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Cited by 1,075Childhood Cancer Survivors' Quality of LifeHealth Systems, Economic Evaluations, Quality of LifePediatric Pain Management Techniques

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

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Varni, James W, Limbers, Christine A, Burwinkle, Tasha M·2007·Health and Quality of Life Outcomes
DOI 10.1186/1477-7525-5-1PMC PMC1769360
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Abstract

BACKGROUND: The last decade has evidenced a dramatic increase in the development and utilization of pediatric health-related quality of life (HRQOL) measures in an effort to improve pediatric patient health and well-being and determine the value of healthcare services. The emerging paradigm shift toward patient-reported outcomes (PROs) in clinical trials has provided the opportunity to further emphasize the value and essential need for pediatric patient self-reported outcomes measurement. Data from the PedsQL DatabaseSM were utilized to test the hypothesis that children as young as 5 years of age can reliably and validly report their HRQOL. METHODS: The sample analyzed represented child self-report age data on 8,591 children ages 5 to 16 years from the PedsQL 4.0 Generic Core Scales DatabaseSM. Participants were recruited from general pediatric clinics, subspecialty clinics, and hospitals in which children were being seen for well-child checks, mild acute illness, or chronic illness care (n = 2,603, 30.3%), and from a State Children's Health Insurance Program (SCHIP) in California (n = 5,988, 69.7%). RESULTS: Items on the PedsQL 4.0 Generic Core Scales had minimal missing responses for children as young as 5 years old, supporting feasibility. The majority of the child self-report scales across the age subgroups, including for children as young as 5 years, exceeded the minimum internal consistency reliability standard of 0.70 required for group comparisons, while the Total Scale Scores across the age subgroups approached or exceeded the reliability criterion of 0.90 recommended for analyzing individual patient scale scores. Construct validity was demonstrated utilizing the known groups approach. For each PedsQL scale and summary score, across age subgroups, including children as young as 5 years, healthy children demonstrated a statistically significant difference in HRQOL (better HRQOL) than children with a known chronic health condition, with most effect sizes in the medium to large effect size range. CONCLUSION: The results demonstrate that children as young as the 5 year old age subgroup can reliably and validly self-report their HRQOL when given the opportunity to do so with an age-appropriate instrument. These analyses are consistent with recent FDA guidelines which require instrument development and validation testing for children and adolescents within fairly narrow age groupings and which determine the lower age limit at which children can provide reliable and valid responses across age categories.

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  • The WEMWBS has good internal consistency with Cronbach's alpha coefficients of 0.89 (student sample) and 0.91 (general population sample).

    “This measure has good internal consistency with a Cronbach’s alpha coefficient of 0.89 (student sample) and 0.91 (general population sample).33”

    From Mixed-methods feasibility outcomes for a novel ACT-based video game ‘ACTing Minds’ to support mental health (2024) · cites this paper as [33]

    The Results > Internal consistency reliability tables report Cronbach’s alpha for children’s PedsQL™ 4.0 scores, not WEMWBS. Searches for WEMWBS and the stated student and general-population samples found no passage reporting the claimed coefficients for that measure; page numbers were unavailable. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

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Research works printed but not linked: 1

  1. Nunnally JC Bernstein IR Psychometric theory 1994 3rd New York, McGraw-Hill

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Authors
Varni, J. W., Limbers, C. A., & Burwinkle, T. M.
Affiliations
  • Texas A&M University (US)
  • Texas A&M Health Science Center (US)
Corresponding author
Varni, James W
ORCID
Venue
Health and Quality of Life Outcomes
Publisher
Springer Science and Business Media LLC
Published
2007-01-03
Volume
5
Issue
1
Pages
1-1
ISSN
1477-7525 (ISSN-L)
DOI
10.1186/1477-7525-5-1
PMC
PMC1769360
OpenAlex
W2121614161
Cited by
1,075
References
67
Citations by year
2026: 43 · 2025: 47 · 2024: 62 · 2023: 56 · 2022: 47 · 2021: 100 · 2020: 64 · 2019: 78 · 2018: 49 · 2017: 66 · 2016: 70 · 2015: 63 · 2014: 62 · 2013: 61 · 2012: 51
FWCI
37.68
Type
journal article
Language
en
Open access
Licence
Locations
  • Health and Quality of Life Outcomes (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • OakTrust (Texas A&M University Libraries) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
Keywords
health-related quality of life, children, self-report, PedsQL 4.0 Generic Core Scales, patient-reported outcomes, reliability statistics, construct validity, chronic disease, instrument validation, State Children's Health Insurance Program, internal consistency, effect size, well-child visits
MeSH terms
Adolescent, Age Factors, Attitude to Health, California, Child, Child Welfare, Child, Preschool, Female, Health Status, Humans, Male, Pediatrics, Psychometrics, Quality of Life, Self-Assessment, Self Disclosure

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