The linkage between pediatric quality of life and health conditions: establishing clinically meaningful cutoff scores for the PedsQL.
OBJECTIVE
To link pediatric health-related quality of life (HRQOL) and health conditions by establishing clinically meaningful cutoff scores for an HRQOL instrument, the Pediatric Quality of Life Inventory (PedsQL).


METHODS
We conducted telephone interviews with 1745 parents whose children were between 2 and 18 years old and enrolled in the Florida KidCare program and Children's Medical Services Network in 2006. Two anchors, the Children with Special Health Care Needs (CSHCN) Screener and the Clinical Risk Groups (CRGs), were used to identify children with special health-care needs or chronic conditions. We established cutoff scores for the PedsQL's physical, emotional, social, school, and total functioning using the areas under the curves (AUCs) to determine the discriminative property of the PedsQL referring to the anchors.


RESULTS
The discriminative property of the PedsQL was superior, especially in total functioning (AUC > 0.7), between children with special health-care needs (based on the CSHCN Screener) and with moderate and major chronic conditions (based on the CRGs) as compared to healthy children. For children <8 years, the recommended cutoff scores for using total functioning to identify CSHCN were 83, 79 for moderate, and 77 for major chronic conditions. For children ≥8 years, the cutoff scores were 78, 76, and 70, respectively.


CONCLUSIONS
Pediatric HRQOL varied with health conditions. Establishing cutoff scores for the PedsQL's total functioning is a valid and convenient means to potentially identify children with special health-care needs or chronic conditions. The cutoff scores can help clinicians to conduct further in-depth clinical assessments.
Huang
I-Chan
IC
Department of Epidemiology and Health Policy Research, College of Medicine, University of Florida, Gainesville, FL, USA. ichuang@ufl.edu
Thompson
Lindsay A
LA
Chi
Yueh-Yun
YY
Knapp
Caprice A
CA
Revicki
Dennis A
DA
Seid
Michael
M
Shenkman
Elizabeth A
EA
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease / Q000523:psychology*; D005260:Female; D005431:Florida; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D002666:Psychology, Child / Q000706:statistics & numerical data; D011788:Quality of Life; D012917:Social Adjustment; D012959:Socioeconomic Factors