# Performance of the Experimental EuroQol Toddler and Infant Populations (EQ-TIPS) and PedsQL in Infants and Toddlers with a Health Condition

## TL;DR

This study compares two tools for measuring health-related quality of life in infants and toddlers, finding differences in how they capture issues like eating, pain, and school functioning.

## Contribution

The study provides empirical evidence comparing the EQ-TIPS and PedsQL instruments in infants and toddlers with health conditions.

## Key findings

- EQ-TIPS-3L reported high problems with eating and pain across age groups.
- PedsQL had significant missing data in school functioning items for older children.
- Both measures differentiated by severity but not by age group.

## Abstract

Health-related quality of life measurement in infants and toddlers is increasingly important, but generic preference-weighted instruments lack evidence. This study compared the experimental EuroQol Toddler and Infant Populations (EQ-TIPS) and PedsQL in children 0 to 4 years.

EQ-TIPS-3L v2.0 and PedsQL response distributions were compared by frequency. Item and dimension/summary score associations were computed using Pearson and intra-class correlation coefficient. Age and severity groups (EQ VAS ≥80) were compared with Mann-Whitney U tests.

Cross-sectional data from 260 children were analyzed: 0 to 24 months (n = 111) and 2 to 4 years (n = 149). Most caregivers were mothers, spending significantly more time (≥10 hours) with younger children χ2 = 18.12, P = .001). The EQ-TIPS-3L had the highest problems with eating (27%-31%) and pain (23%-25%) across age groups, with minimal missing data (≤1%). Younger children most frequently had problems with PedsQL: “tired” (54%), “resting a lot” (52%), “crying or fussing when left alone” (61%) and “difficulty soothing when upset” (51%). Older children’s main problems were “hurts or aches” (54%), “afraid or scared” (53%), “sad or blue” (50%), “angry” (64%) and “missing school” (56%-65%). All 3 of the PedsQL school items had missing data for older children (27%-30%). Hypothesized item correlations were reached for 30 of 35 and 11 of 12 items in the younger and older groups, respectively. EQ-TIPS-3L LSS showed moderate to strong correlations with all PedsQL scores except for cognitive (0-24 months) and school functioning (2-4 years). Both measures significantly differentiated by severity groups (EQ VAS ≥80) but not by age group.

Both measures showed similar response distributions despite different time frames and response scales. EQ-TIPS-3L eating and pain reported high problems, with eating strongly associated only with PedsQL physical symptoms. The 2- to 4-year PedsQL version had many missing school functioning items; the 13- to 24-month PedsQL may suit older 2- to 4-year-olds better. Low association between PedsQL cognitive functioning and EQ-TIPS-3L suggests further research is needed on this potentially missing construct.