This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (10)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal

Michael G. Stewart, MD, MPH; Ellen M. Friedman, MD; Marcelle Sulek, MD; Andrew deJong, MD; Gregory F. Hulka, MD; Marilyn H. Bautista, MPH; Susan E. Anderson, RN

Arch Otolaryngol Head Neck Surg. 2001;127:29-35.

Objective  To design and validate a disease-specific health status instrument—the Tonsil and Adenoid Health Status Instrument—for use in children with tonsil and adenoid disease.

Design  Prospective psychometric and clinimetric instrument validation in 3 stages.

Settings  A tertiary academic pediatric specialty hospital and a tertiary academic hospital, in 2 different cities.

Patients/Other Participants  Children with tonsil and adenoid disease presenting for evaluation and treatment (n = 224).

Intervention/Method  Prospective instrument validation. Stage 1 consisted of initial item testing, reduction, and subscale construction; stage 2, reliability and validity testing, factor analysis, and final item reduction; and stage 3, responsiveness analysis.

Main Outcome Measures  Test-retest and internal consistency reliability; content, construct, and criterion validity; orthogonal principal components factor analysis; and response sensitivity analysis.

Results  Factor analysis and item analysis confirmed 6 distinct subscales measuring different constructs (aspects) of disease-specific health status that are affected by tonsil and adenoid disease: eating and swallowing, airway and breathing, infections, health care utilization, cost of care, and behavior. For each subscale, the Tonsil and Adenoid Health Status Instrument demonstrated excellent test-retest reliability (r = 0.72-0.88) and internal consistency reliability (Cronbach = .73-.87). Content validity was ensured during the design process. Construct validity was demonstrated by means of convergent and divergent validity with a global quality-of-life instrument (the Child Health Questionnaire, version PF28). Criterion validity was also satisfactory. Finally, the instrument was appropriately sensitive, with high standardized response means and effect sizes.

Conclusions  The Tonsil and Adenoid Health Status Instrument is a valid, reliable, and sensitive instrument with 6 distinct subscales. This instrument has significant utility for outcomes research in children with tonsil and adenoid disease.

From the Bobby R. Alford Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Tex (Drs Stewart, Friedman, Sulek, and deJong and Ms Bautista), and the Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, Duke University School of Medicine, Durham, NC (Dr Hulka and Ms Anderson).

Corresponding author and reprints: Michael G. Stewart, MD, MPH, Baylor College of Medicine, One Baylor Plaza (NA-102), Houston, TX 77030 (e-mail: mgstew{at}bcm.tmc.edu).

RELATED ARTICLE

Archives of Otolaryngology–Head & Neck Surgery Reader's Choice: Continuing Medical Education
Arch Otolaryngol Head Neck Surg. 2001;127(1):94.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Quality of Life and Sleep Study Findings After Adenotonsillectomy in Children With Obstructive Sleep Apnea
Stewart et al.
Arch Otolaryngol Head Neck Surg 2005;131:308-314.
ABSTRACT | FULL TEXT  

Effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or adenotonsillar hypertrophy: open, randomised controlled trial
van Staaij et al.
BMJ 2004;329:651.
ABSTRACT | FULL TEXT