Whose Values in Health? An Empirical Comparison of the Application of Adolescent and Adult Values for the CHU-9D and AQOL-6D in the Australian Adolescent General Population

Objectives: The Child Health Utility-9D (CHU-9D) and the Assessment of Quality of Life-6D (AQOL-6D) presently represent the only two generic preference-based instruments developed for application with young people with both adult-and adolescent-specific scoring algorithms. The main objective of this study was to compare and contrast the application of adult and adolescent scoring algorithms for the CHU-9D and AQOL-6D in valuing the health of a community-based sample of adolescents. Methods: A Web-based survey including the CHU-9D and the AQOL-6D was developed for administration to adolescents, aged 11 to 17 years, residing in Australia (n - 500). Individual responses to both instruments were converted to values by using first the adult and second the adolescent scoring algorithms pertaining to each instrument. Results: Both the AQOL-6D and the CHU-9D discriminated well according to health status and the presence of long-standing illness regardless of the scoring algorithm. Within each instrument, however, important discrepancies were found in that employment of the adolescent algorithm was found to result in consistently lower mean health state values for the CHU-9D but consistently higher mean health state values for the AQOL-6D relative to the employment of their respective adult algorithms and these differences were statistically significant (P < 0.05). Conclusion: The differences in adolescent and adult values for identical health states are more profound for the CHU-9D and ultimately may be significant enough to have an impact on health care policy. It is important to note that there are important differences between the CHU-9D instrument and the AQOL-6D instrument that may also have a significant impact on the valuations obtained.