Relationships of PedsQL 4.0 generic core scales with other validated HRQoL instruments in braced idiopathic scoliosis patients: An age and curve severity-specific analysis

Purpose: This study aims to investigate if the addition of PedsQL 4.0 generic core scales (PedsQL) with other validated instruments in day-to-day clinical context is feasible. Methods: Patients with idiopathic scoliosis who were undergoing brace treatment and aged 8-18 were asked to fill in the PedsQL 4.0 generic core scales, SRS-22r and EQ5D questionnaires at the spine specialist outpatient clinic and were followed up at 6 months by phone consultation. Questionnaire scores at baseline and follow-up were compared. Correlation of score changes of different questionnaires were tested. Results: A total of 232 patients (58 males, 174 females) were included. PedsQL school functioning scores and total scores at follow-up were lower than at baseline (p < 0.001), with greatest reductions in school functioning domain (range: -2.8 +/- 7.0 to -5.1 +/- 3.6). For those aged 13-18 years, changes of PedsQL school functioning correlated with changes of SRS total score (r = 0.20; p = 0.042). For patients with baseline major Cobb angle >30 degrees, changes in PedsQL physical functioning correlated with SRS domain score changes in function (r = 0.25; p = 0.017), pain (r = 0.24; p = 0.021) and SRS total score (r = 0.26; p = 0.016). Both changes in PedsQL school functioning (r = 0.23; p = 0.032) and total score (r = 0.22; p = 0.043) correlated with SRS total score changes. Conclusion: PedsQL was sensitive to changes of HRQoL together with SRS-22r and EQ-5D-Y-5L questionnaires. Changes in PedsQL scores were related to changes in SRS-22r scores in patients of 13-18 years with more severe curves (>30 degrees). PedsQL is recommended to be used in conjunction with validated instruments like SRS-22r with its ability to assess changes of patient's school functioning and overall HRQoL. The short-term nature of our study highlighted the need for future research with a larger cohort and longer duration to investigate long-term HRQoL outcomes assessed by individual questionnaires.