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A review of patient-reported outcomes for children and adolescents with obesity

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Abstract

Introduction

Obesity is a chronic condition that can impact the physical, emotional, mental and social elements that encompass a child’s life. The objectives of this study were to identify which generic and obesity-specific patient-reported outcome (PRO) instruments are used in obesity literature, as well as review their conceptual approach, health and health-related content, ethical content and psychometric properties.

Method

PubMed, CINAHL, EMBASE and PsycINFO were searched from the inception of each database to May 2012 to identify all studies using multi-dimensional PRO instruments with children who are overweight or obese. The most common generic and all obesity-specific instruments were analyzed according to the study objectives.

Results

From 4,226 articles identified by our search, 70 articles used 6 generic and 4 obesity-specific PRO instruments. While the most commonly used PRO instrument was the generic PedsQL 4.0 (used in 53 studies), many health domains were found in the obesity-specific instruments that are not measured by the PedsQL 4.0. Summary of the development and psychometric properties of the generic and obesity PROs identified that no one instrument meets all the guideline criteria for instrument development and validation, e.g., only one instrument included qualitative input from children with obesity in the content development phase.

Discussion

This comprehensive review provides information to aid in selecting multi-dimensional PRO instruments in children with obesity according to various aspects of content as well as psychometric properties. The conceptual analysis shows that the reviewed PRO instruments contain inconsistencies in their conceptual approaches. Also, certain relevant health domains to children and youth with obesity were not included in the most commonly used generic instrument. The obesity-specific instruments require further validation before they can be used in intervention studies.

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Abbreviations

CHQ:

Child Health Questionnaire

FDH:

Functioning disability and health

HRQOL:

Health-related quality of life

HUI:

Health Utilities Index

KINDL:

KINDL (registered) Quality of Life Questionnaire

ICF-CY:

International Classification of Functioning, Disability, and Health Children and Youth Version

IWQOL-Kids:

Impact of Weight on Quality of Life-Kids

PEDSQL:

Pediatric Quality of Life Inventory

PRO:

Patient-reported outcome

QOL:

Quality of life

WHO:

World Health Organization

YQOL-S:

Youth Quality of Life-Surveillance Version

YQOL-W:

Youth Quality of Life-Weight

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Acknowledgments

Anne Klassen is a recipient of the Canadian Institute of Health Research career award, and Nora Fayed is a recipient of the Canadian Institute of Health Research postdoctoral fellowship.

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Authors and Affiliations

  1. Collage Pediatric Therapy, 1100 Central Pkwy W, Mississauga, ON, L5C 4E5, Canada

    Bani Ahuja

  2. Department of Pediatrics, McMaster University, HSC 3A, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada

    Anne F. Klassen

  3. Infant and Child Development Services Peel, Trillium Health Partners, 6660 Kennedy Road, Suite 200, Mississauga, ON, L5T 2M9, Canada

    Randi Satz

  4. University of Ottawa, Ottawa, ON, Canada

    Nikita Malhotra

  5. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, L8N 3Z5, Canada

    Elena Tsangaris & Matthew Ventresca

  6. Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, L2S 3A1, Canada

    Matthew Ventresca

  7. Division of Healthcare and Outcomes Research, Toronto Western Research Institute, University Health Network, Toronto, ON, Canada

    Nora Fayed

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  1. Bani Ahuja
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  2. Anne F. Klassen
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Correspondence to Bani Ahuja.

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Ahuja, B., Klassen, A.F., Satz, R. et al. A review of patient-reported outcomes for children and adolescents with obesity. Qual Life Res 23, 759–770 (2014). https://doi.org/10.1007/s11136-013-0459-9

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