Reliability and validity of a Nepalese version of the Kiddo-KINDL in adolescents

The objective of this study was to assess the reliability and validity of a Nepalese version of the Kiddo-KINDL to measure Health-Related Quality of Life (HRQOL) in adolescents. We collected data from 204 students between 13 to 16 years old from four secondary schools in Lalitpur district, Nepal. The students answered a Nepalese version of the Kiddo-KINDL and the Center for Epidemiological Studies-Depression Scale (CES-D) with a self-administrated questionnaire. We conducted a test-retest study on the instrument at an interval of 10 days and then compared the Kiddo-KINDL scores between the low CES-D score group and the high CES-D score group students. The instrument showed good reliability and a small response variation. The internal consistency (Cronbach's alpha) of the total score was 0.93. Corrected item-total correlations showed that all items ranged from 0.47 to 0.79. The reproducibility was satisfactory with an Intraclass Correlation Coefficient (ICC) of 0.88-0.95. The Kiddo-KINDL scores in the low CES-D score group were significantly lower than those in the high CES-D score group students. The optimal cut-off score of the Kiddo-KINDL was estimated at 54.7, with an Area Under the Curve (AUC) score of 0.83 and both sensitivity (73.5%) and specificity (71.8%) were acceptably high. We recommended a mean change in Kiddo-KINDL total scores of 4.0 to be used to define a minimal important difference according to two-point CES-D score changes. Our results showed that a Nepalese version of the Kiddo-KINDL has internal consistency, reproducibility, responsiveness, interpretability, and discriminant validity.