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Measuring Quality of Life in Children With Obstructive Sleep Disorders
Lianne M. de Serres, MD;
Craig Derkay, MD;
Susan Astley, PhD;
Richard A. Deyo, MD, MPH;
Richard M. Rosenfeld, MD, MPH;
George A. Gates, MD
Arch Otolaryngol Head Neck Surg. 2000;126:1423-1429.
Objective To validate a disease-specific health-related quality of life (HRQOL) instrument for children with obstructive sleep disorders (OSDs).
Design Prospective cohort study using a 6-item health-related instrument (OSD-6).
Subjects One hundred caregivers of patients with OSDs secondary to adenotonsillar hypertrophy (age range, 2-12 years) from 2 tertiary care, pediatric otolaryngology practices.
Intervention The OSD-6 was administered on initial presentation and 4 to 5 weeks after adenotonsillectomy. A subset of patients repeated the OSD-6 within 3 weeks after presentation to assess test-retest reliability.
Main Outcome Measures Test-retest reliability, internal consistency, construct validity, and responsiveness to clinical change of the OSD-6 score.
Results Test-retest reliability was good (intraclass correlation coefficient = 0.74). Median OSD-6 score was 4.5 (0- to 6-point scale) with higher scores indicating poorer quality of life (QOL). Construct validity was demonstrated by the moderate correlation between OSD-6 score and global adenoid and tonsil-related QOL (R = -0.62), strong correlation between the OSD-6 change score and change in global adenoid and tonsil-related QOL (R = -0.63), and the moderate correlation between the change score and parent estimate of clinical change (R = 0.40). The mean change in OSD-6 score after adenotonsillectomy was 3.0 (95% confidence interval, 2.7-3.4). The mean standardized response was 2.3 (95% confidence interval, 1.9-2.7) indicating the instrument's large responsiveness to clinical change. The change score was very reliable (R = 0.85).
Conclusions The OSD-6 is a reliable, responsive, easily administered instrument. It is valid for detecting change after adenotonsillectomy in children with OSDs.
From the Division of Pediatric Otolaryngology, Children's Hospital and Regional Medical Center (Dr de Serres) and Department of Otolaryngology—Head and Neck Surgery, University of Washington (Drs de Serres and Gates), Seattle; Department of Otolaryngology—Head and Neck Surgery, Children's Hospital of the King's Daughter, Eastern Virginia Medical School, Norfolk (Dr Derkay); Department of Epidemiology, University of Washington School of Public Health (Dr Astley) and Department of Medicine, University of Washington School of Medicine (Dr Deyo), Seattle; and the Division of Pediatric Otolaryngology, State University of New York, Health Science Center at Brooklyn, and Long Island College Hospital, Brooklyn (Dr Rosenfeld). The authors have no commerical, proprietary, or financial interest in the products or companies described in this article.
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