Comparing reliability and validity of pediatric instruments for measuring health and well-being of children with spastic cerebral palsy

Abstract

This study sought to examine the reliability and validity of three generic instruments for measuring the health of children with cerebral palsy (CP) and to compare them with a disease-specific measure, the Gross Motor Function Measure (GMFM). The Pediatric Evaluation and Disability Inventory (PEDI), the Pediatric Outcomes Data Collection Instrument (PODCI), and the Child Health Questionnaire (CHQ) were completed by the primary caregivers of 115 young children with spastic CP. The GMFM was administered to the children. The mean age of the sample was 5 years 8 months (range 3:1 to 10:4) and consisted of more males (58%) than females. The PEDI scales demonstrated higher internal consistency than the PODCI and CHQ scales. In comparison with the GMFM, the PODCI transfer and mobility scale (relative validity, 62%) and the PEDI mobility scale (relative validity, 53%) detected the most significant health differences between children with hemiplegia, diplegia, and quadriplegia. The PEDI social function scale detected the largest differences in cognitive function between children with an IQ of less than 70 compared with those with an IQ of 70 or greater. The reliability and validity of these different instruments varied significantly in this patient population.

Psychometric properties of the initial Brazilian version of the CHQ-PF50 applied to the caregivers of children and adolescents with cerebral palsy

“…These findings are inherent to generic assessment instruments applied in a heterogeneous group such as CP patients. Two previous studies had addressed floor and ceiling effects in only some CHQ scales in patients with CP and their results were similar to ours [6,9].…”

“…The missing data rates were low, as observed in other studies [6,18,20], and indicate good acceptance and effort on the part of those who filled out the questionnaire.…”

“…McCarthy et al [6] also found that GMFM had good correlation with the physical function scale and weak correlation with psychosocial scales (presented in our study as convergent and divergent validity respectively), but only five CHQ scales were evaluated and only spastic CP patients was included (role/social limitations-emotional behavioral scale was not studied by the authors). In the same study, GMFM showed to be better than others instruments in detecting differences in children's health among spastic motor groups.…”

“…Recently, health-related quality of life (HRQOL) has been evaluated in patients with CP in developed countries [6][7][8][9][10][11][12][13][14]. A negative impact was confirmed in relation to the healthy population in both physical and psychosocial domains [7,11,12].…”

“…In the majority of these studies, the generic instrument for the determination of HRQOL most frequently used in children and adolescents with CP was the Child Health Questionnaire (CHQ) [15]. The psychometric properties of the CHQ were tested in this population and were found to be adequate, reliable and valid [6,9,12,16].…”