Skirko Jonathan R, Weaver Edward M, Perkins Jonathan, Kinter Sara, Sie Kathleen C Y
Department of Otolaryngology–Head and Neck Surgery, University of Washington, 1959 Pacific St NE, PO Box 356515, Seattle, WA 98195, USA.
Arch Otolaryngol Head Neck Surg. 2012 Oct;138(10):929-35. doi: 10.1001/2013.jamaoto.122.
To modify the existing 45-item Velopharyngeal Insufficiency (VPI) Quality-of-Life (QOL) instrument (VPIQL), to assess the modified instrument for reliability, and to provide further validation.
Validation convenience sample from a previously conducted pilot study.
Two academic tertiary referral medical centers.
Deidentified data were used from 29 patients with VPI and 29 control patients aged 5 to 17 years and their parents.
Patients and parents completed the VPIQL and a generic pediatric QOL instrument (Pediatric Quality of Life Inventory, Version 4 [PedsQL4-0]). Twenty-two items were removed from the VPIQL for ceiling effects, floor effects, and redundancy to produce the modified instrument: the VPI Effects on Life Outcomes instrument (VELO). The VELO was tested for internal consistency (Cronbach α), discriminant validity (paired t test with control patients), and concurrent validity (Pearson correlation with the PedsQL4-0). These analyses were also completed for the parents.
The 45-item VPIQL was reduced to the 23-item VELO, which had excellent internal consistency (Cronbach α, .96 for parents and .95 for patients with VPI). The VELO also discriminated well between the patients with VPI and the control patients, with a mean (SD) score that was significantly lower (worse) for patients with VPI (67.6 [23.9]) than for control patients (97.0 [5.2]) (P < .001). The VELO total score was significantly correlated with the PedsQL4.0 (r = 0.73) among the patients with VPI. Similar results were seen in parent responses.
The VELO is a 23-item QOL instrument that was designed to measure and follow QOL in patients with VPI, with less burden than the original VPIQL. The VELO demonstrates internal consistency, discriminant validity, and concurrent validity with the PedsQL4-0.
对现有的45项腭咽闭合不全（VPI）生活质量（QOL）量表（VPIQL）进行修订，评估修订后量表的信度，并提供进一步的效度验证。
从之前进行的一项试点研究中选取验证便利样本。
两家学术性三级转诊医疗中心。
使用了29例VPI患者和29例5至17岁对照患者及其父母的匿名数据。
患者及其父母完成VPIQL和一份通用的儿科生活质量量表（儿童生活质量量表，第4版 [PedsQL4-0]）。为避免天花板效应、地板效应和冗余，从VPIQL中删除了22个条目，从而产生修订后的量表：VPI对生活结局的影响量表（VELO）。对VELO进行内部一致性（Cronbach α）、区分效度（与对照患者的配对t检验）和同时效度（与PedsQL4-0的Pearson相关性）测试。这些分析也在父母中完成。
45项的VPIQL缩减为23项的VELO，其具有出色的内部一致性（父母的Cronbach α为0.96，VPI患者的为0.95）。VELO在VPI患者和对照患者之间也有良好区分，VPI患者的平均（标准差）得分（67.6 [23.9]）显著低于（更差）对照患者（97.0 [5.2]）（P < 0.001）。VPI患者中VELO总分与PedsQL4.0显著相关（r = 0.73）。父母的回答也有类似结果。
VELO是一个23项的生活质量量表，旨在测量和跟踪VPI患者的生活质量，其负担比原始的VPIQL更小。VELO具有内部一致性、区分效度以及与PedsQL4-0的同时效度。
