1
|
Viani K, Bernardes BF, Veiga MN, Viani RC, Barbuto TM, Barr RD. Translation and cultural adaptation of the Health Utilities Preschool to Brazilian Portuguese. Hematol Transfus Cell Ther 2024; 46:131-136. [PMID: 36868939 DOI: 10.1016/j.htct.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/20/2023] [Indexed: 02/25/2023] Open
Abstract
INTRODUCTION Health research is particularly important in low- and middle-income countries (LMICs), where improvements must be achieved with limited resources, and where the great majority of the world's population, especially children, live. Improvements in public health detection in Brazil have resulted in cancer becoming the most prevalent cause of death by disease in the group aged 1 to 19 years, hence, delivering cost-effective care to the group is a priority. Preference-based measures of health status and health-related quality of life (HRQL) integrate morbidity and mortality and provide utility scores for the estimation of quality-adjusted life years to be used in cost-effectiveness analyses and economic evaluation. The generic preference-based instrument Health Utilities - Preschool (HuPS) measures the health status of young children and is applicable to the age group 2 to 5 years, who carry the highest incidence of cancer in childhood. METHODS The translation of the HuPS classification system followed recommended protocols from published guidelines. Forward and backward translations were performed by a team of six qualified professionals and linguistic validation was undertaken with a sample of parents of preschool children. MAIN RESULTS Initial disagreements on individual words occurring in 0.5-1.5% were resolved by consensus. A final version of the instrument was validated by the sample of parents. CONCLUSIONS The translation and cultural adaptation of the HuPS into Brazilian Portuguese were accomplished as the first step in the validation of the HuPS instrument in Brazil.
Collapse
Affiliation(s)
- Karina Viani
- Instituto de Tratamento do Câncer Infantil (ITACI), Instituto da Criança e do Adolescente, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brazil.
| | | | | | | | - Tomas Marzagão Barbuto
- Instituto de Tratamento do Câncer Infantil (ITACI), Instituto da Criança e do Adolescente, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brazil
| | | |
Collapse
|
2
|
Ghotra S, Feeny D, Barr R, Yang J, Saigal S, Vincer M, Afifi J, Shah PS, Lee SK, Synnes AR. Parent-reported health status of preterm survivors in a Canadian cohort. Arch Dis Child Fetal Neonatal Ed 2022; 107:87-93. [PMID: 34162693 DOI: 10.1136/archdischild-2021-321635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 06/07/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Health status (HS)/ health-related quality of life measures, completed by self or proxy, are important outcome indicators. Most HS literature on children born preterm includes adolescents and adults with limited data at preschool age. This study aimed to describe parent-reported HS in a large national cohort of extreme preterm children at preschool age and to identify clinical and sociodemographic variables associated with HS. METHODS Infants born before 29 weeks' gestation between 2009 and 2011 were enrolled in a prospective longitudinal national cohort study through the Canadian Neonatal Network (CNN) and the Canadian Neonatal Follow-Up Network (CNFUN). HS, at 36 months' corrected age (CA), was measured with the Health Status Classification System for Pre-School Children tool completed by parents. Information about HS predictors was extracted from the CNN and CNFUN databases. RESULTS Of 811 children included, there were 79, 309 and 423 participants in 23-24, 25-26 and 27-28 weeks' gestational age groups, respectively. At 36 months' CA, 78% had a parent-reported health concern, mild in >50% and severe in 7%. Most affected HS attributes were speech (52.1%) and self-care (41.4%). Independent predictors of HS included substance use during pregnancy, infant male sex, Score for Neonatal Acute Physiology-II, bronchopulmonary dysplasia, severe retinopathy of prematurity, caregiver employment and single caregiver. CONCLUSION Most parents expressed no or mild health concerns for their children at 36 months' CA. Factors associated with health concerns included initial severity of illness, complications of prematurity and social factors.
Collapse
Affiliation(s)
- Satvinder Ghotra
- Pediatrics, Dalhousie University and IWK Health Centre, Halifax, Nova Scotia, Canada
| | - David Feeny
- Economics, McMaster University, Hamilton, Ontario, Canada
| | - Ronald Barr
- Pediatrics, Health Sciences Centre, McMaster University, Hamilton, Ontario, Canada
| | - Junmin Yang
- Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Saroj Saigal
- Pediatrics, Health Sciences Centre, McMaster University, Hamilton, Ontario, Canada
| | - Michael Vincer
- Pediatrics, Dalhousie University and IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Jehier Afifi
- Pediatrics, Dalhousie University and IWK Health Centre, Halifax, Nova Scotia, Canada
| | | | - Shoo K Lee
- Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Anne R Synnes
- Neonatology, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | | | | |
Collapse
|
3
|
Verstraete J, Lloyd AJ, Jelsma J. Performance of the Toddler and Infant (TANDI) Health-Related Quality of Life Instrument in 3-4-Year-Old Children. CHILDREN-BASEL 2021; 8:children8100920. [PMID: 34682184 PMCID: PMC8534352 DOI: 10.3390/children8100920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 11/16/2022]
Abstract
The Toddler and Infant (TANDI) dimensions of Health-Related Quality of Life assess 'age appropriate' behaviour and measurement could be extended to older children. A sample of 203 children 3-4 years of age was recruited, and their caregivers completed the TANDI, Pediatric Quality of Life Inventory (PedsQL) and EQ-5D-Y Proxy. Spearman and Pearson's correlation coefficients, and Kruskal-Wallis H-test were used to explore the feasibility, known-group validity, discriminate validity and concurrent validity of the TANDI. Children with a health condition (n = 142) had a lower ceiling effect (p = 0.010) and more unique health profiles (p < 0.001) than the healthy group (n = 61). The TANDI discriminated between those with and without a health condition. In children with a health condition, the TANDI discriminated between clinician rated severity of the health condition. The TANDI had moderate to strong correlations with similar PedsQL and EQ-5D-Y items and scores. The TANDI is valid for children aged 3-4 years and is recommended for children with a health condition, whereas the PedsQL may be better for healthy children. The TANDI is recommended for studies with young children whereas the EQ-5D-Y Proxy is recommended for a sample including older children or for longitudinal studies with preschoolers. Further work on the TANDI is recommended to establish test-retest reliability and responsiveness.
Collapse
Affiliation(s)
- Janine Verstraete
- Department of Paediatrics and Child Health, Division of Pulmonology, University of Cape Town, Klipfontein Road, Rondebosch, Cape Town 7700, South Africa
- Correspondence:
| | | | - Jennifer Jelsma
- Deparment of Health and Rehabilitation Sciences, Division of Physiotherapy, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa;
| |
Collapse
|
4
|
Poder TG, Guertin JR, Touré M, Pratte G, Gauvin C, Feeny D, Furlong W, Camden C. Canadian French translation and linguistic validation of the health-related quality of life utility measure for pre-school children. Expert Rev Pharmacoecon Outcomes Res 2021; 21:1195-1201. [PMID: 33625303 DOI: 10.1080/14737167.2021.1895754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND There is a need to perform a Canadian French translation and linguistic validation of the health-related quality of life utility measure for pre-school children (HuPS) conceptually equivalent to the original Canadian English version. RESEARCH DESIGN AND METHODS The translation process consisted of forward and back translations. The linguistic validation was performed with the parents of preschool children during face-to-face cognitive debriefing interviews. The whole process was done in accordance with academic standards and the guidance of the Food and Drug Administration (FDA) for patient-reported outcome instruments. RESULTS The results of back translations indicated that 89% of the sentences were identical or almost identical to the original English-language wording. The review of the back translations led to a change in 13 sentences out of 91 from the reconciled forward translation, while the linguistic validation process with 13 parents led to 14 additional changes. Preliminary reliability validation results indicate a Cronbach's alpha of 0.73. CONCLUSION The translation and linguistic testing processes were successful in creating a valid HuPS in Canadian French (HuPS-CF). This translation should be the subject of reliability and validity studies in a wide variety of clinical and general populations before to use in research projects.
Collapse
Affiliation(s)
- Thomas G Poder
- Department de management, evaluation and health policy, School of Public Health, University of Montreal.,Centre de recherche de l'IUSMM, CIUSSS de l'Est-de-l'Île de Montréal, Montreal, QC, Canada
| | - Jason R Guertin
- Department of social and preventive medicine, Faculty of Medicine, Laval University, Quebec, QC, Canada
| | - Moustapha Touré
- Department of economics, School of Management, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Gabrielle Pratte
- School of rehabilitation, Faculty of Medicine and Health Science, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Cheyenne Gauvin
- School of rehabilitation, Faculty of Medicine and Health Science, University of Sherbrooke, Sherbrooke, QC, Canada
| | - David Feeny
- Center for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
| | - William Furlong
- Center for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
| | - Chantal Camden
- School of Rehabilitation, University of Sherbrooke, Sherbrooke, QC, Canada
| |
Collapse
|
5
|
Fang X, Bai G, Windhorst DA, Feeny D, Saigal S, Duijts L, Jaddoe VWV, Hu S, Jin C, Raat H. Feasibility and validity of the Health Status Classification System-Preschool (HSCS-PS) in a large community sample: the Generation R study. BMJ Open 2018; 8:e022449. [PMID: 30567820 PMCID: PMC6303628 DOI: 10.1136/bmjopen-2018-022449] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To evaluate the feasibility, discriminant validity and concurrent validity of the Health Status Classification System-Preschool (HSCS-PS) in children aged 3 years in a large community sample in the Netherlands. DESIGN/SETTING A prospective population-based cohort in Rotterdam, the Netherlands. PARTICIPANTS A questionnaire was administrated to a sample of parents of 4546 children (36.7±1.5 months). OUTCOME MEASURES Health-related quality of life (HRQOL) of children was measured by HSCS-PS. The HSCS-PS consists of 10 original domains. Two single-item measures of 'General health' and 'Behavior' were added. A disability score was calculated by summing up all 10 original domains to describe the overall health status. Feasibility was assessed by the response rate, percentages of missing answers, score distributions and the presence of floor/ceiling effects. Discriminant validity was analysed between subgroups with predefined conditions: low birth weight, preterm birth, wheezing, Ear-Nose-Throat surgical procedures and behaviour problems. In the absence of another HRQOL measure, this study uses the single-items 'General health' and 'Behavior' as a first step to evaluate concurrent validity of the HSCS-PS. RESULTS Feasibility: response rate was 69%. Ceiling effects were observed in all domains. Discriminant validity: the disability score discriminated clearly between subgroups of children born with a 'very low birth weight', 'very preterm birth', with 'four or more than four times wheezing', 'at least one ear-nose-throat surgical procedures', 'behaviour problems present' and the 'reference' group. Concurrent validity: HSCS-PS domains correlated better with hypothesised parallel additional domains than with other non-hypothesised original domains. CONCLUSIONS This study supports the feasibility and validity of the HSCS-PS among preschoolers in community settings. We recommend developing a utility-based scoring algorithm for the HSCS-PS. Further empirical studies and repeated evaluations in varied populations are recommended.
Collapse
Affiliation(s)
- Xinye Fang
- Shanghai Medical Information Center, Shanghai, China
- Shanghai Health Development Research Center, Shanghai, China
| | - Guannan Bai
- Department of Public Health, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
- The Generation R Group, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Dafna A Windhorst
- Department of Public Health, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - David Feeny
- Department of Economics and Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
| | - Saroj Saigal
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Liesbeth Duijts
- Division of Respiratory Medicine and Allergology, Department of Pediatrics, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
- Division of Neonatology, Department of Pediatrics, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Group, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatrics, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Shanlian Hu
- Shanghai Health Development Research Center, Shanghai, China
| | - Chunlin Jin
- Shanghai Medical Information Center, Shanghai, China
- Shanghai Health Development Research Center, Shanghai, China
| | - Hein Raat
- Department of Public Health, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
6
|
Poder TG, Carrier N, Mead H, Stevens KJ. Canadian French translation and linguistic validation of the child health utility 9D (CHU9D). Health Qual Life Outcomes 2018; 16:168. [PMID: 30157857 PMCID: PMC6114803 DOI: 10.1186/s12955-018-0998-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 08/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several preference based measures are validated for adults in cost utility analysis, but less are available for children and many researchers have criticized the quality of pediatric economic studies. The objective of this study was to perform a Canadian French translation and linguistic validation of the Child Health Utility 9D (CHU9D) that was conceptually equivalent to the original English version for use in Canada. METHODS The translation and linguistic validation were realized by ICON Clinical Research (UK) Limited in association with the developer of the CHU9D and Canadian collaborators. This was done in accordance with industry standards and the guidance of the Food and Drug Administration (FDA) for patient-reported outcome (PRO) instruments. Five steps were considered: concept elaboration; forward translation; back translation; linguistic validation; proofreading and final verification. RESULTS The CHU9D Canadian French translation and linguistic validation were realized without any major difficulties. Only 3 changes were made after the forward translation and 5 after the back translation. The result of back translation was very similar to the original English version. Six additional changes suggested by the developer team were accepted and the linguistic validation with five children led to 2 additional changes. Most changes were generally to change one word to better sounding Canadian French. CONCLUSION We produced a Canadian French translation and cross-cultural adaptation of the Child Health Utility 9D (CHU9D). Before being used in clinical settings and research projects, the final Canadian French translation needs to be validated for metrological qualities of reliability and validity.
Collapse
Affiliation(s)
- Thomas G Poder
- UETMIS and CRCHUS, CIUSSS de l'Estrie - CHUS, Sherbrooke, Canada.
| | | | | | | |
Collapse
|
7
|
Morris C, Janssens A, Allard A, Thompson Coon J, Shilling V, Tomlinson R, Williams J, Fellowes A, Rogers M, Allen K, Beresford B, Green C, Jenkinson C, Tennant A, Logan S. Informing the NHS Outcomes Framework: evaluating meaningful health outcomes for children with neurodisability using multiple methods including systematic review, qualitative research, Delphi survey and consensus meeting. HEALTH SERVICES AND DELIVERY RESEARCH 2014. [DOI: 10.3310/hsdr02150] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BackgroundThe identification of suitable outcome measures will improve the evaluation of integrated NHS care for the large number of children affected by neurodisability, and has the potential to encourage the provision of more appropriate and effective health care. This research sought to appraise the potential of patient-reported outcome measures (PROMs) for children and young people with neurodisability.AimThis research aimed (i) to identify key outcomes of health care for children with neurodisability, beyond morbidity and mortality, from the perspectives of children, parents and professionals; (ii) to critically appraise existing generic multidimensional PROMs; and (iii) to examine whether or not the key outcomes might be measured by existing PROMs. We also sought agreement on a definition of neurodisability.MethodsData were gathered in three main ways, (i) a systematic review identified eligible generic multidimensional PROMs and peer-reviewed studies evaluating psychometric performance using English-language questionnaires. Studies were appraised for methodological quality and psychometric performance was appraised using standard criteria. (ii) Focus groups and interviews with children and young people with neurodisability, and separately with parents, sought to identify important outcomes of NHS care, and their feedback on example PROM questionnaires. (iii) An online Delphi survey was conducted with a multidisciplinary sample of health professionals to seek agreement on appropriate NHS outcomes. In addition, we convened a consensus meeting with a small nominal group of young people, parents and professionals; the group sought agreement on a core set of important health outcomes.ResultsFrom the systematic review, we identified 126 papers that reported eligible evidence regarding the psychometric performance of 25 PROMs. Evidence of psychometric robustness was more favourable for a small number of PROMs: KIDSCREEN (generic), DISABKIDS (chronic-generic) and Child Health Utility 9D (preference-based measure). The Pediatric Quality of Life Inventory and KINDL offer both self-report and a proxy report version for a range of age bands, but evidence of their psychometric performance was weaker. Evidence was lacking in one or more respects for all candidate PROMs, in both general populations and those with neurodisability. Proxy reporting was found generally to be poorly correlated with self-report. Focus groups and interviews included 54 children and young people, and 53 parents. The more important health outcomes were felt to be communication, emotional well-being, pain, mobility, independence/self-care, worry/mental health, social activities and sleep. In addition, parents of children with intellectual impairment identified behaviour, toileting and safety as important outcomes. Participants suggested problems with the face validity of example PROM questionnaires for measuring NHS care. In the Delphi survey, 276 clinicians from a wide range of professions contributed to at least one of four rounds. Professionals rated pain, hearing, seeing, sleep, toileting, mobility and communication as key goals for the NHS but also identified treating neurological symptoms as important. Professionals in the Delphi survey and parents working with the research team agreed a proposed definition for neurodisability. The consensus meeting confirmed overlap between the outcomes identified as important by young people, parents and professionals, but not complete agreement.ConclusionsThere was agreement between young people, parents and professionals regarding a core suite of more important health outcomes: communication, emotional well-being, pain, mobility, independence/self-care, worry/mental health, social activities and sleep. In addition, behaviour, toileting and safety were identified as important by parents. This research suggests that it would be appropriate to measure these constructs using PROMs to assess health care. None of the candidate PROMs in the review adequately captures all of the identified constructs, and there is inadequate evidence that candidate PROMs are psychometrically robust for use across children with neurodisability. Further consultation with young people, families and professionals is warranted to support the use of PROMs to measure NHS outcomes. Research to test potential PROMs with different age groups and conditions would be valuable.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
Collapse
Affiliation(s)
| | - Astrid Janssens
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Amanda Allard
- Council for Disabled Children, National Children’s Bureau, London, UK
| | | | - Valerie Shilling
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Richard Tomlinson
- Department of Child Health, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Jane Williams
- Department of Child Health and Paediatrics, Nottingham Children’s Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Andrew Fellowes
- Council for Disabled Children, National Children’s Bureau, London, UK
| | - Morwenna Rogers
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Karen Allen
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | | | - Colin Green
- University of Exeter Medical School, University of Exeter, Exeter, UK
| | | | - Alan Tennant
- Department of Rehabilitation Medicine, University of Leeds, Leeds, UK
| | - Stuart Logan
- University of Exeter Medical School, University of Exeter, Exeter, UK
| |
Collapse
|
8
|
Barr RD, Feeny D, Furlong W, Horsman J. Letter to the Editor: Concerning Paltzer, Jason, Emily Barker, and Whitney P. Witt: Measuring the health-related quality of life (HRQoL) of young children in resource-limited settings: a review of existing measures, Quality of Life Research. Qual Life Res 2014; 23:1047-8. [DOI: 10.1007/s11136-013-0558-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2013] [Indexed: 11/30/2022]
|
9
|
Solans M, Pane S, Estrada MD, Serra-Sutton V, Berra S, Herdman M, Alonso J, Rajmil L. Health-related quality of life measurement in children and adolescents: a systematic review of generic and disease-specific instruments. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2008; 11:742-64. [PMID: 18179668 DOI: 10.1111/j.1524-4733.2007.00293.x] [Citation(s) in RCA: 379] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
OBJECTIVE To identify currently available generic and disease-specific health-related quality of life (HRQOL) instruments for children and adolescents up to 19 years old, to describe their content, and to review their psychometric properties. STUDY DESIGN Previous reviews on the subject and a new literature review from 2001 to December 2006 (MEDLINE, the ISI Science Citation Index, HealthSTAR and PsycLit) were used to identify measures of HRQOL for children and adolescents. The characteristics (country of origin, age range, type of respondent, number of dimensions and items, name of the dimensions and condition) and psychometric properties (reliability, validity, and sensitivity to change) of the instruments were assessed following international guidelines published by the Scientific Committee of the Medical Outcomes Trust. RESULTS In total, 30 generic and 64 disease-specific instruments were identified, 51 of which were published between 2001 and 2005. Many generic measures cover a core set of basic concepts related to physical, mental and social health, although the number and name of dimensions varies substantially. The lower age limit for self-reported instruments was 5-6 years old. Generic measures developed recently focused on both child self-report and parent-proxy report, although 26% of the disease-specific questionnaires were exclusively addressed to proxy-respondents. Most questionnaires had tested internal consistency (67%) and to a lesser extent test-retest stability (44.7%). Most questionnaires reported construct validity, but few instruments analyzed criterion validity (n = 5), structural validity (n = 15) or sensitivity to change (n = 14). CONCLUSIONS The development of HRQOL instruments for children and adolescents has continued apace in recent years, particularly with regard to disease-specific questionnaires. Many of the instruments meet accepted standards for psychometric properties, although instrument developers should include children from the beginning of the development process and need to pay particular attention to testing sensitivity to change.
Collapse
Affiliation(s)
- Maite Solans
- Agency for Quality, Research and Assessment in Health (AQuRAHealth), formerly Catalan Agency for Health Technology Assessment and Research, Barcelona, Spain
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Raat H, Landgraf JM, Oostenbrink R, Moll HA, Essink-Bot ML. Reliability and validity of the Infant and Toddler Quality of Life Questionnaire (ITQOL) in a general population and respiratory disease sample. Qual Life Res 2007; 16:445-60. [PMID: 17111231 PMCID: PMC2792359 DOI: 10.1007/s11136-006-9134-8] [Citation(s) in RCA: 145] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2006] [Accepted: 09/26/2006] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate feasibility, internal consistency, test-retest reliability, and concurrent and discriminative validity of the Infant and Toddler Quality of Life Questionnaire (ITQOL) for parents of pre-school children with 12 scales (103-items) covering physical and psychosocial domains and impact of child health on parents, in comparison with the TNO-AZL Pre-school Children Quality of Life Questionnaire (TAPQOL). METHODS Parents of children from a random general population sample (2 months-4 years old; n = 500) and of an outpatient clinic sample of children with respiratory disease (5 months-[Formula: see text] years old; n = 217) were mailed ITQOL and TAPQOL questionnaires; a retest was sent after two weeks. RESULTS Feasibility: The response was >or=80% with few missing and non-unique ITQOL-answers (<2%) in both study populations. Some ITQOL-scales (3-4 scales) showed a ceiling effect (>25% at maximum score). Internal consistency: All Cronbach's alpha >0.70. Test-retest Intraclass Correlation Coefficients (ICCs) were moderate or adequate (>or=0.50; p < 0.01) for 10 ITQOL-scales. VALIDITY ITQOL-scales, with a few exceptions, correlated better with predefined parallel TAPQOL scales than with non-parallel scales. Five to eight ITQOL-scales discriminated clearly between children with few and with many parent-reported chronic conditions, between children with and without doctor-diagnosed respiratory disease and with a low and a high parent-reported medical consumption (p < 0.05). CONCLUSIONS This study supported the evidence that the ITQOL is a feasible instrument with adequate psychometric properties. The study provided reference ITQOL scores for gender/age subgroups. We recommend repeated evaluations of the ITQOL in varied populations, especially among very young children, including repeated assessments of test-retest characteristics and evaluations of responsiveness to change. We recommend developing and evaluating a shortened ITQOL version.
Collapse
Affiliation(s)
- Hein Raat
- Department of Public Health, Erasmus MC - University Medical Center Rotterdam, P.O. Box 2040, Rotterdam, ZH, 3000, CA, The Netherlands.
| | | | | | | | | |
Collapse
|
11
|
Lau KM, Chow SMK, Lo SK. Parents’ perception of the quality of life of preschool children at risk or having developmental disabilities. Qual Life Res 2006; 15:1133-41. [PMID: 17048077 DOI: 10.1007/s11136-006-0067-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2006] [Indexed: 10/24/2022]
Abstract
Despite increased concern for the health related quality of life (HRQOL) of people with disabilities, little is known about the HRQOL of children with developmental disabilities. The present study aimed to explore the HRQOL of children who were at risk or having developmental disabilities in Hong Kong. Using the parent-reported Chinese Pediatric Quality of Life Inventory (PedsQL), the HRQOL of 173 children (2-4 years) with signs of delays in development was contrasted with that of 132 children with typical development. We found that those who exhibited high risk of developing a developmental disability had significantly lower overall well-being (76.3 +/- 13.7 vs. 84.2 +/- 11.3; p<0.001) and psychosocial health (71.3 +/- 15.6 vs. 82.5 +/- 12.9; p<0.001) but not necessarily physical health. The findings are consistent with previous findings in children with different disabilities and chronic illnesses. They suggest children at risk or having DDs need help in restoring their quality of life up to the standard experienced by their healthy peers, particular in psychosocial aspects such as social functioning, emotion functioning, and school functioning.
Collapse
Affiliation(s)
- Ka-Ming Lau
- Hong Chi Pinehill Preschool Center, Hong Kong SAR, China
| | | | | |
Collapse
|
12
|
Furlong W, Barr RD, Feeny D, Yandow S. Patient-focused measures of functional health status and health-related quality of life in pediatric orthopedics: a case study in measurement selection. Health Qual Life Outcomes 2005; 3:3. [PMID: 15647118 PMCID: PMC548287 DOI: 10.1186/1477-7525-3-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2004] [Accepted: 01/12/2005] [Indexed: 11/23/2022] Open
Abstract
The objectives of this report are to review the assessment of patient-focused outcomes in pediatric orthopedic surgery, to describe a framework for identifying appropriate sets of measures, and to illustrate an application of the framework to a challenging orthopedic problem. A detailed framework of study design and measurement factors is described. The factors are important for selecting appropriate instruments to measure health status and health-related quality of life (HRQL) in a particular context. A study to evaluate treatment alternatives for patients with neurofibromatosis type 1 and congenital tibial dysplasia (NF1-CTD) provides a rich illustration of the application of the framework. The application involves great variability in the instrument selection factors. Furthermore, these patients and their supportive caregivers face numerous complex health challenges with long-term implications for HRQL. Detailed summaries of important generic preference-based multi-attribute measurement systems, pediatric health profile instruments, and pediatric orthopedic-specific instruments are presented. Age-appropriate generic and specific measures are identified for study of NF1-CTD patients. Selected measures include the Activities Scale for Children, Gillette Functional Assessment Questionnaire Walking Scale, Health Utilities Index, and Pediatric Inventory of Quality of Life. Reliable and valid measures for application to pediatric orthopedics are available. There are important differences among measures. The selected measures complement each other. The framework in this report provides a guide for selecting appropriate measures. Application of appropriate sets of measures will enhance the ability to describe the morbidity of pediatric orthopedic patients and to assess the effectiveness of alternative clinical interventions. The framework for measurement of health status and HRQL from a patient perspective has relevance to many other areas of orthopedic practice.
Collapse
Affiliation(s)
- William Furlong
- Centre for Health Economics and Policy Analysis, and Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton Canada
- Health Utilities Inc., Dundas Canada
| | - Ronald D Barr
- Department of Pediatrics, McMaster University, Hamilton Canada
- McMaster Children's Hospital, Hamilton Health Sciences, Hamilton Canada
| | - David Feeny
- Health Utilities Inc., Dundas Canada
- Institute of Health Economics, Edmonton Canada
- Departments of Public Health Sciences and Economics and Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton Canada
| | - Suzanne Yandow
- Honolulu Shriners Hospital for Children, Honolulu, Hawaii USA
| |
Collapse
|