Establishing clinical cutoffs for the PedsQL™ Epilepsy Module

Area of Science:

• Pediatric Neurology
• Quality of Life Research
• Clinical Psychology

Background:

• Health-related quality of life (HRQOL) is crucial for children with epilepsy (CWE).
• Existing tools may not fully capture the specific impacts of epilepsy and its treatment on HRQOL.
• Establishing clear clinical cutoffs can enhance the utility of HRQOL measures.

Purpose of the Study:

• To establish clinical cutoffs for the PedsQL Epilepsy Module scales.
• To dichotomize scores into normative or impaired categories.
• To identify youth at greater risk for HRQOL impairments due to seizures, antiepileptic drugs (AEDs), and polytherapy.

Main Methods:

• Recruited 237 youth (2-18 years) and caregivers from five US tertiary care hospitals.
• Administered PedsQL Epilepsy Module (parent/self-report) and caregiver-completed measures of behavior, mood, AED side effects, and executive functioning.
• Calculated clinical cutoffs using anchor-based (ROC curve) and distribution-based (0.5 SD) methods; analyzed differences based on seizure freedom, AED side effects, and polytherapy.

Main Results:

• Established clinical cutoffs for PedsQL Epilepsy Module subscales (Impact, Cognitive, Executive Functioning, Sleep, Mood/Behavior) for both parent and child reports.
• Youth experiencing more severe AED side effects, ongoing seizures, and/or polytherapy were significantly more likely to have impaired HRQOL across domains.

Conclusions:

• The established clinical cutoffs enhance the PedsQL Epilepsy Module's utility for surveillance of psychosocial comorbidities in youth with epilepsy (YWE).
• These cutoffs aid in tracking functional changes over time and inform clinical decision-making.
• Recommendations for additional assessment and intervention can be guided by these cutoffs for YWE.