title: Comparison of 4 Pediatric Health-Related Quality-of-Life Instruments: A Study on a Medicaid Population.
abstract: Few studies have compared multiple health-related quality-of-life (HRQOL) instruments simultaneously for pediatric populations. This study aimed to test psychometric properties of 4 legacy pediatric HRQOL instruments: the Child Health and Illness Profile (CHIP), the KIDSCREEN-52, the KINDL, and the Pediatric Quality of Life Inventory (PedsQL).
  
  
  
  This study used data from 908 parents whose children (ages 2-19 years) 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) versus 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).
  
  
  
  Domain scores of the 4 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, KINDL, and 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.
  
  
  
  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.
authors.affiliation: Center for Outcomes and Effectiveness Research and Education, University of Alabama at Birmingham, AL, USA (KMK)
authors.forename: Kelly M
authors.initials: KM
authors.lastname: Kenzik
authors.affiliation: Division of General Pediatrics, Department of Pediatrics, University of Florida, Gainesville, FL, USA (SYT)
authors.forename: Sanjeev Y
authors.initials: SY
authors.lastname: Tuli
authors.affiliation: Center for Health Outcomes Research, Evidera, Bethesda, MD, USA (DAR)
authors.forename: Dennis A
authors.initials: DA
authors.lastname: Revicki
authors.affiliation: Institute for Child Health Policy, Department of Health Outcomes & Policy, University of Florida, Gainesville, FL, USA (EAS, I-CH).
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Shenkman
authors.affiliation: Institute for Child Health Policy, Department of Health Outcomes & Policy, University of Florida, Gainesville, FL, USA (EAS, I-CH).
authors.forename: I-Chan
authors.initials: IC
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005163:Factor Analysis, Statistical; D005260:Female; D005431:Florida; D006304:Health Status; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D010290:Parents / Q000523:psychology; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires / Q000592:standards*; D014481:United States; D055815:Young Adult
keywords: HRQOL; Medicaid; measurement; pediatric
references.citation: Disabil Rehabil. 2011;33(15-16):1330-9
references.pmid: 21067341
references.citation: J Behav Med. 2004 Jun;27(3):297-318
references.pmid: 15259457
references.citation: Pharmacoeconomics. 1999 Dec;16(6):605-25
references.pmid: 10724790
references.citation: Med Care. 2001 Sep;39(9):990-1001
references.pmid: 11502956
references.citation: Ambul Pediatr. 2004 Jul-Aug;4(4 Suppl):371-6
references.pmid: 15264962
references.citation: Pediatrics. 2001 Aug;108(2):264-70
references.pmid: 11483786
references.citation: Med Care. 2004 Mar;42(3):210-20
references.pmid: 15076820
references.citation: Ambul Pediatr. 2003 Nov-Dec;3(6):329-41
references.pmid: 14616041
references.citation: Qual Life Res. 1998 Jul;7(5):399-407
references.pmid: 9691720
references.citation: Dev Med Child Neurol. 2006 Apr;48(4):311-8
references.pmid: 16542522
references.citation: Med Care. 1996 Mar;34(3):220-33
references.pmid: 8628042
references.citation: Health Qual Life Outcomes. 2009 Aug 26;7:77
references.pmid: 19709410
references.citation: Expert Rev Pharmacoecon Outcomes Res. 2005 Jun;5(3):353-64
references.pmid: 19807604
references.citation: Disabil Rehabil. 2011;33(7):605-16
references.pmid: 20695793
references.citation: Dev Neurorehabil. 2011;14(1):41-53
references.pmid: 21034288
references.citation: Arthritis Rheum. 2006 Jun 15;55(3):378-84
references.pmid: 16739206
references.citation: Med Care. 2000 Feb;38(2):175-86
references.pmid: 10659691
references.citation: Arch Dis Child. 2001 Mar;84(3):205-11
references.pmid: 11207164
references.citation: Health Qual Life Outcomes. 2005 May 16;3:34
references.pmid: 15904527
references.citation: JAMA. 2002 Dec 18;288(23):3027-34
references.pmid: 12479768
references.citation: Health Qual Life Outcomes. 2004 Sep 10;2:48
references.pmid: 15361252
references.citation: Med Care. 1993 Mar;31(3):247-63
references.pmid: 8450681
references.citation: Pharmacoeconomics. 2005;23(7):659-85
references.pmid: 15987225
references.citation: Med Care. 1999 Feb;37(2):126-39
references.pmid: 10024117
references.citation: J Clin Psychol. 2001 Apr;57(4):571-85
references.pmid: 11255207
references.citation: Ambul Pediatr. 2002 Jan-Feb;2(1):38-48
references.pmid: 11888437
references.citation: Pharmacoeconomics. 2006;24(12):1199-220
references.pmid: 17129075
references.citation: Med Care. 2000 Sep;38(9 Suppl):II28-42
references.pmid: 10982088
references.citation: Value Health. 2008 Jul-Aug;11(4):742-64
references.pmid: 18179668
references.citation: BMJ. 1997 Feb 22;314(7080):572
references.pmid: 9055718
references.citation: Value Health. 2008 Jul-Aug;11(4):645-58
references.pmid: 18179669
references.citation: J Pediatr Psychol. 2003 Jan-Feb;28(1):29-39
references.pmid: 12490628
references.citation: J Pediatr. 2002 Jul;141(1):76-83
references.pmid: 12091855
references.citation: BMJ. 2001 May 26;322(7297):1297-300
references.pmid: 11375237
references.citation: Am J Dis Child. 1992 Jan;146(1):103-7
references.pmid: 1531284
references.citation: J Pediatr Psychol. 2011 Sep;36(8):878-90
references.pmid: 21745809
references.citation: Health Qual Life Outcomes. 2007 Jan 03;5:2
references.pmid: 17201923
references.citation: Psychol Bull. 1959 Mar;56(2):81-105
references.pmid: 13634291
references.citation: Am J Public Health. 2010 Sep;100(9):1611-6
references.pmid: 20634449
references.citation: Med Care. 1995 May;33(5):553-66
references.pmid: 7739277
references.citation: N Engl J Med. 2000 Feb 3;342(5):326-33
references.pmid: 10655532
references.citation: Med Care. 2004 Mar;42(3):221-31
references.pmid: 15076821
references.citation: J Asthma. 2010 Apr;47(3):295-302
references.pmid: 20394514
references.citation: Dev Med Child Neurol. 2009 Aug;51(8):660-9
references.pmid: 19627340