Current generic childhood health-related quality-of-life instruments lack comprehensive psychometric evidence across all ages. The Pediatric Quality-of-Life Inventory v4.0 Generic Core Scales (PedsQL GCS) covers ages 2 to 18 years old, but evidence on its psychometric properties is limited to restricted age groups. This study aimed to evaluate the proxy-reported PedsQL GCS across the entire childhood lifespan.
The study used data from the Longitudinal Study of Australian Children for children aged 2 to 17 years with 1 of 6 health conditions: high weight status, eczema, attention deficit hyperactivity disorder, vision problems, hearing problems, and learning difficulty. Psychometric properties of the proxy-reported PedsQL GCS were assessed in early childhood, middle childhood, and adolescence against established criteria.
In analyses of 9317 children with 50 934 total observations, the PedsQL GCS demonstrated good acceptability across the childhood lifespan, except for high rates of missing data in 2 to 9 year olds (range = 12%-30%). Strong internal consistency was evident across health conditions and age (α range = 0.72-0.93; item-total correlations range = 0.28-0.80). Known group validity was strong with differentiation between children with/without the condition across all ages, except for eczema. Responsiveness was variable with inconsistencies mainly in early childhood.
This study adds to the PedsQL psychometric evidence base, finding that the proxy-reported PedsQL GCS demonstrated robust reliability and known group validity, good acceptability, and mixed responsiveness in Australian children with health conditions across age. We propose the PedsQL GCS as a robust instrument to take forward for valuation to directly generate utility values for use in economic evaluations.
This study examines how well the parent-reported version of the Pediatric Quality-of-Life Inventory Generic Core Scales (PedsQL GCS) works when used to measure health-related quality of life in Australian children aged 2 to 17 years with specific health conditions. Measures of health-related quality of life, such as the PedsQL GCS, help us understand how much a health condition affects a child’s daily life. These instruments are important for guiding healthcare decisions, research, and determining the allocation of health services.
This research is significant because health-related quality of life instruments for children often have limited evidence supporting their validity and reliability across different health conditions and stages of childhood. The study aimed to fill this gap by testing the PedsQL GCS across all childhood ages and for common health conditions, thereby providing evidence to support its wider use and to inform the future development of utility values for generating quality adjusted life years (QALYs) in health economic evaluations.
The study analyzed data from the Longitudinal Study of Australian Children and included 9317 children with 50,934 observations. It focused on children and adolescents with 6 health conditions: overweight or obesity, eczema, attention deficit hyperactivity disorder (ADHD), vision problems, hearing problems, and learning difficulties. The findings demonstrated that the PedsQL GCS was reliable at differentiating health-related quality of life among children with and without these health conditions. It performed well in terms of internal consistency, indicating that the items within the scales consistently measure health-related quality of life across different conditions and ages. However, the study noted that the instrument was less responsive in detecting changes over time, particularly in early childhood, suggesting potential difficulty in tracking quality of life changes in these health conditions.
For patients, caregivers, and clinicians, this research highlights the importance of reliable and valid tools to assess children's health-related quality of life, which can help in understanding the impact of health conditions on daily life. Clinicians and healthcare decision makers can rely on the use of such tools to inform treatment strategies and support allocation of resources. For researchers, the study supports the use of the PedsQL GCS as a robust tool for measuring quality of life in pediatric studies. It also identifies areas for further work, specifically improved understanding of its responsiveness and developing utility values for the PedsQL GCS.
Overall, the study suggests that the PedsQL GCS is a sound tool for evaluating health-related quality of life in children, and the development of country-specific valuation sets would enable its use in economic evaluations and better support informed decision making in pediatric healthcare.