Development of a health state classification system for the PedsQL™ 4.0 Generic Core Scales for preference-based valuation in Australia

Journal article

Objectives: Pediatric Quality-of-Life Inventory Version 4.0 Generic Core Scales (PedsQL GCS), comprising 23 items covering 4 subscales (physical, emotional, social, and school functioning), is a widely applied generic measure of childhood health-related quality of life but does not provide health utilities for cost-effectiveness-based decision making. This study aimed to develop a reduced item version of PedsQL GCS amenable to health utility derivation in Australia.

Methods: Data sources were 2 cohorts of the Longitudinal Study of Australian Children, including proxy responses for all PedsQL GCS versions (Toddlers, Young Children, Children, and Teens), and the CheckPoint sample containing child self-report to the Children version. Three analytic samples were CheckPoint sample (n = 1874); Mallinson sample containing 1 measurement per child from one of the Young Children, Children, or Teens versions (n = 7855); and Toddlers sample (n = 7401). Exploratory and confirmatory factor analyses assessed dimensionality. Psychometric analyses used Rasch and classical criteria on 3 randomly selected subsamples (n = 500) per sample. Item selection prioritized psychometric performance in the CheckPoint sample, also considering performance in other samples and conceptual content.

Results: Dimensionality assessments did not generate an alternative empirical structure for the measure, and psychometric analyses were conducted on the original 4 subscales. The selected items were: “Get aches and pains” for physical functioning; “Feel sad/blue” for emotional functioning; “Other kids not friends” for social functioning; and “Keeping up with school work” for school functioning.

Conclusions: The final 4-item set, pending further psychometric validation and valuation, can generate health utilities from the widely used PedsQL GCS to inform cost-effectiveness-based decision making.

Authors: Kwon, J; Raghunandan, R; Nghiem, SH; Howard, K; Lancsar, E

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Elsevier
• Journal: Value in Health
• Volume: 28
• Issue: 1
• Pages: 88-98
• Publication date: 2024-09-27
• Acceptance date: 2024-08-27
• DOI: 10.1016/j.jval.2024.08.005
• EISSN: 1524-4733
• ISSN: 1098-3015
• Language: English
• Keywords: health-state classification system; health utility; item set selection; Pediatric Quality of Life Inventory Version 4.0 Generic Core Scales; psychometric evaluation