The measurement of HRQL in children poses special challenges in characterizing, reporting, and valuing health states, and is particularly in need of further research and development of approaches and instruments.

Nationally representative data that support HRQL measurement are essential for QALY-based CEA for regulations. To date, efforts to incorporate HRQL measures into national health surveys have been ad hoc and unsystematic.

HRQL measures and methods can be improved with further research. In particular, establishing the relationships among and conversion factors for estimates derived from the most commonly used generic HRQL instruments would make integration and synthesis of the results from different studies possible and thus expand the tools and data available for regulatory analysis. In addition, it would improve the reliability of cost-effectiveness comparisons among different analyses and regulations.

Standards of good research practice such as those that have been developed for stated preference valuation surveys for BCA offer a model for developing best practice standards for HRQL valuation instruments, surveys, and studies.

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