[Background] EQ-5D instruments (HRQOL), incuding the three-level (Y-3L) and five-level (Y-5L) child-friendly versions (EQ-5D-Y) are widely employed for assessing health-related quality of life. However, their effectiveness in children with asthma remains understudied. This study aimed to assess their performance in pediatric asthma patients and their caregivers. [Methods] Dyads of asthmatic patients (n=76, aged 8-16.7) and caregivers completed Y-5L and Y-3L, respectively, at two visits. Test-retest reliability and patient-caregiver agreement were assessed via intraclass correlation coefficient (ICC). Known-groups validity was assessed by comparing scores across varying asthma control levels. Responsiveness was assessed in children showing improved overall health and asthma control. [Results] ICCs for test-retest reliability ranged from 0.744 to 0.898 (self-complete) and 0.525 to 0.767 (proxy), indicating satisfactory reliability. As expected, overall scores for both EQ-5D-Y versions were higher (better HRQOL) in well-/partially-controlled asthma patients. Standardized effect sizes ranged from 0.19 to 1.00 (self-complete), 0.39 to 0.83 (proxy), and 0.26 to 1.40 (EQ VAS) in improved patients. Patient-caregiver agreement ranged from moderate to good. [Conclusion] Both self-complete and proxy EQ-5D-Y versions appeared to be suitable for assessing HRQOL in pediatric asthma patients, with the self-complete version being more preferable. Further investigation on the responsiveness of EQ-5D-Y is warranted.

Background The child-friendly EQ-5D (EQ-5D-Y) has been available in both a 3-level (Y-3L) and a 5-level (Y-5L) version. The study aimed to assess the measurement properties of both versions in paediatric patients with asthma and their caregivers. Methods Patients and their caregivers completed the self-complete and proxy Y-5L and Y-3L questionanires, respectively, twice in two consecutive visits. Test-retest reliability and patient-caregiver agreement of Y-3L index, Y-5L level sum score (LSS) and EQ Visual Analogue Scale (VAS) were assessed using intraclass correlation coefficient (ICC). Known-groups validity compared scores of patients with different asthma control statuses. Responsiveness to improved overall health and asthma control was assessed uisng standardized effect size (SES). Results Seventy-six patients (age range: 8-16.7 years) and their caregivers participanted. The ICC for test-retest reliability of the Y-3L, Y-5L and EQ VAS scores ranged from 0.744 to 0.898 for the slef-complete version and 0.525 to 0.767 for the proxy version. As hypothesized, Y-3L, Y-5L and EQ VAS scores derived from both EQ-5D-Y versions indicated that well or partially controlled patients had better health than uncontrolled patients. SES values ranged from 0.20 to 1.40 for self-complete version and 0.39 to 1.26 for proxy version. ICC for parient-caregiver agreement ranged from 0.556 for Y-5L LSS to 0.833 for Y-3L index. Conclusion The results support the relaibility, validity, and responsiveness of both the self-complete and proxy versions of the two EQ-5D-Y questionnaires for assessing health outcomes of asthmatic children. Moreover, the self-complete and proxy-reported versions appears to have good agreement.