The European Journal of Health Economics

, Volume 15, Issue 9, pp 967–977

Validity and responsiveness of the EQ-5D and the KIDSCREEN-10 in children with ADHD

  • Clazien Bouwmans
  • Annemarie van der Kolk
  • Mark Oppe
  • Saskia Schawo
  • Elly Stolk
  • Michel van Agthoven
  • Jan Buitelaar
  • LeonaHakkaart van Roijen
Original Paper

Abstract

Background

The aim of our study is to compare the validity of a generic preference-based Quality of Life (QoL) instrument for adults to that of a generic child-specific QoL instrument in children and adolescents with attention deficit hyperactivity disorder (ADHD).

Methods

EQ-5D and KIDSCREEN-10 data were collected using a questionnaire survey performed among parents with a child or adolescent diagnosed with ADHD. The measurements were compared to assess (dis)similarities of the instruments’ constructs and responsiveness to different health states. Principal component analysis (PCA) with varimax rotation was used to identify factors underlying the constructs of both instruments. Instruments’ index scores of respondents with different treatment and comorbidity profiles were compared using Student’s t tests. Cohen’s effect sizes were calculated for an indirect comparison of the instruments’ responsiveness and discriminating ability. Separate analyses were performed in children aged 8–12 and 13–18 years.

Results

A strong relation was found between the EQ-5D and KIDSCREEN-10 index scores. However correlations between EQ-5D and KIDSCREEN-10 items were moderate or low. The PCA identified five separate factors of quality of life. A physical and a mental factor included a combination of three EQ-5D dimensions and six KIDSCREEN-10 items; the remaining EQ-5D and KIDSCREEN-10 items constituted complementary factors without any overlap between the separate instruments. Scores of both instruments differed significantly according to respondents’ response to treatment and comorbidity profile. Cohen’s effect sizes indicated comparable results of the instruments’ responsiveness and discriminative ability.

Conclusions

The results highlight that the instruments measure different constructs of QoL in children with ADHD. Despite this, the analyses showed comparable responsiveness and discriminative ability of the instruments. These results suggest that for economic evaluations, the EQ-5D is an appropriate and valid instrument for measuring QoL in children.

Keywords

Health-related quality of life Discriminative ability Responsiveness Validity 

References

  1. 1.
    Petrou, S.: Methodological issues raised by preference-based approaches to measuring the health status of children. Health Econ. 12(8), 697–702 (2003)PubMedCrossRefGoogle Scholar
  2. 2.
    Eiser, C., Morse, R.: The measurement of quality of life in children: past and future perspectives. J Dev Behav Pediatr. 22(4), 248–256 (2001)PubMedCrossRefGoogle Scholar
  3. 3.
    Ravens-Sieberer, U., Erhart, M., Wille, N., Wetzel, R., Nickel, J., Bullinger, M.: Generic health-related quality-of-life assessment in children and adolescents: methodological considerations. Pharmacoeconomics 24(12), 1199–1220 (2006)PubMedCrossRefGoogle Scholar
  4. 4.
    Raat, H., Landgraf, J., Bonsel, G., Gemke, R., Essink-Bot, M.: Reliability and validity of the child health questionnaire-child form (CHQ-CF87) in a Dutch adolescent population. Qual Life Res. 11, 575–581 (2002)PubMedCrossRefGoogle Scholar
  5. 5.
    Raat, H., Mohangoo, A.D., Grootenhuis, M.A.: Pediatric health-related quality of life questionnaires in clinical trials. Curr Opin Allergy Clin Immunol. 6(3), 180–185 (2006)PubMedCrossRefGoogle Scholar
  6. 6.
    Ravens-Sieberer, U., Auquier, P., Erhart, M., Gosch, A., Rajmil, L., Bruil, J., Power, M., Duer, W., Cloetta, B., Czemy, L., Mazur, J., Czimbalmos, A., Tountas, Y., Hagquist, C., Kilroe, J.: European KIDSCREEN Group: The KIDSCREEN-27 quality of life measure for children and adolescents: psychometric results from a cross-cultural survey in 13 European countries. Qual Life Res. 16(8), 1347–1356 (2007)PubMedCrossRefGoogle Scholar
  7. 7.
    Ravens-Sieberer, U., Gosch, A., Rajmil, L., Erhart, M., Bruil, J., Power, M., Duer, W., Auquier, P., Cloetta, B., Czemy, L., Mazur, J., Czimbalmos, A., Tountas, Y., Hagquist, C., Kilroe, J., Group, K.: The KIDSCREEN-52 quality of life measure for children and adolescents: psychometric results from a cross-cultural survey in 13 European countries. Value Health 11(4), 645–658 (2008)PubMedCrossRefGoogle Scholar
  8. 8.
    Ravens-Sieberer, U., Erhart, M., Rajmil, L., Herdman, M., Auquier, P., Bruil, J., Power, M., Duer, W., Abel, T., Czemy, L., Mazur, J., Czimbalmos, A., Tountas, Y., Hagquist, C., Kilroe, J.: European KIDSCREEN group: reliability, construct and criterion validity of the KIDSCREEN-10 score: a short measure for children and adolescents’ well-being and health-related quality of life. Qual Life Res. 19(10), 1487–1500 (2010)PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Fekkes, M., Theunissen, N.C., Brugman, E., Veen, S., Verrips, E.G., Koopman, H.M., Vogels, T., Wit, J.M., Verloove-Vanhorick, S.P.: Development and psychometric evaluation of the TAPQOL: a health-related quality of life instrument for 1-5-year-old children. Qual Life Res. 9(8), 961–972 (2000)PubMedCrossRefGoogle Scholar
  10. 10.
    Stolk, E.A., Busschbach, J.J., Vogels, T.: Performance of the EuroQol in children with imperforate anus. Qual Life Res. 9(1), 29–38 (2000)PubMedCrossRefGoogle Scholar
  11. 11.
    Vogels, T., Verrips, G.H., Verloove-Vanhorick, S.P., Fekkes, M., Kamphuis, R.P., Koopman, H.M., Theunissen, N.C., Wit, J.M.: Measuring health-related quality of life in children: the development of the TACQOL parent form. Qual Life Res. 7(5), 457–465 (1998)PubMedCrossRefGoogle Scholar
  12. 12.
    Varni, J.W., Limbers, C.A., Burwinkle, T.M.: How young can children reliably and validly self-report their health-related quality of life? An analysis of 8,591 children across age subgroups with the PedsQL 4.0 generic core scales. Health Qual Life Outcomes 5, 1 (2007)PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Varni, J.W., Limbers, C.A., Neighbors, K., Schulz, K., Lieu, J.E., Heffer, R.W., Tuzinkiewicz, K., Mangione-Smith, R., Zimmerman, J.J., Alonso, E.M.: The PedsQL infant scales: feasibility, internal consistency reliability, and validity in healthy and ill infants. Qual Life Res. 20(1), 45–55 (2011)PubMedCrossRefGoogle Scholar
  14. 14.
    Ravens-Sieberer, U., Wille, N., Badia, X., Bonsel, G., Burstrom, K., Cavrini, G., Devlin, N., Egmar, A.C., Gusi, N., Herdman, M., Jelsma, J., Kind, P., Olivares, P.R., Scalone, L., Greiner, W.: Feasibility, reliability, and validity of the EQ-5D-Y: results from a multinational study. Qual Life Res. 19(6), 887–897 (2010)PubMedCentralPubMedCrossRefGoogle Scholar
  15. 15.
    Wille, N., Badia, X., Bonsel, G., Burstrom, K., Cavrini, G., Devlin, N., Egmar, A.C., Greiner, W., Gusi, N., Herdman, M., Jelsma, J., Kind, P., Scalone, L., Ravens-Sieberer, U.: Development of the EQ-5D-Y: a child-friendly version of the EQ-5D. Qual Life Res. 19(6), 875–886 (2010)PubMedCentralPubMedCrossRefGoogle Scholar
  16. 16.
    Ratcliffe, J., Couzner, L., Flynn, T., Sawyer, M., Stevens, K., Brazier, J., Burgess, L.: Valuing child health utility 9D health states with a young adolescent sample: a feasibility study to compare best-worst scaling discrete-choice experiment, standard gamble and time trade-off methods. Appl Health Econ Health Policy 9(1), 15–27 (2011)PubMedCrossRefGoogle Scholar
  17. 17.
    Harpin, V.A.: The effect of ADHD on the life of an individual, their family, and community from preschool to adult life. Arch Dis Child. 90(Suppl 1), i2–i7 (2005)PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    Gillberg, C., Gillberg, I.C., Rasmussen, P., Kadesjo, B., Soderstrom, H., Rastam, M., Johnson, M., Rothenberger, A., Niklasson, L.: Co-existing disorders in ADHD: implications for diagnosis and intervention. Eur Child Adolesc Psychiatr 13(Suppl 1), I80–I92 (2004)Google Scholar
  19. 19.
    Greenhill, L.L., Halperin, J.M., Abikoff, H.: Stimulant medications. J Am Acad Child Adolesc Psychiatr. 38(5), 503–512 (1999)CrossRefGoogle Scholar
  20. 20.
    Spencer, T., Biederman, J., Wilens, T., Harding, M., O’Donnell, D., Griffin, S.: Pharmacotherapy of attention-deficit hyperactivity disorder across the life cycle. J Am Acad Child Adolesc Psychiatr. 35(4), 409–432 (1996)CrossRefGoogle Scholar
  21. 21.
    Lamers, L.M., Stalmeier, P.F., McDonnell, J., Krabbe, P.F., van Busschbach, J.J.: Measuring the quality of life in economic evaluations: the Dutch EQ-5D tariff]. Ned Tijdschr Geneeskd. 149(28), 1574–1578 (2005)PubMedGoogle Scholar
  22. 22.
    Terwee, C.B., Bot, S.D., de Boer, M.R., van der Windt, D.A., Knol, D.L., Dekker, J., Bouter, L.M., de Vet, H.C.: Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 60(1), 34–42 (2007)PubMedCrossRefGoogle Scholar
  23. 23.
    Nunnally, J.C., Bernstein, I.H.: Psychometric theory, 3rd edn. McGraw-Hill, New York (1994)Google Scholar
  24. 24.
    Fagerland, M.W.: T-tests, non-parametric tests, and large studies: a paradox of statistical practice? BMC Med Res Methodol. 12, 78 (2012)PubMedCentralPubMedCrossRefGoogle Scholar
  25. 25.
    Ravens-Sieberer U, the KIDSCREEN Europe Group: The KIDSCREEN questionnaire- Quality of life questionnaires for children and adolescents-handbook. Papst Science Publisher, Lengerich (2006)Google Scholar
  26. 26.
    Busschbach J, Rabin R, de Charro F (Eds): Proceedings of the 24the scientific plenary meeting of the EuroQol group pp. 153–165 (2009)Google Scholar
  27. 27.
    Bullinger, M.: Assessing health related quality of life in medicine. An overview over concepts, methods and applications in international research. Restor Neurol Neurosci 20(3–4), 93–101 (2002)PubMedGoogle Scholar
  28. 28.
    Anonymous The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med 41(10):1403–1409 (1995)Google Scholar
  29. 29.
    Delaney, L., Smith, J.P.: Childhood health: trends and consequences over the life course. Future Child. 22(1), 43–63 (2012)PubMedCentralPubMedCrossRefGoogle Scholar
  30. 30.
    Rabin, R., de Charro, F.: EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 33(5), 337–343 (2001)PubMedCrossRefGoogle Scholar
  31. 31.
    Noyes, J., Edwards, R.T.: EQ-5D for the assessment of health-related quality of life and resource allocation in children: a systematic methodological review. Value Health 14(8), 1117–1129 (2011)PubMedCrossRefGoogle Scholar
  32. 32.
    Tarride, J.E., Burke, N., Bischof, M., Hopkins, R.B., Goeree, L., Campbell, K., Xie, F., O’Reilly, D., Goeree, R.: A review of health utilities across conditions common in paediatric and adult populations. Health Qual Life Outcomes. 8, 12 (2010)PubMedCentralPubMedCrossRefGoogle Scholar
  33. 33.
    Willems, D.C., Joore, M.A., Nieman, F.H., Severens, J.L., Wouters, E.F., Hendriks, J.J.: Using EQ-5D in children with asthma, rheumatic disorders, diabetes, and speech/language and/or hearing disorders. Int J Technol Assess Health Care. 25(3), 391–399 (2009)PubMedCrossRefGoogle Scholar
  34. 34.
    Klaassen, R.J., Krahn, M., Gaboury, I., Hughes, J., Anderson, R., Grundy, P., Ali, S.K., Jardine, L., Abla, O., Silva, M., Barnard, D., Cappelli, M.: Evaluating the ability to detect change of health-related quality of life in children with Hodgkin disease. Cancer 116(6), 1608–1614 (2010)PubMedCrossRefGoogle Scholar
  35. 35.
    Brussoni, M., Kruse, S., Walker, K.: Validity and reliability of the EQ-5D-3LTM among a paediatric injury population. Health Qual Life Outcomes. 11(1), 157 (2013)PubMedCentralPubMedCrossRefGoogle Scholar
  36. 36.
    Grootenhuis, M.A., Koopman, H.M., Verrips, E.G., Vogels, A.G., Last, B.F.: Health-related quality of life problems of children aged 8-11 years with a chronic disease. Dev Neurorehabil. 10(1), 27–33 (2007)PubMedCrossRefGoogle Scholar
  37. 37.
    Danckaerts, M., Sonuga-Barke, E.J., Banaschewski, T., Buitelaar, J., Dopfner, M., Hollis, C., Santosh, P., Rothenberger, A., Sergeant, J., Steinhausen, H.C., Taylor, E., Zuddas, A., Coghill, D.: The quality of life of children with attention deficit/hyperactivity disorder: a systematic review. Eur Child Adolesc Psychiatr. 19(2), 83–105 (2010)CrossRefGoogle Scholar
  38. 38.
    Rebok, G., Riley, A., Forrest, C., Starfield, B., Green, B., Robertson, J., Tambor, E.: Elementary school-aged children’s reports of their health: a cognitive interviewing study. Qual Life Res. 10(1), 59–70 (2001)PubMedCrossRefGoogle Scholar
  39. 39.
    Rodriguez, E., Pinto, J.L.: The social value of health programmes: is age a relevant factor? Health Econ. 9(7), 611–621 (2000)PubMedCrossRefGoogle Scholar
  40. 40.
    Busschbach, J.J., Hessing, D.J., de Charro, F.T.: The utility of health at different stages in life: a quantitative approach. Soc Sci Med. 37(2), 153–158 (1993)PubMedCrossRefGoogle Scholar
  41. 41.
    Sculpher, M., Gafni, A.: Recognizing diversity in public preferences: the use of preference sub-groups in cost-effectiveness analysis. Health Econ. 10(4), 317–324 (2001)PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Clazien Bouwmans
    • 1
  • Annemarie van der Kolk
    • 2
  • Mark Oppe
    • 1
  • Saskia Schawo
    • 1
  • Elly Stolk
    • 1
  • Michel van Agthoven
    • 2
  • Jan Buitelaar
    • 3
  • LeonaHakkaart van Roijen
    • 1
  1. 1.Institute for Medical Technology AssessmentErasmus University RotterdamRotterdamThe Netherlands
  2. 2.Janssen-Cilag BVTilburgThe Netherlands
  3. 3.Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and BehaviorRadboud University Medical CentreNijmegenThe Netherlands

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