Abstract Cost–utility analyses are slowly becoming part of randomized control trials evaluating physical and mental health treatments and (preventive) interventions in child and adolescent development. The British National Institute of Health and Care Excellence, for example, insists on the use of gains in Quality Adjusted Life Years (QALYs) to compute the “value for money” of interventions. But what counts as a gain in quality of life? For one of the most widely used instruments, the EuroQol 5 Dimensions scale (EQ‐5D), QALYs are estimated by healthy individuals who provide utility scores for specific health states, assuming that the best life is a life without self‐experienced problems in five domains: mobility, self‐care, usual activities, pain/discomfort, and anxiety/depression. The worst imaginable outcome is defined as “a lot of problems” in each of these five domains. The impact of the individual's problems on the social network is not weighted, and important social–developmental domains (externalizing problems, social competence) are missing. Current cost–utility computations based on EQ‐5D favor physical health over mental health, and they rely on adult weights for child and adolescent quality of life. Thus, a level playing field is absent, and developmental expertise is sorely missing.

中文翻译：

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儿童和青少年行为问题干预措施的成本效益分析

摘要成本-效用分析正逐渐成为评估生理和心理健康治疗以及（预防性）儿童和青少年发育干预的随机对照试验的一部分。例如，英国国立卫生保健卓越学院坚持使用质量调整生命年（QALYs）中的收益来计算干预措施的“物有所值”。但是，什么才算是生活质量的提高呢？对于使用最广泛的工具之一，EuroQol 5维度量表（EQ-5D），QALY是由健康个体估算的，这些个体为特定的健康状态提供效用评分，假设最佳生活是没有五个经历过自我问题的生活领域：活动能力，自我护理，日常活动，疼痛/不适和焦虑/抑郁。可以想象的最糟糕的结果被定义为这五个领域中的“很多问题”。个体问题对社会网络的影响没有得到加权，重要的社会发展领域（外部化问题，社会能力）缺失。当前基于EQ-5D的成本-效用计算更偏重于身体健康而不是精神健康，并且他们依靠成人的体重来衡量儿童和青少年的生活质量。因此，缺少一个公平的竞争环境，并且非常缺乏开发专业知识。他们依靠成人的体重来提高儿童和青少年的生活质量。因此，缺少一个公平的竞争环境，并且非常缺乏开发专业知识。他们依靠成人的体重来提高儿童和青少年的生活质量。因此，缺少一个公平的竞争环境，并且非常缺乏开发专业知识。