Quality of Life Research

, Volume 27, Issue 8, pp 2165–2176 | Cite as

Giving voice to the child perspective: psychometrics and relative precision findings for the Child Health Questionnaire self-report short form (CHQ-CF45)

  • Jeanne M. LandgrafEmail author
  • Amy van Grieken
  • Hein Raat



To derive and evaluate a shorter self-report Child Health Questionnaire (CHQ) legacy measure for use in research and clinical trials/care.


Stepwise regression, factor analysis, and item scaling principles were used to derive and guide item selection, using data from a large general sample in the Netherlands (n = 933). Feasibility was assessed in a school sample (n = 114) and item internal consistency, discriminant validity, floor, and ceiling effects were evaluated using an external larger validation sample in the US (n = 1468). Reliabilities were estimated using Cronbach’s alpha. Relative precision (RP), the ability to distinguish between clinical subgroups, was computed by comparing the proportion of variance explained by the short-form scales vs. respective full-length scales.


The CHQ-CF was reduced from 87 to 45 items. The median alpha coefficient was 0.89. Ninety-seven to 100% scaling successes for item discriminant validity were observed. Floor effects were not observed; some ceiling effects were detected. RP estimates ranged from 0.73 to 1.37.


The CHQ-SF45 is reliable and valid and exceeds item level scaling criteria.


Psychometrics Children Adolescents Health-related Quality of life PRO Child-centered 



The principal author would like to thank Suzanne Fitch, D. Ed., Mr. Mike Collins, P., teachers, and parents for their overwhelming support for this work and most especially, the students for their enthusiastic participation and insights.

Compliance with ethical standards

Conflict of interest

None of the authors received financial compensation for this work nor do they have a conflict of interest to report. Ms. Landgraf is the Vice President and Chief Scientific Officer at HealthActCHQ, Inc., which owns the intellectual property rights to the CHQ-CF45.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Jeanne M. Landgraf
    • 1
    Email author
  • Amy van Grieken
    • 2
  • Hein Raat
    • 2
  1. 1.HealthActCHQBostonUSA
  2. 2.Department of Public Health, Erasmus MCUniversity Medical CenterRotterdamThe Netherlands

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