Hsu Chien-Ning, Lin Hsiang-Wen, Pickard A Simon, Tain You-Lin
Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, 123 Dabi Rd., Niausung, Kaohsiung 83301, Taiwan.
School of Pharmacy, Kaohsiung Medical University, 100 Shih-Chuan 1st Rd., Kaohsiung 80708, Taiwan.
Int J Qual Health Care. 2018 May 1;30(4):298-305. doi: 10.1093/intqhc/mzy011.
To assess if health-related quality of life (HRQOL) of children with chronic kidney disease (CKD) and different comorbid conditions can be identified based on the EQ-5D child-friendly version (EQ-5D-Y).
Prospective cross-sectional study.
A tertiary care medical center in Taiwan.
All CKD patients aged 7-18 years treated at the center between May 2014 and December 2016.
HRQOL assessment was done using EQ-5D-Y. Spearman correlation tests were used for construct validity of the traditional Chinese version of EQ-5D-Y. Test-retest reliability was determined through Cohen's kappa values and intraclass correlation coefficients (ICC). Laboratory results and CKD-related morbid conditions were ascertained and assessed their associations with HRQOL score using multivariate linear regression.
Of 68 participants, 53 of them completed two HRQOL assessments of HRQOL at least 6-month. Cross-sectional analysis revealed fair to moderate correlations between EQ visual analogue score and patient characteristics. Older children at assessment (P < 0.01), girls (P = 0.03) and presence of mineral bone disorders had a significantly negative impact on HRQOL. Children self-reported EQ-5D-Y dimensions were found to be fairly to highly reliable (kappa = 0.2 to 0.8), except for 'pain/discomfort' and 'anxiety/depression'.
The EQ-5D-Y discriminated among children with different level of CKD-related clinical burden, but the psychometric properties may be limited in some HRQOL dimensions. Further research will need to address factors that may threaten validity and reliability data provided by children and adolescents.
评估能否基于儿童友好版EQ-5D（EQ-5D-Y）识别出患有慢性肾脏病（CKD）及不同合并症的儿童的健康相关生活质量（HRQOL）。
前瞻性横断面研究。
台湾的一家三级医疗中心。
2014年5月至2016年12月期间在该中心接受治疗的所有7至18岁的CKD患者。
使用EQ-5D-Y进行HRQOL评估。采用Spearman相关性检验评估中文版EQ-5D-Y的结构效度。通过Cohen's kappa值和组内相关系数（ICC）确定重测信度。确定实验室检查结果和CKD相关的疾病状况，并使用多元线性回归评估它们与HRQOL评分的关联。
68名参与者中，53人至少间隔6个月完成了两次HRQOL评估。横断面分析显示，EQ视觉模拟评分与患者特征之间存在中等程度的相关性。评估时年龄较大的儿童（P < 0.01）、女孩（P = 0.03）以及存在矿物质骨疾病对HRQOL有显著负面影响。发现儿童自我报告的EQ-5D-Y维度具有中等至高度的可靠性（kappa = 0.2至0.8），但“疼痛/不适”和“焦虑/抑郁”维度除外。
EQ-5D-Y能够区分不同CKD相关临床负担水平的儿童，但在某些HRQOL维度上心理测量特性可能有限。需要进一步研究解决可能威胁儿童和青少年提供的有效性和可靠性数据的因素。
