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Measuring quality of life in children with asthma
E F Juniper1, G H Guyatt, D H Feeny
1Department of Clinical Epidemiology and Biostatistics, McMaster University Medical Centre, Hamilton, Ontario, Canada. Juniper@fhs.mcmaster.ca
Insights
The Paediatric Asthma Quality of Life Questionnaire effectively measures quality of life changes in children with asthma. It is a valid and reproducible tool for assessing asthma
Area of Science:
- Pediatric Pulmonology
- Health Outcomes Research
- Quality of Life Measurement
Background:
- Pediatric asthma significantly impacts children's daily lives and well-being.
- Assessing quality of life is crucial for comprehensive asthma management.
- Existing tools may not fully capture the patient-reported experiences of childhood asthma.
Purpose of the Study:
- To evaluate the measurement properties of the Paediatric Asthma Quality of Life Questionnaire (PAQLQ).
- To determine the validity and reliability of the PAQLQ in a pediatric asthma population.
- To assess the PAQLQ's ability to detect changes in quality of life related to asthma status.
Main Methods:
- A 9-week single-cohort study involving 52 children (7-17 years) with varying asthma severity.
- Repeated assessments of the PAQLQ, Feeling Thermometer, clinical asthma control, and spirometry at 1, 5, and 9 weeks.
- Daily symptom diaries and peak flow monitoring for one week prior to each visit.
Main Results:
- The PAQLQ demonstrated significant ability to detect quality of life changes in children whose asthma status fluctuated (p < 0.001) and differentiate them from stable patients (p < 0.0001).
- High reproducibility was observed in stable patients (ICC = 0.95), indicating strong discriminative capacity.
- The questionnaire showed good longitudinal and cross-sectional correlations with standard asthma indices and general quality of life measures.
Conclusions:
- The Paediatric Asthma Quality of Life Questionnaire possesses robust measurement properties.
- It is a valid instrument for both evaluating changes and discriminating between different levels of impairment in pediatric asthma.
- The PAQLQ captures patient-important aspects of asthma, complementing traditional clinical outcomes.
Abstract:
The Paediatric Asthma Quality of Life Questionnaire contains 23 items that children with asthma have identified as troublesome in their daily lives. The aim was to evaluate the measurement properties of the questionnaire. The study design consisted of a 9 week single cohort study with assessments at 1, 5 and 9 weeks. Patients participating in the study were fifty-two children, 7-17 years of age, with a wide range of asthma severity. At each clinic visit, a trained interviewer administered the Paediatric Asthma Quality of Life Questionnaire, the Feeling Thermometer, a clinical asthma control questionnaire and measured spirometry. For 1 week before each clinic visit, patients recorded morning peak flow rates, medication use and symptoms in a diary. The Paediatric Asthma Quality of Life Questionnaire was able to detect quality of life changes in those patients who altered their health status either as a result of treatment or natural fluctuations in their asthma (p < 0.001) and to differentiate these patients from those who remained stable (p < 0.0001). It was reproducible in patients who were stable (ICC = 0.95), which also indicates the instrument's strength to discriminate between subjects of different impairment levels. The questionnaire showed good levels of both longitudinal and cross-sectional correlations with the conventional asthma indices and with general quality of life. The results were consistent across individual domains and different age strata. The Paediatric Asthma Quality of Life Questionnaire has good measurement properties and is valid both as an evaluative and a discriminative instrument. It captures aspects of asthma most important to the patient and adds additional information to conventional clinical outcomes.