Verstraete Janine, Scott Des
Department of Paediatrics and Child Health, Division of Pulmonology, Cape Town, South Africa.
Faculty of Health and Rehabilitation Sciences, Division of Physiotherapy, Cape Town, South Africa.
Dialogues Health. 2022 Aug 1;1:100032. doi: 10.1016/j.dialog.2022.100032. eCollection 2022 Dec.
The aim of this study is to compare the performance and validity of the EQ-5D-Y-3L (Y-3L) and EQ-5D-Y-5L (Y-5L) in South African children and adolescents with cerebral palsy (CP).
Children/adolescents with CP and those from the general population completed the Y-5L, Y-3L, and PedsQL. Physiotherapists at the school classified participants' functional ability on the Gross Motor Functioning Classification System (GMFCS).
Fifty-one children/adolescents completed the measures. The ceiling effect had a 44% relative reduction for and floor effects decreased across all dimensions except for when moving from the Y-3L to Y-5L. Informativity of dimensions improved on average by 0.27 on the Y-5L with similar evenness. There was a range of 6-16% inconsistent responses when moving from the Y-3L to the Y-5L. Convergent validity was strong on paired Y-3L and Y-5L dimensions: Kendall's Tau B (range 0.53 - 0.85) and Gamma (range 0.79 - 0.99). There was significant moderate association between Y-3L and Y-5L with similar items on the PedsQL. The physical dimensions of and were significantly associated with GMFCS with those having less independent mobility reporting more severe problems on dimension scores.
The Y-5L showed a notable reduction in ceiling and floor effects, improved discriminatory power, higher criterion validity with the GMFCS and similar concurrent validity with the PedsQL as the Y-3L. It is recommended that the Y-5L is further tested for reliability and responsiveness in this population group so that its utility for detecting change in clinical trials or as a routine outcome measure can be determined.
本研究旨在比较EQ-5D-Y-3L(Y-3L)和EQ-5D-Y-5L(Y-5L)在南非脑瘫(CP)儿童和青少年中的表现及有效性。
患有CP的儿童/青少年以及普通人群完成了Y-5L、Y-3L和儿童生活质量量表(PedsQL)。学校的物理治疗师根据粗大运动功能分类系统(GMFCS)对参与者的功能能力进行分类。
51名儿童/青少年完成了测量。从Y-3L转换到Y-5L时,天花板效应相对降低了44%,除[此处原文缺失具体维度]外,所有维度的地板效应均有所下降。Y-5L上各维度的信息性平均提高了0.27,均匀性相似。从Y-3L转换到Y-5L时,不一致回答的范围为6%-16%。配对的Y-3L和Y-5L维度的收敛效度很强:肯德尔等级相关系数B(范围0.53 - 0.85)和伽马系数(范围0.79 - 0.99)。Y-3L和Y-5L与PedsQL上的相似项目之间存在显著的中度关联。[此处原文缺失具体维度]的身体维度与GMFCS显著相关,那些独立移动能力较差的人在维度得分上报告的问题更严重。
Y-5L显示出天花板效应和地板效应显著降低,辨别力提高,与GMFCS的效标效度更高,与PedsQL的同时效度与Y-3L相似。建议进一步测试Y-5L在该人群中的信度和反应度,以便确定其在临床试验中检测变化或作为常规结局指标的效用。