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Parents of eligible patients were invited to complete a web-based survey. Proxy-reported cross-sectional data from children aged 5\u201312 years were included in the analysis and categorized into three age groups: 5\u20136, 7\u20138, and 9\u201312 years. Convergent validity, known-groups validity, and the explanatory power of the Y-3L were assessed across the three age groups as well as in the overall sample.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The Y-3L showed strong ceiling effects for \u201cpain\/discomfort\u201d and \u201cfeeling worried, sad, or unhappy,\u201d and floor effects in the three physical dimensions. Ceiling effects generally decreased with age for \u201cpain\/discomfort\u201d and \u201cfeeling worried, sad, or unhappy.\u201d Level sum scores and index values correlated moderately to strongly with other measures. Four dimensions correlated well with comparator scales, but \u201cdoing usual activities\u201d showed weaker links. Known-groups validity was highest for Y-3L, with clear age differences. Y-3L dimensions explained less EQ VAS variance with age, while emotional problems were more influential in 5\u20136-year-olds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The Y-3L is a valid instrument for assessing health-related quality of life in SMA children aged between 5 and 12 years, with better psychometric properties observed in older children aged over 7 years.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10198-026-01980-x","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T02:40:54Z","timestamp":1787107254000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation of proxy-reported EQ-5D-Y-3L in younger children with spinal muscular atrophy: age-related differences in performance"],"prefix":"10.1007","author":[{"given":"Chenxi","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janine","family":"Verstraete","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard Huan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"1980_CR1","doi-asserted-by":"publisher","first-page":"100031","DOI":"10.1016\/j.prerep.2025.100031","volume":"3","author":"NK Mishra","year":"2025","unstructured":"Mishra, N. 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