Abstract
The PedsQL™ is a modular instrument designed to measure health-related quality of life (HRQOL) in children and adolescents ages 2–18. The PedsQL™ 4.0 Generic Core Scales were developed to be integrated with the PedsQL™ Disease-Specific Modules. The PedsQL™ 3.0 Asthma Module was designed to measure pediatric asthma-specific HRQOL. The PedsQL™ was administered to 529 families. Internal consistency reliability was demonstrated for the PedsQL™ 4.0 Total Score (α = 0.90 child, 0.91 parent report) and Asthma Module (average α = 0.71 child, 0.86 parent report). The PedsQL™ 4.0 distinguished between healthy children and children with asthma. The validity of the PedsQL™ Asthma Module was demonstrated through intercorrelations with a previously standardized asthma disease- specific instrument. Responsiveness was demonstrated through patient change over time as a result of clinical intervention. The results demonstrate the reliability, validity, and responsiveness of the PedsQL™ required for an outcome measure in pediatric asthma clinical trials and research.
Similar content being viewed by others
References
Aday, L. A. (1996). Designing and Conducting Health Surveys: A Comprehensive Guide 2nd ed.,, Jossey-Bass, San Francisco.
Campbell, D. T., and Fiske, D. W. (1959). Convergent and discriminant validation by the multitrait–multimethod matrix. Psychol. Bull. 56: 81-105.
Campo, J. V., Comer, D. M., Jansen-McWilliams, L., Gardner, W., and Kelleher, K. J. (2002). Recurrent pain, emotional distress, and health service use in childhood. J. Pediatr. 141: 76-83.
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences, 2nd ed., Erlbaum, Hillsdale, NJ.
Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika 16: 297-334.
Drotar, D. (Ed.). (1998). Measuring Health-Related Quality of Life in Children and Adolescents, Erlbaum, Mahwah, NJ.
Fairclough, D. L. (2002). Design and Analysis of Quality of Life Studies in Clinical Trials: Interdisciplinary Statistics, Chapman & Hall/CRC, New York.
Fayers, P. M., and Machin, D. (2000). Quality of Life: Assessment, Analysis, and Interpretation, Wiley, New York.
Feeny, D. H., Juniper, E. F., Ferrie, P. J., Griffith, L. E., and Guyatt, G. H. (1998). Why not just ask the kids? Health-related quality of life in children with asthma. In Drotar, D. (Ed.), Measuring Health-Related Quality of Life in Children and Adolescents: Implications for Research and Practice, Erlbaum, Mahwah, NJ, pp. 171-185.
Fowler, F. J., Jr. (1995). Improving Survey Questions: Design and Evaluation,2nd ed., Sage, Thousand Oaks, CA.
French, D. J. (2001). Asthma. In Koot, H. M., and Wallander, J. L. (Eds.), Quality of Life in Child and Adolescent Illness: Concepts, Methods and Findings, Brunner-Routledge, East Sussex, UK, pp. 241-265.
Janicke, D. M., Finney, J. W., and Riley, A. W. (2001). Children's health care use: A prospective investigation of factors related to care-seeking. Med. Care 39: 990-1001.
Juniper, E. F., Guyatt, G. H., Feeny, D. H., Ferrie, P. J., Griffith, L. E., and Townsend, M. (1996). Measuring quality of life in children with asthma. Qual. Life Res. 5: 35-46.
Kazis, L. E., Anderson, J. J., and Meenan, R. F. (1989). Effect sizes for interpreting changes in health status. Med. Care 27: 178-189.
Koot, H. M., and Wallander, J. L. (Eds.). (2001). Quality of Life in Child and Adolescent Illness: Concepts, Methods and Findings, Brunner-Routledge, East Sussex, UK.
McHorney, C. A., Ware, J. E., Lu, J. F. R., and Sherbourne, C. D. (1994). The MOS 36-item short-form health survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med. Care 32: 40-66.
McHorney, C. A., Ware, J. E., and Raczek, A. E. (1993). The MOS 36-item short-form health survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med. Care 31: 247-263.
McHorney, C. A., Ware, J. E., Rogers, W., Raczek, A. E., and Lu, J. F. R. (1992). The validity and relative precision of MOS short-and long-form health status scales and Dartmouth COOP charts: Results from the Medical Outcomes Study. Med. Care 30: MS253-MS265.
National Institutes of Health (1997). Expert Panel Report 2: Guidelines for the diagnosis and management of asthma. NIH Publication No. 97-4051.
Novick, M., and Lewis, G. (1967). Coefficient alpha and the reliability of composite measurements. Psychometrika 32: 1-13.
Nunnally, J. C., and Bernstein, I. R. (1994). Psychometric Theory, 3rd ed., McGraw-Hill, New York.
Pedhazur, E. J., and Schmelkin, L. P. (1991). Measurement, Design, and Analysis: An Integrated Approach, Erlbaum, Hillsdale, NJ.
Schwarz, N., and Sudman, N. (Eds.). (1996). Answering Questions: Methodology for Determining Cognitive and Communicative Processes in Survey Research, Jossey-Bass, San Francisco.
Smith, K. W., Avis, N. E., and Assmann, S. F. (1999). Distinguishing between quality of life and health status in quality of life research: A meta-analysis. Qual. Life Res. 8: 447-459.
Spilker, B. (1996). Quality of Life and Pharmacoeconomics in Clinical Trials, 2nd ed., Lippincott-Raven, Philadelphia.
Sprangers, M. A. G., Cull, A., Bjordal, K., Groenvold, M., and Aaronson, N. K. (1993). The European Organization for Research and Treatment of Cancer approach to quality of life assessment: Guidelines for developing questionnaire modules. Qual. Life Res. 2: 287-295.
SPSS. (1998). SPSS 8.0 for Windows, SPSS, Inc., Chicago.
Thompson, K. L., and Varni, J. W. (1986). A developmental cognitive–biobehavioral approach to pediatric pain assessment. Pain 25: 282-296.
Uzark, K., Jones, K., Burwinkle, T. M., and Varni, J. W. (2003). The Pediatric Quality of Life Inventory™ in children with heart disease. Prog. Pediatr. Cardiol. 18: 141-148.
Varni, J. W., Burwinkle, T. M., Jacobs, J. R., Gottschalk, M., Kaufman, F., and Jones, K. L. (2003a). The PedsQL™ in Type 1 and Type 2 diabetes: Reliability and validity of the Pediatric Quality of Life Inventory™ Generic Core Scales and Type 1 Diabetes Module. Diabetes Care 26: 631-637.
Varni, J. W., Burwinkle, T. M., Katz, E. R., Meeske, K., and Dickinson, P. (2002a). The PedsQL™ in pediatric cancer: Reliability and validity of the Pediatric Quality of Life Inventory™ Generic Core Scales, Multidimensional Fatigue Scale, and Cancer Module. Cancer 94: 2090-2106.
Varni, J. W., Burwinkle, T. M., Seid, M., and Skarr, D. (2003b). The PedsQL™ 4.0 as a pediatric population health measure: Feasibility, reliability, and validity. Ambul. Pediatr. 3: 329-341.
Varni, J. W., Jacobs, J. R., and Seid, M. (2000). Treatment adherence as a predictor of health-related quality of life. In Drotar, D. (Ed.), Promoting Adherence to Medical Treatment in Chronic Childhood Illness: Concepts, Methods, and Interventions, Erlbaum, Mahwah, NJ, pp. 287-305.
Varni, J. W., Katz, E. R., Colegrove, R., and Dolgin, M. (1995). Adjustment of children with newly diagnosed cancer: Cross-informant variance. J. Psychosoc. Oncol. 13: 23-38.
Varni, J. W., Katz, E. R., Seid, M., Quiggins, D. J. L., and Friedman-Bender, A. (1998a). The Pediatric Cancer Quality of Life Inventory-32 (PCQL-32): I. Reliability and validity. Cancer 82: 1184-1196.
Varni, J. W., Katz, E. R., Seid, M., Quiggins, D. J. L., Friedman-Bender, A., and Castro, C. M. (1998b). The Pediatric Cancer Quality of Life Inventory (PCQL): I. Instrument development, descriptive statistics, and cross-informant variance. J. Behav. Med. 21: 179-204.
Varni, J. W., Seid, M., Knight, T. S., Burwinkle, T. M., Brown, J., and Szer, I. S. (2002b). The PedsQL™ in pediatric rheumatology: Reliability, validity, and responsiveness of the Pediatric Quality of Life Inventory™ Generic Core Scales and Rheumatology Module. Arthritis Rheum. 46: 714-725.
Varni, J. W., Seid, M., Knight, T. S., Uzark, K., and Szer, I. S. (2002c). The PedsQL™ 4.0 Generic Core Scales: Sensitivity, responsiveness, and impact on clinical decision-making. J. Behav. Med. 25: 175-193.
Varni, J. W., Seid, M., and Kurtin, P. S. (1999a). Pediatric health-related quality of life measurement technology: A guide for health care decision makers. J. Clin. Outcomes Manage. 6: 33-40.
Varni, J. W., Seid, M., and Kurtin, P. S. (2001). The PedsQL™ 4.0: Reliability and validity of the Pediatric Quality of Life Inventory™ Version 4.0 Generic Core Scales in healthy and patient populations. Med. Care 39: 800-812.
Varni, J. W., Seid, M., and Rode, C. A. (1999b). The PedsQL™: Measurement model for the Pediatric Quality of Life Inventory. Med. Care 37: 126-139.
Varni, J. W., and Setoguchi, Y. (1992). Screening for behavioral and emotional problems in children and adolescents with congenital or acquired limb deficiencies. Am. J. Dis. Child. 146: 103-107.
Varni, J. W., Thompson, K. L., and Hanson, V. (1987). The Varni/Thompson Pediatric Pain Questionnaire: I. Chronic musculoskeletal pain in juvenile rheumatoid arthritis. Pain 28: 27-38.
Varni, J. W., Waldron, S. A., Gragg, R. A., Rapoff, M. A., Bernstein, B. H., Lindsley, C. B., and Newcomb, M. D. (1996). Development of the Waldron/Varni Pediatric Pain Coping Inventory. Pain 67: 141-150.
Varni, J. W., Wilcox, K. T., Hanson, V., and Brik, R. (1988). Chronic musculoskeletal pain and functional status in juvenile rheumatoid arthritis: An empirical model. Pain 32: 1-7.
World Health Organization. (1948). Constitution of the World Health Organization Basic Document, World Health Organization, Geneva, Switzerland.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Varni, J.W., Burwinkle, T.M., Rapoff, M.A. et al. The PedsQL™ in Pediatric Asthma: Reliability and Validity of the Pediatric Quality of Life Inventory™ Generic Core Scales and Asthma Module. J Behav Med 27, 297–318 (2004). https://doi.org/10.1023/B:JOBM.0000028500.53608.2c
Issue Date:
DOI: https://doi.org/10.1023/B:JOBM.0000028500.53608.2c