Comparison of 4 Pediatric Health-Related Quality-of-Life Instruments

Abstract

Background Few studies have compared multiple health-related quality of life (HRQOL) instruments simultaneously for pediatric populations. This study aimed to test psychometric properties of four legacy pediatric HRQOL instruments: the Child Health and Illness Profile (CHIP), the KIDSCREEN-52, the KINDL, and the Pediatric Quality of Life Inventory (PedsQL). Methods This study used data of 908 parents whose children (ages 2–19) were enrolled in Florida Medicaid. Parents were asked via telephone interview to complete each instrument appropriate to the age of their children. Structural, convergent/discriminant, and known-group validities were investigated. We examined structural validity using confirmatory factor analyses. We examined convergent/discriminant validity by comparing Spearman rank correlation coefficients of homogeneous (physical functioning and physical well-being) vs. heterogeneous (physical and psychological functioning) domains of the instruments. We assessed known-groups validity by examining the extent to which HRQOL differed by the status of children with special health needs (CSHCN). Results Domain scores of the four instruments were not normally distributed and ceiling effects were significant in most domains. The KIDSCREEN-52 demonstrates the best structural validity, followed by the CHIP and the KINDL, and the PedsQL. The PedsQL and the KIDSCREEN-52 show better convergent/discriminant validity than the other instruments. Known-groups validity in discriminating CSHCN versus no needs was the best for the PedsQL, followed by the KIDSCREEN-52, the CHIP, and the KINDL. Conclusion No one instrument was fully satisfactory in all psychometric properties. Strategies are recommended for future comparison of item content and measurement properties across different HRQOL instruments for research and clinical use.

Health-related quality of life in adolescents with persistent pain and the mediating role of self-efficacy: a cross-sectional study

“…Several studies that examined the association between pain and HRQOL among adolescents showed that persistent pain is associated with reduced HRQOL [10,20,[22][23][24][25]. There are several questionnaires that measure HRQOL, of which KIDSCREEN-52 has been shown to have the best structural validity [26]. However, there is limited research investigating HRQOL and pain in a school-based population of adolescents using the 10 sub-scales of the KIDSCREEN-52 questionnaire [27].…”

Developing Item Banks for Measuring Pediatric Generic Health-Related Quality of Life: An Application of the International Classification of Functioning, Disability and Health for Children and Youth and Item Response Theory

“…In addition, good generic instruments should be able to assess the HRQoL in children with varying health conditions and across different languages and cultures [12] , [13] . Using a large sample of children enrolled in the Medicaid program, our previous study based on the classical test theory (CTT) method suggested that none of the existing pediatric HRQoL instruments (the CHIP, KIDSCREEN, KINDL-R, or PedsQL) was superior to any other in the different psychometric properties [14] , [15] . Although the CTT has often been applied to compare or develop new HRQoL instruments, the use of the CTT alone may neglect item-level information, which might bias the conclusions in comparative effectiveness research and clinical applications [16] .…”

Measuring health-related quality of life in young children: how far have we come?

“…Many of these did not contain the dimensions recommended by the World Health Organization to be central to the definition of QoL. Kenzik et al undertook a comparison of the KINDL, the KIDSCREEN-52, the PedsQL and the Child Health and Illness Profile [49]. The authors administered these questionnaires in an observational study and investigated structural, convergent/discriminant, and known-group validities.…”