Abstract
Objectives
Spinal muscular atrophy (SMA) is a rare, hereditary, autosomal recessive neuromuscular disorder that, in its most severe forms, impacts infants and children. Once symptomatic, it is characterized clinically by a distinct inability to achieve motor milestones, such as the ability to lift the head, sit, stand, or walk. Quality of life (QOL) measurement in very young infants presents a particular challenge. Therefore, this review aims to highlight commonly used measurement tools and identifies future research opportunities for QOL measurement in SMA.
Methods
A systematic literature review was carried out focusing on the various tools used to measure QOL in children < 18 years of age with formally diagnosed SMA type I, II, or III. Although the disease area of interest was SMA, data on Duchenne’s muscular dystrophy were also included because of the rare nature of SMA.
Results
The Pediatric Quality of Life Inventory was the most commonly utilized tool to measure QOL in children; this included the generic and neuromuscular modules. No disease-specific tool to capture QOL in children with SMA was identified. Additionally, no measurement tools exist for very young infants (i.e., under 12 months) with SMA Type 1.
Conclusions
Evolving standards of care will lead to increased interest by stakeholders, on the methods used to measure QOL in infants and children across all types of SMA. Generic tools may not adequately capture QOL changes in SMA, especially given the age group affected by the disease. Further research is required to explore the scope for a disease-focused approach.
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Change history
14 September 2018
In the original publication of the article, the co-author name “Stefan Boes” has been mistakenly missed out. This has been updated in this correction.
References
Lunn, M. R., & Wang, C. H. (2008). Spinal muscular atrophy. The Lancet, 371(9630), 2120–2133.
Finkel, R. S., et al. (2016). Treatment of infantile-onset spinal muscular atrophy with Nusinersen: A phase 2, open-label, dose-escalation study. The Lancet, 388(10063), 3017–3026.
Luan, X., et al. (2016). Infantile spinal muscular atrophy with respiratory distress type I presenting without respiratory involvement: Novel mutations and review of the literature. Brain Development, 38(7), 685–689.
European Medicines Agency. (2017). Spinraza. Retrieved August 07, 2017, from http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/medicines/004312/human_med_002119.jsp&mid=WC0b01ac058001d124.
Kocova, H., et al. (2014). Health-related quality of life in children and adolescents with spinal muscular atrophy in the Czech Republic. Pediatric Neurology, 50(6), 591–594.
Khanna, D., & Tsevat, J. (2007). Health-related quality of life: An introduction. American Journal of Managed Care, 13(Suppl 9), S218–S223.
O’Reilly, D., et al. (2015). Evidence-based decision-making 3: Health technology assessment. Methods in Molecular Biology, 1281, 417–441.
de Oliveira, C. M., & Araújo, A. P. D. Q. C. (2011). Self-reported quality of life has no correlation with functional status in children and adolescents with spinal muscular atrophy. European Journal of Paediatric Neurology, 15(1), 36–39.
Eiser, C., & Morse, R. (2001). A review of measures of quality of life for children with chronic illness. Archives of Disease in Childhood, 84(3), 205–211.
Liberati, A., et al. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: Explanation and elaboration. BMJ, 339, b2700.
Matza, L. S., et al. (2004). Assessment of health-related quality of life in children: A review of conceptual, methodological, and regulatory issues. Value in Health, 7(1), 79–92.
Sturaro, C., et al. (2011). The role of peer relationships in the development of early school-age externalizing problems. Child Development, 82(3), 758–765.
Eiser, C., & Morse, R. (2001). Quality-of-life measures in chronic diseases of childhood. Health Technology Assessment (Winchester, England), 5(4), 1–157.
Clarke, S.-A., & Eiser, C. (2004). The measurement of health-related quality of life (QOL) in paediatric clinical trials: A systematic review. Health and Quality of life Outcomes, 2(1), 1.
Iannaccone, S. T., & Hynan, L. S. (2003). Reliability of 4 outcome measures in pediatric spinal muscular atrophy. Archives of Neurology, 60(8), 1130–1136.
Iannaccone, S. T. (2002). Outcome measures for pediatric spinal muscular atrophy. Archives of Neurology, 59(9), 1445–1450.
Davis, S. E., et al. (2010). The PedsQL™ in pediatric patients with Duchenne muscular dystrophy: Feasibility, reliability, and validity of the pediatric quality of life inventory neuromuscular module and generic core scales. Journal of Clinical Neuromuscular Disease, 11(3), 97–109.
Wallander, J. L., Schmitt, M., & Koot, H. M. (2001). Quality of life measurement in children and adolescents: Issues, instruments, and applications. Journal of Clinical Psychology, 57(4), 571–585.
Solans, M., et al. (2008). Health-related quality of life measurement in children and adolescents: A systematic review of generic and disease-specific instruments. Value in Health, 11(4), 742–764.
Lohr, K. N. (2002). Assessing health status and quality-of-life instruments: Attributes and review criteria. Quality of Life Research, 11(3), 193–205.
Davis, E., et al. (2016). Measuring the quality of life of children and adolescents☆, in reference module in biomedical sciences. New York: Elsevier.
Iannaccone, S. T., et al. (2009). The PedsQL in pediatric patients with spinal muscular atrophy: Feasibility, reliability, and validity of the Pediatric Quality of Life Inventory Generic Core Scales and Neuromuscular Module. Neuromuscular Disorders, 19(12), 805–812.
Hu, J., et al. (2013). Reliability and validity of the Chinese version of the Pediatric Quality Of Life InventoryTM (PedsQLTM) 3.0 neuromuscular module in children with Duchenne muscular dystrophy. Health Quality of Life Outcomes, 11, 47.
Messina, S., et al. (2016). Health-related quality of life and functional changes in DMD: A 12-month longitudinal cohort study. Neuromuscular Disorders, 26(3), 189–196.
Uzark, K., et al. (2012). Health-related quality of life in children and adolescents with Duchenne muscular dystrophy. Pediatrics, 130(6), e1559–e1566.
Bach, J. R., et al. (2003). Spinal muscular atrophy type 1 quality of life. American Journal of Physical Medicine & Rehabilitation, 82(2), 137–142.
Houwen-van Opstal, S. L., et al. (2014). Health-related quality of life and its relation to disease severity in boys with Duchenne muscular dystrophy: Satisfied boys, worrying parents—a case-control study. Journal of Child Neurology, 29(11), 1486–1495.
Pangalila, R. F., et al. (2015). Quality of life of adult men with Duchenne muscular dystrophy in the Netherlands: Implications for care. Journal of Rehabilitation Medicine, 47(2), 161–166.
Zamani, G., et al. (2016). The quality of life in boys with Duchenne muscular dystrophy. Neuromuscular Disorders, 26(7), 423–427.
Kohler, M., et al. (2005). Quality of life, physical disability, and respiratory impairment in Duchenne muscular dystrophy. American Journal of Respiratory and Critical Care Medicine, 172(8), 1032–1036.
Iannaccone, S. T., et al. (2009). The PedsQL™ in pediatric patients with spinal muscular atrophy: Feasibility, reliability, and validity of the Pediatric Quality of Life Inventory™ Generic Core Scales and Neuromuscular Module. Neuromuscular Disorders, 19(12), 805–812.
de Oliveira, C. M., & Alexandra, P. (2011). Self-reported quality of life has no correlation with functional status in children and adolescents with spinal muscular atrophy. European Journal of Paediatric Neurology, 15(1), 36–39.
Bendixen, R. M., et al. (2012). Participation and quality of life in children with Duchenne muscular dystrophy using the international classification of functioning, disability, and health. Health Quality of Life Outcomes, 10, 43.
Wei, Y., et al. (2016). Factors associated with health-related quality of life in children with Duchenne muscular dystrophy. Journal of Child Neurology, 31(7), 879–886.
Baiardini, I., et al. (2011). Quality of life in Duchenne muscular dystrophy: Subjective impact on children and parents. Journal of Child Neurology, 26, 707–713.
McDonald, C. M., et al. (2010). Relationship between clinical outcome measures and parent proxy reports of health-related quality of life in ambulatory children with Duchenne muscular dystrophy. Journal of Child Neurology, 25(9), 1130–1144.
Desai, A. D., et al. (2014). Validity and responsiveness of the pediatric quality of life inventory (pedsql) 4.0 generic core scales in the pediatric inpatient setting. JAMA Pediatrics, 168(12), 1114–1121.
Varni, J. (2017). Pediatric Quality Of Life Inventory™ Neuromuscular Module (PedsQL™ Neuromuscular Module). Retrieved from https://eprovide.mapi-trust.org/instruments/pediatric-quality-of-life-inventory-neuromuscular-module.
Bann, C. M., et al. (2015). Measuring quality of life in muscular dystrophy. Neurology, 84(10), 1034–1042.
Grootenhuis, M. A., de Boone, J., & van der Kooi, A. J. (2007). Living with muscular dystrophy: Health related quality of life consequences for children and adults. Health and Quality of Life Outcomes, 5, 31.
Bray, P., et al. (2010). Feasibility of a computerized method to measure quality of “everyday” life in children with neuromuscular disorders. Physical & Occupational Therapy In Pediatrics, 30(1), 43–53.
Lai, J.-S., et al. (2012). Quality-of-life measures in children with neurological conditions pediatric neuro-QOL. Neurorehabilitation and Neural Repair, 26(1), 36–47.
Vuillerot, C., et al. (2010). Self-perception of quality of life by adolescents with neuromuscular diseases. Journal of Adolescent Health, 46(1), 70–76.
Bjornson, K. F., & McLaughlin, J. F. (2001). The measurement of health-related quality of life (HRQL) in children with cerebral palsy. European Journal of Neurology, 8(s5), 183–193.
Brunner, H. I., et al. (2003). Preference-based measurement of health-related quality of life (HRQL) in children with chronic musculoskeletal disorders (MSKDs). Medical Decision Making, 23(4), 314–322.
Mabugu, T., Revill, P., & van den Berg, B. (2013). The methodological challenges for the estimation of quality of life in children for use in economic evaluation in low-income countries. Value in Health Regional Issues, 2(2), 231–239.
Wallander, J. L., & Koot, H. M. (2016). Quality of life in children: A critical examination of concepts, approaches, issues, and future directions. Clinical Psychology Review, 45, 131–143.
Theunissen, N. C. M., et al. (1998). The proxy problem: Child report versus parent report in health-related quality of life research. Quality of Life Research, 7(5), 387–397.
Varni, J. W., Limbers, C. A., & Burwinkle, T. M. (2007). 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 and Quality of Life Outcomes, 5(1), 1.
Varni, J. W., Limbers, C. A., & Burwinkle, T. M. (2007). Parent proxy-report of their children’s health-related quality of life: An analysis of 13,878 parents’ reliability and validity across age subgroups using the PedsQL™ 4.0 Generic Core Scales. Health and Quality of Life Outcomes, 5(1), 1.
Laaksonen, C., et al. (2007). Paediatric health-related quality of life instrument for primary school children: Cross-cultural validation. Journal of Advanced Nursing, 59(5), 542–550.
Bitton, A., et al. (2014). Toward a better understanding of patient-reported outcomes in clinical practice. American Journal of Managed Care, 20(4), 281–283.
Funding
Financial support was made possible through a student internship with Biogen international for the corresponding author during the Ph.D. period. This paper was funded through an internship for Shalvaree Vaidya at Biogen International. However, the internship was not contingent on the completion nor results of this review.
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The original version of this article was revised: Co-author name has been included and the e-mail address of the corresponding author has been updated.
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Vaidya, S., Boes, S. Measuring quality of life in children with spinal muscular atrophy: a systematic literature review. Qual Life Res 27, 3087–3094 (2018). https://doi.org/10.1007/s11136-018-1945-x
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DOI: https://doi.org/10.1007/s11136-018-1945-x