Validity and Responsiveness of the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales in the Pediatric Inpatient Setting

Desai, Arti D.; Zhou, Chuan; Stanford, S Clare; Haaland, Wren; Varni, James W.; Mangione-Smith, Rita

doi:10.1001/jamapediatrics.2014.1600

Cited by 161 publications

(145 citation statements)

References 32 publications

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“…Preliminary validation of the PedsQL in the inpatient setting was recently performed in children, making it the only measure of HRQOL examined to date in this setting in children 7 . Measurement of broad health outcomes is essential in assessing pediatric surgical populations and should be considered in future research.…”

Section: Discussionmentioning

confidence: 99%

“…Measurement of broad health outcomes is essential in assessing pediatric surgical populations and should be considered in future research. Evaluation of inpatient health services from the patient and family perspective 7 is also critical when comparing outcomes of surgical care, for example by surgical center volumes, as in recent studies surrounding the debate of regionalization of pediatric surgical care. Examining change in HRQOL relative to baseline values takes into account the baseline difference in health status between samples, making such comparisons possible.…”

Section: Discussionmentioning

confidence: 99%

“…Parent proxy-report on the PedsQL has shown excellent agreement with child self-report for Total score, Physical Health, and Psychosocial Health subscales (Intraclass Correlations ≥ .81) 36 . Preliminary construct validity and responsiveness to improvement after hospitalization has recently been demonstrated in pediatric inpatients 7 . Varni et al described a 4.5 point change on the PedsQL (parent-proxy report) from baseline to follow-up assessment as a minimal clinically important difference in HRQOL, based on one Standard Error of Measurement with repeated measurement in a population sample 35 .…”

Section: Methodsmentioning

confidence: 99%

“…Baseline HRQOL in hospitalized children has been shown to predict clinical outcomes (e.g., length of stay/LOS), and changes in HRQOL from baseline to follow-up predict important cost-associated outcomes such as unplanned readmission 7 . HRQOL assessed at hospital admission and at follow-up may therefore serve as a marker of risk for poor postsurgical outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Pain and Health-Related Quality of Life After Pediatric Inpatient Surgery

Rabbitts

Palermo

Zhou

et al. 2015

The Journal of Pain

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Around 4 million children undergo inpatient surgery in the U.S. each year, however little is known about the impact of surgery and postoperative pain on children’s health-related quality of life (HRQOL) during the weeks and months after surgery. We measured pain and HRQOL in a large, heterogeneous pediatric postsurgical population from baseline to 1-month follow-up. Over a 20-month period, parents of 915 children age 2–18 years (Mean=9.6 years), 50% male, 56% white, admitted to surgical services at a children’s hospital enrolled in the study. Parent participants reported on sociodemographics, child HRQOL and pain characteristics at baseline and 1 month post-discharge. While the majority of children recovered to baseline by 1-month post-hospital discharge, 23% of children had a significant declination in HRQOL. Multivariate logistic regression analyses found that increasing child age (OR=2.1 for age 13–18), and presence of moderate-severe postsurgical pain at 1-month (OR=5.7) were significantly associated with deterioration in HRQOL from baseline to 1-month follow-up (p’s<0.05). While HRQOL returns to baseline for most children, a sizeable proportion have significant deterioration in HRQOL, which is associated with continued postsurgical pain at 1-month after hospital discharge from surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pain and Health-Related Quality of Life After Pediatric Inpatient Surgery

Rabbitts

Palermo

Zhou

et al. 2015

The Journal of Pain

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“…(13)(14)(15) PedsQL™ is an instrument of quality of life measures in children, that may be used in healthy children as well as children with given medical conditions such as asthma, cancer, or gastrointestinal tract disorders. (16,1) There are two forms of the instrument, i.e.…”

Section: Data Collectionmentioning

confidence: 99%

Flatfoot decreases school functioning among children < 11 years of age

2018

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Association of Posttraumatic Headache With Symptom Burden After Concussion in Children

et al. 2023

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ImportanceHeadache is the most common symptom after pediatric concussion.ObjectivesTo examine whether posttraumatic headache phenotype is associated with symptom burden and quality of life 3 months after concussion.Design, Setting, and ParticipantsThis was a secondary analysis of the Advancing Concussion Assessment in Pediatrics (A-CAP) prospective cohort study, conducted September 2016 to July 2019 at 5 Pediatric Emergency Research Canada (PERC) network emergency departments. Children aged 8.0-16.99 years presenting with acute (&lt;48 hours) concussion or orthopedic injury (OI) were included. Data were analyzed from April to December 2022.ExposurePosttraumatic headache was classified as migraine or nonmigraine headache, or no headache, using modified International Classification of Headache Disorders, 3rd edition, diagnostic criteria based on self-reported symptoms collected within 10 days of injury.Main Outcomes and MeasuresSelf-reported postconcussion symptoms and quality-of-life were measured at 3 months after concussion using the validated Health and Behavior Inventory (HBI) and Pediatric Quality of Life Inventory–Version 4.0 (PedsQL-4.0). An initial multiple imputation approach was used to minimize potential biases due to missing data. Multivariable linear regression evaluated the association between headache phenotype and outcomes compared with the Predicting and Preventing Postconcussive Problems in Pediatrics (5P) clinical risk score and other covariates and confounders. Reliable change analyses examined clinical significance of findings.ResultsOf 967 enrolled children, 928 (median [IQR] age, 12.2 [10.5 to 14.3] years; 383 [41.3%] female) were included in analyses. HBI total score (adjusted) was significantly higher for children with migraine than children without headache (estimated mean difference [EMD], 3.36; 95% CI, 1.13 to 5.60) and children with OI (EMD, 3.10; 95% CI, 0.75 to 6.62), but not children with nonmigraine headache (EMD, 1.93; 95% CI, −0.33 to 4.19). Children with migraine were more likely to report reliable increases in total symptoms (odds ratio [OR], 2.13; 95% CI, 1.02 to 4.45) and somatic symptoms (OR, 2.70; 95% CI, 1.29 to 5.68) than those without headache. PedsQL-4.0 subscale scores were significantly lower for children with migraine than those without headache only for physical functioning (EMD, −4.67; 95% CI, −7.86 to −1.48).Conclusions and RelevanceIn this cohort study of children with concussion or OI, those with posttraumatic migraine symptoms after concussion had higher symptom burden and lower quality of life 3 months after injury than those with nonmigraine headache. Children without posttraumatic headache reported the lowest symptom burden and highest quality of life, comparable with children with OI. Further research is warranted to determine effective treatment strategies that consider headache phenotype.

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Validity and Responsiveness of the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales in the Pediatric Inpatient Setting

Abstract: The PedsQL demonstrated responsiveness, construct validity, and predictive validity in hospitalized pediatric patients. The PedsQL may be a useful patient-reported outcome for hospital-based clinical effectiveness research.

Cited by 161 publications

References 32 publications

Pain and Health-Related Quality of Life After Pediatric Inpatient Surgery

Pain and Health-Related Quality of Life After Pediatric Inpatient Surgery

Flatfoot decreases school functioning among children < 11 years of age

Association of Posttraumatic Headache With Symptom Burden After Concussion in Children

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