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Feasibility and validity of the Health Status Classification System-Preschool (HSCS-PS) in a large community sample:

Xinye Fang^1,2, Guannan Bai^3,4, Dafna A Windhorst³

¹Shanghai Medical Information Center, Shanghai, China.

|December 21, 2018

Insights

The Health Status Classification System-Preschool (HSCS-PS) is feasible and valid for assessing preschooler health-related quality of life (HRQOL) in community settings. Further research is recommended to develop a utility-based scoring algorithm for the HSCS-PS.

Area of Science:

Pediatric Health Outcomes
Health Services Research
Quality of Life Measurement

Background:

Assessing health-related quality of life (HRQOL) in preschoolers is crucial for understanding child well-being.
The Health Status Classification System-Preschool (HSCS-PS) is a tool designed for this purpose.
Evaluating the psychometric properties of HRQOL measures is essential for their reliable application.

Purpose of the Study:

To determine the feasibility, discriminant validity, and concurrent validity of the HSCS-PS in a large community sample of 3-year-old children in the Netherlands.
To assess the performance of the HSCS-PS in a real-world, population-based setting.

Main Methods:

A prospective, population-based cohort study was conducted in Rotterdam, Netherlands.
Parental questionnaires were administered to 4546 children aged approximately 36.7 months.
Feasibility was assessed via response rates and missing data; validity was examined by comparing HSCS-PS scores between predefined subgroups and correlating with single-item health measures.

Main Results:

The study achieved a 69% response rate, indicating good feasibility.
The HSCS-PS demonstrated clear discriminant validity, distinguishing between children with various health conditions (e.g., low birth weight, wheezing, behavioral problems) and a reference group.
Concurrent validity was supported by correlations between HSCS-PS domains and hypothesized parallel measures.

Conclusions:

The findings support the feasibility and validity of the HSCS-PS for use in community-based preschool populations.
The development of a utility-based scoring algorithm for the HSCS-PS is recommended to enhance its clinical utility.
Further empirical studies and repeated evaluations in diverse populations are advised to solidify its application.

Read full analysis

Abstract

Objectives:

To evaluate the feasibility, discriminant validity and concurrent validity of the Health Status Classification System-Preschool (HSCS-PS) in children aged 3 years in a large community sample in the Netherlands.

Design/Setting:

A prospective population-based cohort in Rotterdam, the Netherlands.

Participants:

A questionnaire was administrated to a sample of parents of 4546 children (36.7±1.5 months).

Outcome Measures:

Health-related quality of life (HRQOL) of children was measured by HSCS-PS. The HSCS-PS consists of 10 original domains. Two single-item measures of 'General health' and 'Behavior' were added. A disability score was calculated by summing up all 10 original domains to describe the overall health status. Feasibility was assessed by the response rate, percentages of missing answers, score distributions and the presence of floor/ceiling effects. Discriminant validity was analysed between subgroups with predefined conditions: low birth weight, preterm birth, wheezing, Ear-Nose-Throat surgical procedures and behaviour problems. In the absence of another HRQOL measure, this study uses the single-items 'General health' and 'Behavior' as a first step to evaluate concurrent validity of the HSCS-PS.

Results:

Feasibility: response rate was 69%. Ceiling effects were observed in all domains. Discriminant validity: the disability score discriminated clearly between subgroups of children born with a 'very low birth weight', 'very preterm birth', with 'four or more than four times wheezing', 'at least one ear-nose-throat surgical procedures', 'behaviour problems present' and the 'reference' group. Concurrent validity: HSCS-PS domains correlated better with hypothesised parallel additional domains than with other non-hypothesised original domains.

Conclusions:

This study supports the feasibility and validity of the HSCS-PS among preschoolers in community settings. We recommend developing a utility-based scoring algorithm for the HSCS-PS. Further empirical studies and repeated evaluations in varied populations are recommended.

Keywords:

children concurrent validity discriminant validity preschool quality of llife

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