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The 14-item Paediatric Throat Disorders Outcome Test: a valid, sensitive, reliable, parent-reported outcome measure
1ENT Department of Guy's and St Thomas' Hospital, London, UK. clairehopkins@yahoo.com
Insights
The Paediatric Throat Disorders Outcome Test is a reliable tool for assessing quality of life in children with throat issues. This 14-item questionnaire shows high validity and responsiveness to surgical treatment outcomes.
Area of Science:
- Pediatric Otolaryngology
- Health-Related Quality of Life (HRQoL) Research
- Psychometric Validation
Background:
- Tonsil and adenoid diseases significantly impact children's quality of life.
- Existing research tools may not be optimally suited for rapid, disease-specific assessment in the UK context.
- There is a need for validated instruments to measure health outcomes in pediatric throat disorders.
Purpose of the Study:
- To modify and abbreviate the Tonsil and Adenoid Health Status Instrument for rapid completion.
- To develop and validate the 14-item Paediatric Throat Disorders Outcome Test (PTDOT) as a disease-specific HRQoL tool for UK children.
- To determine the psychometric properties of the Pcdot.
Main Methods:
- Parental completion of pre- and post-operative questionnaires for children with throat disorders (recurrent tonsillitis, obstructive sleep apnoea).
- Inclusion of a control group of healthy children for comparative analysis.
- Analysis of internal consistency (Cronbach's alpha), test-retest reliability, and construct validity (known-group differences).
Main Results:
- The 14-item Pcdot demonstrated high internal consistency (Cronbach's alpha = 0.84) and excellent test-retest reliability (coefficient = 0.98).
- The Pcdot effectively discriminated between children with throat problems and healthy controls (p < 0.0001).
- Significant improvement in parent-reported scores was observed six months post-surgery (p < 0.0001), with a large effect size (1.53).
Conclusions:
- The 14-item Paediatric Throat Disorders Outcome Test is a valid and reliable disease-specific outcome measure for children with throat disorders.
- The Pcdot demonstrates strong internal consistency, reliability, and responsiveness to surgical intervention.
- This parent-reported tool is appropriate for use in clinical research settings in the UK.
Objectives:
We modified and abbreviated a pre-existing research questionnaire, the Tonsil and Adenoid Health Status Instrument, to make it suitable for rapid completion as a disease-specific, health-related quality of life research tool for children with tonsil and adenoid disease in the UK. We determined the main psychometric properties of the resulting 14-item Paediatric Throat Disorders Outcome Test.
Design, Setting And Participants:
Pre- and post-operative questionnaires were completed by the parents of children with throat disorders referred to two large hospitals. We included children with recurrent tonsillitis and with obstructive sleep apnoea. A separate cohort of healthy children of comparable age range was also studied.
Main Outcome Measures:
The test's internal consistency and responsiveness were analysed and its construct validity documented via known-group differences.
Results:
A total of 126 completed questionnaires were received from the hospital referral group. The children's mean age was 6.5 years (range one to 16). The 40 unaffected children were well matched in age to the study population (mean 6.1 years, range two to 15). Cronbach's alpha coefficient for the pre-operative assessment total score was 0.84. The test-retest reliability coefficient for the total score was 0.98, indicating very high reproducibility. The 14-item Paediatric Throat Disorders Outcome Test discriminated well between children known to suffer with throat problems and a group of healthy controls (p < 0.0001; t = 24.016). Six months after surgical intervention, parentally reported questionnaire scores had improved (i.e. were lower) (p < 0.0001; t = 7.01). The standard effect size (i.e. change in mean divided by baseline standard deviation) for children for whom post-operative questionnaires were completed was 1.53; this is very large.
Conclusions:
The 14-item Paediatric Throat Disorders Outcome Test is an appropriate, disease-specific, parent-reported outcome measure for children with throat disorders, for which we have demonstrated internal consistency, reliability, responsiveness to change and two forms of construct validity.
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