Generic patient-reported outcomes in child health research: a review of conceptual content using World Health Organization definitions.
OBJECTIVE
Our aims were to (1) describe the conceptual basis of popular generic instruments according to World Health Organization (WHO) definitions of functioning, disability, and health (FDH), and quality of life (QOL) with health-related quality of life (HRQOL) as a subcomponent of QOL; (2) map the instruments to the International Classification of Functioning, Disability and Health (ICF); and (3) provide information on how the analyzed instruments were used in the literature. This should enable users to make valid choices about which instruments have the desired content for a specific context or purpose.


METHODS
Child health-based literature over a 5-year period was reviewed to find research employing health status and QOL/HRQOL instruments. WHO definitions of FDH and QOL were applied to each item of the 15 most used instruments to differentiate measures of FDH and QOL/HRQOL. The ICF was used to describe the health and health-related content (if any) in those instruments. Additional aspects of instrument use were extracted from these articles.


RESULTS
Many instruments that were used to measure QOL/HRQOL did not reflect WHO definitions of QOL. The ICF domains within instruments were highly variable with respect to whether body functions, activities and participation, or environment were emphasized.


CONCLUSIONS
There is inconsistency among researchers about how to measure HRQOL and QOL. Moreover, when an ICF content analysis is applied, there is variability among instruments in the health components included and emphasized. Reviewing content is important for matching instruments to their intended purpose.
Department of Pediatrics at McMaster University, Hamilton, ON, Canada. fayedn@mcmaster.ca
Nora
N
Fayed
Olaf Kraus
OK
de Camargo
Elizabeth
E
Kerr
Peter
P
Rosenbaum
Ankita
A
Dubey
Cristina
C
Bostan
Markus
M
Faulhaber
Parminder
P
Raina
Alarcos
A
Cieza
D002648:Child; D002669:Child Welfare / Q000145:classification; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000592:standards; D011788:Quality of Life; D011795:Surveys and Questionnaires / Q000592:standards / Q000706:statistics & numerical data; D014944:World Health Organization