Is the pediatric quality of life inventory valid for use in preschool children with refractive errors?

Publications // Young Lab // Nov 01 2010

PubMed ID: 20852452

Author(s): Lamoureux EL, Marella M, Chang B, Dirani M, Kah-Guan AE, Chia A, Young TL, Wong TY, Saw SM. Is the pediatric quality of life inventory valid for use in preschool children with refractive errors? Optom Vis Sci. 2010 Nov;87(11):813-22. doi: 10.1097/OPX.0b013e3181f6fb84. PMID 20852452

Journal: Optometry And Vision Science : Official Publication Of The American Academy Of Optometry, Volume 87, Issue 11, Nov 2010

PURPOSE To determine the psychometric validity of the pediatric quality of life inventory (PedsQL 4.0) in assessing the impact of refractive errors on health-related quality of life (HRQoL) in preschool children in Singapore.

METHODS Parents of toddlers (aged 25 to 48 months) and young children (49 to 72 months) completed the PedsQL 4.0, an HRQoL scale as part of population-based trial in Singapore. The outcome measures were the overall score, and the “physical”; “emotional”; “social”; and “school” functioning subscales. Rasch analysis was used to validate the PedsQL 4.0.

RESULTS Parents of 939 (48.9%) toddlers and 982 (51.1%) young children completed the PedsQL 4.0 survey. The overall mean (±standard deviation) spherical equivalence for the right eye was 0.47 ± 1.13 diopter (D) for toddlers and 0.74 ± 1.22 D for young children. One hundred forty-nine (15.9%) toddlers and 90 (9.2%) young children were considered myopic (≥-0.50 D). Most participants (n = 1286, 89.6%) had presenting visual acuity 6/9 or better. Rasch analysis showed evidence of disordered category thresholds and poor person-item targeting for both groups. The separation reliability was 0.00 for toddlers and 0.03 for young children, indicating there was no variance in both samples. The PedsQL 4.0 overall and subscale scores displayed substantial multidimensionality as the variance values explained by the measures was <25% in both groups. A minimum value of 60% is usually considering acceptable.

CONCLUSIONS The PedsQL 4.0 in its current state is not a valid psychometric scale to effectively evaluate the impact of refractive errors on HRQoL in preschool children in Singapore.