[Instruments for measuring health-related quality of life in children and adolescents with asthma]

Measures of health-related quality of life (HRQOL) are proving to be useful in providing a comprehensive evaluation of illness and its effects on patients' daily lives. The aim of this review is to describe HRQOL instruments that are currently available to measure the HRQOL in children and adolescents with asthma.

The MEDLINE database from 1980to 2000was reviewed, as well as the website of the American Thoracic Society and the Quality of Life Research journal. Studies that included instruments measuring HRQOL in children with asthma were included as long as the instruments included met the selection criteria of multidimensionality, scoring was through standardized ordinal scales and psychometric properties were evaluated.

Of the 21instruments initially identified 7were excluded because they did not meet one or more of the selection criteria. Fourteen instruments were included in the final review, 6were generic instruments for children (CHQ, KINDL, PedsQL, FS-IIR, RAND and CHIP-AE) and eight were specific to children with asthma (SSES, ASDQ, AMA, CAQ, LAQCA, PACQLQ, PAQLQ and APBC). The generic instruments measured the four basic aspects of HRQOL (symptoms, physical, mental and social functioning), whilst the majority of the specific instruments focused more closely on symptom measurement and physical functioning. Reliability (Cronbach's alpha) and construct validity were the most widely tested psychometric properties. In general, sensitivity to change was the least widely tested property, and only three disease-specific instruments were sensitive to change (LAQCQ, PACQLQ and PAQLQ). All the instruments could be self-administered. Only two of the generic instruments (FS-IIR and RAND) had been validated for use in Spain. At present two more generic instruments (PedsQL and CHIP-AE) and two specific instruments (PACQLQ and PAQLQ) are currently being validated.

The availability of instruments to measure the HRQOL of children with asthma in Spain is currently limited. Validated versions of the PedsQL (generic) and PAQLQ (specific) instruments, both of which have been demonstrated to be useful in other countries, should shortly be available to measure the HRQOL of children with asthma in Spain.