Measurement Properties of the Online EuroQol-5D-Youth Instrument in Children and Adolescents With Type 1 Diabetes Mellitus: Questionnaire Study
Por:
Mayoral, K, Rajmil, L, Murillo, M, Garin, O, Pont, A, Alonso, J, Bel, J, Perez, J, Corripio, R, Carreras, G, Herrero, J, Mengibar, JM, Rodriguez-Arjona, D, Ravens-Sieberer, U, Raat, H, Serra-Sutton, V, Ferrer, M
Publicada:
12 nov 2019
Resumen:
Background: The lack of continuity between health-related quality of life (HRQoL) instruments designed for children and adults hinders change analysis with a life course approach. To resolve this gap, EuroQol (EQ) developed the EQ-5D-Youth (EQ-5D-Y), derived from the EQ-5D for adults. Few studies have assessed the metric properties of EQ-5D-Y in children with specific chronic conditions, and none have done so for children with type I diabetes mellitus (T1DM).
Objective: This study aimed to evaluate the acceptability, validity, reliability, and responsiveness of the EQ-5D-Y in children and adolescents with T1DM, when administered online.
Methods: Participants with T1DM were consecutively recruited from July to December 2014, from a list of potential candidates aged 8-19 years, who attended outpatient pediatric endocrinology units. Before every quarterly routine visit, participants received an email/telephone reminder to complete the online version of two generic HRQoL questionnaires . EQ-5D-Y and KID SCREEN-27. The EQ-5D-Y measures five dimensions, from which an equally weighted summary score was constructed (range: 0-100). Completion rate and distribution statistics were calculated. Construct validity was evaluated through known group comparisons based on general health, acute diabetic decompensations, mental health, family function, and a multitrait, multimethod matrix between EQ-5D-Y and KIDSCREEN by using Spearman correlations. Construct validity hypotheses were stated a priori. Reliability was assessed with the intraclass correlation coefficient and responsiveness by testing changes over time and calculating the effect size. Reliability and responsiveness were tested among the stable and improved subsamples defined by a KIDSCREEN-10 index change of <4.5 points or >= 4.5 points, respectively, from the first to the fourth visit.
Results: Of the 136 participants, 119 (87.5%) responded to the EQ-5D-Y at the last visit. The dimensions that showed higher percentages of participants with problems were "having pain/discomfort" (34.6%) and "worried/sad/unhappy" (28.7%). The mean (SD) of the EQ-5D-Y summary score was 8.5 (10.9), with ceiling and floor effects of 50.7% and 0%, respectively. Statistically significant HRQoL differences between groups defined by their general health (excellent/very good and good/regular/bad) and mental health (Strengths and Difficulties Questionnaire score <= 15 and >16, respectively) were found in three EQ-5D-Y dimensions ("doing usual activities," "having pain/discomfort," and "feeling worried/sad/unhappy"), summary score (effect size for general health and mental health groups=0.7 and 1.5, respectively), and KID S CREEN-10 index (effect size for general health and mental health groups=0.6 and 0.9, respectively). Significant differences in the EQ-5D-Y dimensions were also found according to acute diabetic decompensations in "looking after myself' (P=.005) and according to family function in "having pain/discomfort" (P=.03). Results of the multitrait, multimethod matrix confirmed three of the four relationships hypothesized as substantial (0.21, 0.58, 0.50, and 0.46). The EQ-5D-Y summary score presented an intraclass correlation coefficient of 0.83. Statistically significant change between visits was observed in the improved subsample, with an effect size of 0.7 (P<.001).
Conclusions: These results support the use of the EQ-5D-Y administered online as an acceptable, valid, reliable, and responsive instrument for evaluating HRQoL in children and adolescents with T1DM.
Filiaciones:
Mayoral, K:
Hosp del Mar, Med Res Inst, Hlth Serv Res Grp, Doctor Aiguader 88,Off 144, Barcelona 08003, Spain
Univ Autonoma Barcelona, Dept Paediat Obstet & Gynaecol & Prevent Med, Barcelona, Spain
Ctr Invest Biomed Red Epidemiol & Salud Publ, Madrid, Spain
Rajmil, L:
Agcy Hlth Qual & Assessment Catalonia, Barcelona, Spain
Murillo, M:
Univ Hosp Germans Trias & Pujol, Dept Pediat Endocrinol, Serv Pediat, Barcelona, Spain
Garin, O:
Hosp del Mar, Med Res Inst, Hlth Serv Res Grp, Doctor Aiguader 88,Off 144, Barcelona 08003, Spain
Ctr Invest Biomed Red Epidemiol & Salud Publ, Madrid, Spain
Pompeu Fabra Univ, Expt & Hlth Sci, Barcelona, Spain
Pont, A:
Hosp del Mar, Med Res Inst, Hlth Serv Res Grp, Doctor Aiguader 88,Off 144, Barcelona 08003, Spain
Ctr Invest Biomed Red Epidemiol & Salud Publ, Madrid, Spain
Alonso, J:
Hosp del Mar, Med Res Inst, Hlth Serv Res Grp, Doctor Aiguader 88,Off 144, Barcelona 08003, Spain
Ctr Invest Biomed Red Epidemiol & Salud Publ, Madrid, Spain
Pompeu Fabra Univ, Expt & Hlth Sci, Barcelona, Spain
Bel, J:
Univ Hosp Germans Trias & Pujol, Dept Pediat Endocrinol, Serv Pediat, Barcelona, Spain
Perez, J:
Hosp Sabadell, Corp Sanitaria Parc Tauli, Dept Pediat Endocrine, Sabadell, Spain
Univ Autonoma Barcelona, Univ Inst Parc Tauli, Sabadell, Spain
Corripio, R:
Hosp Sabadell, Corp Sanitaria Parc Tauli, Dept Pediat Endocrine, Sabadell, Spain
Univ Autonoma Barcelona, Univ Inst Parc Tauli, Sabadell, Spain
Carreras, G:
Hosp Santa Creu & Sant Pau, Pediat Endocrinol, Barcelona, Spain
Univ Autonoma Barcelona, Med Dept, Barcelona, Spain
Herrero, J:
Hosp Calella, Corp Salut Maresme & Selva, Calella, Spain
Mengibar, JM:
Hosp Blanes, Corp Salut Maresme & Selva, Blanes, Spain
Rodriguez-Arjona, D:
Agcy Hlth Qual & Assessment Catalonia, Barcelona, Spain
Ravens-Sieberer, U:
Univ Med Ctr Hamburg Eppendorf, Dept Child & Adolescent Psychiat Psychotherapy &, Hamburg, Germany
Raat, H:
Erasmus Univ, Med Ctr Rotterdam, Dept Publ Hlth, Rotterdam, Netherlands
Serra-Sutton, V:
Ctr Invest Biomed Red Epidemiol & Salud Publ, Madrid, Spain
Agcy Hlth Qual & Assessment Catalonia, Barcelona, Spain
Ferrer, M:
Hosp del Mar, Med Res Inst, Hlth Serv Res Grp, Doctor Aiguader 88,Off 144, Barcelona 08003, Spain
Univ Autonoma Barcelona, Dept Paediat Obstet & Gynaecol & Prevent Med, Barcelona, Spain
Ctr Invest Biomed Red Epidemiol & Salud Publ, Madrid, Spain
Gold, Green Published
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