{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T21:58:25Z","timestamp":1777759105648,"version":"3.51.4"},"reference-count":18,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Astura Medical"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Cost-utility analysis (CUA) is frequently used by reimbursement agencies and national advisory bodies to make informed decisions on whether or not to reimburse surgical interventions. Health state preferences (utilities) are a key component in valuing health outcomes in that they are used in calculating quality-adjusted life-years (QALY). Unfortunately, disease-specific HRQoL measures commonly lack the preference weights necessary to produce health-state utility values for use in CUA. A solution to this problem is to map a disease-specific quality-of-life measure to a generic preference-based measure. The aim of this study was to develop health-state utility values for cerebral palsy (CP) patients with scoliosis by mapping disease-specific quality-of-life scores (CPCHILD outcome questionnaire) to the Health Utility Index Mark 3 (HUI3) questionnaire. Methods: A prospective, multicentre CP scoliosis database was analysed identifying consecutive CP patients with \u22652 years follow-up who completed both the CPCHILD and HUI3 at enrolment, at 1-, and at 2 years follow-up. Ordinary least squared regression models were constructed to estimate HUI3 utility values from CPCHILD scores and clinical variables. The model was developed using enrolment data, while 1- and 2-years follow-up data were used for confirmatory analysis of the goodness of fit of the model (i.e., paired t test between observed and calculated HUI utility values). Results: A total of 232 patients were included, 91.9% were GMFCS IV and V, 87.9% underwent surgery during the study period, and the average magnitude of scoliosis deformity at enrolment was 81.93\u00b0 \u00b1 25.13\u00b0. A log-linear regression model was developed, including three predicting variables: CPCHILD total score (\u03b2 = 0.016, p = 0.0001), communication (\u03b2 = \u22120.436, p = 0.0001), and feeding ability (\u03b2 = \u22120.289, p = 0.0001). The R2 of the model was 0.578, and F 49.73 (p = 0.0001). The mean difference of means between observed HUI3 values and calculated HUI3 values at 1- and 2 years was \u22120.020 (p = 0.129) and 0.017 points (p = 0.187), respectively. Conclusions: Although the use of a preference-based HRQoL measure is the ideal method to generate health-state utility values, we demonstrate that HUI3 scores can be accurately predicted using the CPCHILD questionnaire. This mapping algorithm will be useful in estimating health-state utilities in clinical trials, and hence CUA, of CP patients undergoing scoliosis surgery to help better inform patients, care-givers, health-care providers, and decision makers of the economic burden of surgery in this patient population.<\/jats:p>","DOI":"10.3390\/jcm15093398","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T12:31:56Z","timestamp":1777465916000},"page":"3398","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Health-State Utility Values in CP Patients Following Deformity Surgery: Are We Now Ready for Cost-Utility Analysis in This Patient Population?"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3023-3660","authenticated-orcid":false,"given":"Firoz","family":"Miyanji","sequence":"first","affiliation":[{"name":"British Columbia Children\u2019s Hospital, 4500 Oak St, Vancouver, BC V6H 3N1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3291-9911","authenticated-orcid":false,"given":"Luigi A.","family":"Nasto","sequence":"additional","affiliation":[{"name":"British Columbia Children\u2019s Hospital, 4500 Oak St, Vancouver, BC V6H 3N1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4206-610X","authenticated-orcid":false,"given":"Amer","family":"Samdani","sequence":"additional","affiliation":[{"name":"Shriners Children\u2019s Philadelphia, 3551 N Broad St, Philadelphia, PA 19140, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4885-0138","authenticated-orcid":false,"given":"Suken A.","family":"Shah","sequence":"additional","affiliation":[{"name":"Nemours Children\u2019s Hospital, 1600 Rockland Rd, Wilmington, DE 19803, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Unni G.","family":"Narayanan","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children, 170 Elizabeth St, Toronto, ON M5G 1E8, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Jain","sequence":"additional","affiliation":[{"name":"The Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD 21287, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracey P.","family":"Bryan","sequence":"additional","affiliation":[{"name":"Rady Children\u2019s Hospital, 3020 Children\u2019s Way, San Diego, CA 92123, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter O.","family":"Newton","sequence":"additional","affiliation":[{"name":"Rady Children\u2019s Hospital, 3020 Children\u2019s Way, San Diego, CA 92123, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul D.","family":"Sponseller","sequence":"additional","affiliation":[{"name":"The Johns Hopkins Hospital, 1800 Orleans St, Baltimore, MD 21287, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2395","DOI":"10.1007\/s11999-011-1873-3","article-title":"In Brief: Cost-effectiveness analyses in orthopaedics","volume":"469","author":"Vavken","year":"2011","journal-title":"Clin. 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