Detzel², Livia Dainelli², Karin M Vermeulen¹, Antoinette D I van Asselt¹

Affiliations

¹ Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
² Nestlé Research Center, Lausanne, Switzerland.

Abstract

Background: Because of a lack of preference-based health-related quality of life (HRQoL) instruments suitable for infants aged 0-12 months, we previously developed the Infant QoL Instrument (IQI). The present study aimed to generate an algorithm to estimate utilities for the IQI.

Methods: Via an online survey, respondents from the general population and primary caregivers from China-Hong Kong, the UK, and the USA were presented 10 discrete choice scenarios based on the IQI classification system. An additional sample of respondents from the general population were also asked if they considered the examined health states to be worse than death. Coefficients for the IQI item levels were obtained with a conditional logit model based on the responses of the primary caregivers for IQI states only. These coefficients were then normalized using the rank-ordered logit model based on the responses from the general population who assessed "death" as a choice option. In this way, the values were rescaled from full health (1.0) to death (0.0), and consequently, they became suitable for the computation of quality-adjusted life years.

Results: The total sample consisted of 1409 members of the general population and 1229 primary caregivers. Results indicated that, out of the 7 IQI items ("sleeping," "feeding," "breathing," "stooling/poo," "mood," "skin," and "interaction"), "breathing" had the highest impact on the HRQoL of infants. Moreover, except for "stooling," all item levels were statistically significant. The general population sample considered none of the health states as worse than death. The utility value for the worst health state was 0.015 (State 4444444).

Conclusions: The IQI is the first generic instrument to assess overall HRQoL in 0-1-year-old infants by providing values and utilities. Using discrete choice experiments, we demonstrated that it is possible to derive utilities of infant health states. The next step will be to collect IQI values in a clinical population of infants and to compare these values with those of other instruments.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child, Preschool
Female
Humans
Infant
Infant Health / statistics & numerical data*
Infant, Newborn
Male
Quality of Life*
Surveys and Questionnaires

Grants and funding

This study has been funded by Nestec Ltd to finance the research activities of RJ, KV, AvA and PK. PD and LD are employed at Nestlé Research Center. The funder provided support in the form of salaries for authors [RJ, KV, PD, LD, AvA, PK], but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.