PedsQL™ Cognitive Functioning Scale in youth with epilepsy: Reliability and validity
James W Varni1, Katherine F Junger2, Tanja Kellermann3
1Department of Pediatrics, College of Medicine, Texas A&M University, College Station, TX, USA; Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, College Station, TX, USA.
Insights
The Pediatric Quality of Life Inventory™ (PedsQL™) Cognitive Functioning Scale is a reliable and valid brief measure for assessing cognitive function in youth with epilepsy. This scale is suitable for clinical research and practice in pediatric epilepsy.
Area of Science:
- Pediatric Neurology
- Psychometrics
- Quality of Life Measurement
Background:
- Cognitive functioning is a critical aspect of quality of life for youth with epilepsy.
- Brief, reliable, and valid measures are needed to assess cognitive function in this population.
- The Pediatric Quality of Life Inventory™ (PedsQL™) Cognitive Functioning Scale is a potential tool for this purpose.
Purpose of the Study:
- To evaluate the internal consistency reliability and validity (discriminant, concurrent, construct) of the PedsQL™ Cognitive Functioning Scale.
- To assess its suitability as a brief generic cognitive functioning measure in youth with epilepsy.
Main Methods:
- The PedsQL™ Cognitive Functioning Scale (6 items) and PedsQL™ 4.0 Generic Core Scales (23 items) were administered to 221 pediatric patients with epilepsy (ages 5-18).
- Parents of these patients (ages 2-18) also completed the Behavior Rating Inventory of Executive Function (BRIEF) (86 items).
- A national field test study was conducted for the PedsQL™ Epilepsy Module.
Main Results:
- The PedsQL™ Cognitive Functioning Scale demonstrated excellent internal consistency reliability (patient self-report α=0.88; parent proxy-report α=0.96).
- It showed strong discriminant validity, distinguishing between youth with epilepsy and healthy controls (large effect sizes).
- Concurrent and construct validity were supported by significant correlations with the BRIEF and PedsQL™ Generic Core Scales (rs=0.43-0.74, P<0.001).
Conclusions:
- The PedsQL™ Cognitive Functioning Scale exhibits excellent reliability and validity in youth with epilepsy.
- It is a suitable brief, generic patient-reported outcome (PRO) measure for pediatric epilepsy research and clinical practice.
- The scale aids in assessing cognitive function and informing clinical decisions in pediatric epilepsy management.
Objective:
The objective of the study was to report on the internal consistency reliability and discriminant, concurrent and construct validity of the Pediatric Quality of Life Inventory™ (PedsQL™) Cognitive Functioning Scale as a brief generic cognitive functioning measure in youth with epilepsy.
Methods:
The 6-item PedsQL™ Cognitive Functioning Scale and 23-item PedsQL™ 4.0 Generic Core Scales were completed by 221 pediatric patients ages 5-18 years with epilepsy and 336 parents of patients ages 2-18 years in a national field test study for the PedsQL™ Epilepsy Module. Parents also completed the 86-item Behavior Rating Inventory of Executive Function (BRIEF), a widely validated measure of executive functioning.
Results:
The PedsQL™ Cognitive Functioning Scale evidenced excellent reliability (patient self-report α = 0.88; parent proxy-report α = 0.96), distinguished between youth with epilepsy and an age, gender, and race/ethnicity-matched healthy sample supporting discriminant validity with large effect sizes (~20-30 point score differences, P < 0.001), and demonstrated concurrent and construct validity, respectively, through large effect size intercorrelations with the BRIEF (Behavioral Regulation Index, Metacognition Index, Global Executive Composite Summary Scores rs = 0.43-0.67, P < 0.001) and the PedsQL™ Generic Core Scales (Total Scale Scores rs = 0.67-0.74, P < 0.001). Minimal clinically important difference (MCID) scores ranged from 5.92 to 8.80.
Conclusions:
The PedsQL™ Cognitive Functioning Scale demonstrated excellent internal consistency reliability, discriminant, concurrent, and construct validity in youth with epilepsy and may be suitable as a brief generic patient-reported outcome (PRO) measure for clinical research, clinical trials, and routine clinical practice in pediatric epilepsy.
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