PedsQL

Original Editor - Khloud Shreif

Top Contributors - Khloud Shreif  


Objective[edit | edit source]

The Pediatric Quality of Life Inventory (PedsQL) is a valid, practical, brief, standardized, generic, and self-reporting assessment tool to measure health-related quality of life HRQOL for pediatrics and adolescents, it can be carried by patients himself and their parents, there are different forms for both methods.

PedsQL measure facilitates to assess risk, tracking health status, assessing the impact of an intervention on HRQOL, and used for measuring treatment outcomes for inpatient in pediatric populations. PedsQL is used with both healthy school populations and with pediatric populations with acute and chronic health conditions, there are different modules of PedsQL for different health conditions for pediatrics that developed by the creators of PedsQL[1].

The PedsQL 4.0 Generic Core Scales instrument is the last version of PedsQL contain 23-items, including formats for typically developing children and adolescents 2 to 18 years old, and consists of the following:

  1. Physical functioning (8 items).
  2. Emotional functioning (5 items).
  3. Social functioning (5 items).
  4. School functioning (5 items).

Intended Population[edit | edit source]

PedsQL was used with healthy populations, and to measure primary outcomes with inpatient children.

There are different modules of PedsQL used with acute and chronic[2]:

  • Duchene muscular dystrophy
  • Neuromuscular disease
  • Asthma: PedsQLTM 3.0 Asthma Module Asthma contains 28-item including four scales; asthma symptoms (11 items), treatment problems (11 items), Worry (3 items), and communication (3 items)[3].
  • Cardiac conditions: PedsQL 3.0 Cardiac Module use the same format of PedsQL and contain items specific to heart disease as follows; symptoms (7 items), perceived physical appearance(3 items), cognitive problems (4items), treatment anxiety (5 items), and communication(3 items).
  • Rheumatology[4]
  • Patients with diabetes
  • Cancer.

Method of Use[edit | edit source]

PedsQL contains appropriate forms for different ages of developing children 2–4, 5–7, 8–12, and 13–18 years to assess HRQOL over the past month. The self-report is used in children and adolescents ages 5 to 18 years, while parents or parent proxy-report of a child is used for children and adolescents ages 2 to 18 years.

Each item of the instrument is scored on a 5-point scale from 0- 4 for ages 8-18, (0 = never a problem, 1 = almost never a problem, 2 = sometimes a problem, 3 = often a problem, 4 = almost always a problem) ad 3-point scale for young child self reporting (ages 5- 7) as following (0 = not at all a problem, 2 = sometimes a problem, 4 = a lot of a problem) the large score means worst symptoms , scores are linearly transformed to a 0–100 scale (0 = 100, 1 = 75, 2 = 50, 3 = 25, 4 = 0) in which high score means better condition. You can find different forms for different ages here.

PHYSICAL FUNCTIONING Never

0

Almost never

1

Sometimes

2

Often

3

Almost always

4

1. Walking more than one block
2. Running
3. Participating in sports activity or exercise
4. Lifting something heavy
5. Taking a bath or shower by him or herself
6. Doing chores around the house
7. Having hurts or aches
8. Low energy level
EMOTIONAL FUNCTIONING
1. Feeling afraid or scared
2. Feeling sad or blue
3. Feeling angry
4. Trouble sleeping
5. Worrying about what will happen to him or her
SOCIAL FUNCTIONING
1. Getting along with other children
2. Other kids not wanting to be his or her friend
3. Getting teased by other children
4. Not able to do things that other children his or her age can do
5. Keeping up when playing with other children
SCHOOL FUNCTIONING
1. Paying attention in class
2. Forgetting things
3. Keeping up with schoolwork
4. Missing school because of not feeling well
5. Missing school to go to the doctor or hospital

Evidence[edit | edit source]

Reliability[edit | edit source]

Reliability varied with the age of the child, being less for younger children. Reliability was also not as good for the Rheumatology Module.

Internal consistency IC[5]: The IC  generally exceeded minimum reliability the standard of 0.70 self-report and proxy- report[6].

The PedsQL NF1 Module Scales demonstrated excellent feasibility and excellent reliability for patient self-report Total Scale Scores α = 0.98 and can be used to assess the specific symptoms associated with NF1 and problems with clinical research[7][8].

Validity[edit | edit source]

For construct validity[5]:

Healthy children show higher scores than acutely or chronically ill children. There are small to medium correlations with the number of days missed from school and the number of days the child needed care for the past month with self-report and proxy-report in addition proxy-report shows medium correlations with the number of days missed from work.

Patients with no chronic illness have reported significantly higher total scores than patients with chronic illness and showed physical and psychosocial improvements[9].

Predictive validity: it has demonstrated predictive validity for inpatient admission; risk for length of stay of 3 days or longer, unplanned readmissions, or return visits to emergency department[9][8].

Responsiveness[edit | edit source]

The PedsQL has demonstrated an improvement of the outcome measures in the inpatient, there was a significant improvement in the PedsQL score from patient admission to the follow-up, with moderate variability by age and minimal variability for patients with medical conditions[9].

References[edit | edit source]

  1. Varni JW, Seid M, Rode CA. The PedsQL™: measurement model for the pediatric quality of life inventory. Medical care. 1999 Feb 1:126-39.
  2. Varni JW, Burwinkle TM, Seid M. The PedsQL™ as a pediatric patient-reported outcome: Reliability and validity of the PedsQL™ Measurement Model in 25,000 children. Expert review of pharmacoeconomics & outcomes research. 2005 Dec 1;5(6):705-19.
  3. Seid M, Limbers CA, Driscoll KA, Opipari-Arrigan LA, Gelhard LR, Varni JW. Reliability, validity, and responsiveness of the Pediatric Quality of Life Inventory™(PedsQL™) Generic Core Scales and Asthma Symptoms Scale in vulnerable children with asthma. Journal of Asthma. 2010 Mar 1;47(2):170-7.
  4. Varni JW, Seid M, Smith Knight T, Burwinkle T, Brown J, Szer IS. The PedsQL™ in pediatric rheumatology: reliability, validity, and responsiveness of the Pediatric Quality of Life Inventory™ Generic Core Scales and Rheumatology Module. Arthritis & Rheumatism. 2002 Mar;46(3):714-25.
  5. 5.0 5.1 Varni JW, Seid M, Kurtin PS. PedsQL™ 4.0: Reliability and validity of the Pediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales in healthy and patient populations. Medical care. 2001 Aug 1:800-12.
  6. Varni JW, Burwinkle TM, Seid M, Skarr D. The PedsQL™* 4.0 as a pediatric population health measure: feasibility, reliability, and validity. Ambulatory pediatrics. 2003 Nov 1;3(6):329-41.
  7. Nutakki K, Varni JW, Swigonski NL. PedsQL Neurofibromatosis Type 1 Module for children, adolescents, and young adults: feasibility, reliability, and validity. Journal of neuro-oncology. 2018 Apr;137(2):337-47.
  8. 8.0 8.1 Varni JW, Burwinkle TM, Seid M. The PedsQL TM 4.0 as a school population health measure: feasibility, reliability, and validity. Quality of life research. 2006 Mar;15(2):203-15.
  9. 9.0 9.1 9.2 Desai AD, Zhou C, Stanford S, Haaland W, Varni JW, Mangione-Smith RM. Validity and responsiveness of the pediatric quality of life inventory (PedsQL) 4.0 generic core scales in the pediatric inpatient setting. JAMA pediatrics. 2014 Dec 1;168(12):1114-21.