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Construct validity and responsiveness of the Child Health Questionnaire in children with acute asthma
Marc H Gorelick1, Philip V Scribano, Molly W Stevens
1Section of Emergency Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. mgorelic@mcw.edu
Insights
The Child Health Questionnaire (CHQ-PF28) shows moderate responsiveness in assessing functional status changes in children with acute asthma exacerbations, correlating with short-term outcomes.
Area of Science:
- Pediatric Emergency Medicine
- Respiratory Health
- Health Outcomes Research
Background:
- Acute asthma exacerbations significantly impact children's health and daily functioning.
- Assessing functional status is crucial for managing pediatric asthma.
- The Child Health Questionnaire (CHQ-PF28) is a tool used to evaluate child health.
Purpose of the Study:
- To evaluate the validity and responsiveness of the Child Health Questionnaire (CHQ-PF28).
- To assess the CHQ-PF28's utility in children experiencing acute asthma exacerbations.
- To determine the questionnaire's ability to detect short-term changes in functional status.
Main Methods:
- A prospective cohort study involving children aged 5+ treated for acute asthma in urban pediatric emergency departments.
- The CHQ-PF28, with a modified 2-week recall period, was administered via telephone 14 days post-visit.
- Poor 14-day outcome was defined by missed school/work, persistent asthma symptoms, or unscheduled care.
Main Results:
- Out of 732 enrolled subjects, 622 had successful 14-day follow-up; 43% experienced a poor outcome.
- Significant differences in CHQ-PF28 physical and psychosocial subscale scores were observed between good and poor outcome groups.
- Moderate responsiveness was noted, with an effect size of 0.37 for the physical subscale.
Conclusions:
- The CHQ-PF28 physical and psychosocial subscales correlate with poor short-term functional outcomes in pediatric asthma exacerbations.
- The questionnaire demonstrates moderate responsiveness to acute changes in functional status.
- The CHQ-PF28 can be a useful tool for assessing outcomes in pediatric asthma management.
Objective:
To examine the validity and responsiveness of the Child Health Questionnaire (CHQ-PF28) in the context of acute exacerbation of asthma in children.
Design And Methods:
This was a prospective cohort study of children age 5 years and older treated for acute asthma at two urban pediatric emergency departments (EDs). At 14 days after the visit, all patients were contacted by telephone and the CHQ-PF28 (modified to have a 2-week recall period) was administered. Poor 14-day outcome was defined as one or more of the following: child or parent missed at least 5 days of school/day care/work; child still having asthma symptoms above baseline at 14 days; or unscheduled care within 7 days after the ED visit.
Results:
A total of 732 subjects (median age, 9 years) were enrolled; 622 (85%) had successful follow-up at day 14. At the 14-day follow-up, 254 (43%) were classified as having a poor outcome. The mean physical subscale score of the CHQ-PF28 was 48.2 among those with a good outcome, vs 35.9 among the poor outcome group (difference = 12.3; 95% confidence interval, 10.2 to 14.3). For the psychosocial subscale the average difference between groups was 6.9 (95% confidence interval, 5.1 to 8.7). Among the 146 patients at one site who also had a CHQ score obtained at the initial visit, there was a significant improvement in mean physical subscale score among those with good, but not poor, outcome. However, the relative responsiveness was moderate, with an effect size of only 0.37.
Conclusions:
Both the physical and psychosocial subscales of the CHQ-PF28 administered 14 days after an ED visit for acute exacerbation of asthma are correlated with poor short-term functional outcome, but scores are only moderately responsive to acute changes in functional status.