Measuring quality of life in children with obstructive sleep disorders.
OBJECTIVE
To validate a disease-specific health-related quality of life (HRQOL) instrument for children with obstructive sleep disorders (OSDs).


METHODS
Prospective cohort study using a 6-item health-related instrument (OSD-6).


METHODS
One hundred caregivers of patients with OSDs secondary to adenotonsillar hypertrophy (age range, 2-12 years) from 2 tertiary care, pediatric otolaryngology practices.


METHODS
The OSD-6 was administered on initial presentation and 4 to 5 weeks after adenotonsillectomy. A subset of patients repeated the OSD-6 within 3 weeks after presentation to assess test-retest reliability.


METHODS
Test-retest reliability, internal consistency, construct validity, and responsiveness to clinical change of the OSD-6 score.


RESULTS
Test-retest reliability was good (intraclass correlation coefficient = 0.74). Median OSD-6 score was 4.5 (0- to 6-point scale) with higher scores indicating poorer quality of life (QOL). Construct validity was demonstrated by the moderate correlation between OSD-6 score and global adenoid and tonsil-related QOL (R = -0.62), strong correlation between the OSD-6 change score and change in global adenoid and tonsil-related QOL (R = -0.63), and the moderate correlation between the change score and parent estimate of clinical change (R = 0.40). The mean change in OSD-6 score after adenotonsillectomy was 3.0 (95% confidence interval, 2.7-3.4). The mean standardized response was 2.3 (95% confidence interval, 1.9-2.7) indicating the instrument's large responsiveness to clinical change. The change score was very reliable (R = 0.85).


CONCLUSIONS
The OSD-6 is a reliable, responsive, easily administered instrument. It is valid for detecting change after adenotonsillectomy in children with OSDs. Arch Otolaryngol Head Neck Surg. 2000;126:1423-1429
de Serres
L M
LM
Division of Pediatric Otolaryngology, Children's Hospital and Regional Medical Center, University of Washington, Seattle, USA. LMD54@columbia.edu
Derkay
C
C
Astley
S
S
Deyo
R A
RA
Rosenfeld
R M
RM
Gates
G A
GA
D000233:Adenoidectomy; D000367:Age Factors; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D012106:Research; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000601:surgery*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014068:Tonsillectomy