Health-related quality of life for pediatric emergency department febrile illnesses: an Evaluation of the Pediatric Quality of Life Inventory™ 4.0 generic core scales

Objective: We sought to assess the validity and short-term responsiveness of the Pediatric Quality of Life Inventory (TM) 4.0 Generic Core Scales (PedsQL (TM)) for febrile illnesses evaluated in the pediatric emergency department (ED). Design: Prospective cohort study of children 2-18 years discharged after ED evaluation for fever (>= 38 degrees C). Self-administered, parent-report of health-related quality of life (HRQOL) was assessed using the PedsQL (TM) Acute Version, a validated HRQOL instrument. HRQOL was measured on ED presentation and at 7-10 day follow-up. At follow-up, duration of fever, child functional impairment, missed daycare/school, and disrupted family unit functioning, were assessed. Results: Of 160 subjects enrolled, 97 (61%) completed the study; mean follow-up was 8.7 days. Mean total HRQOL score on ED presentation was 76.4; mean follow-up score was 86.3. Compared to subjects that returned to baseline, statistically significant differences in HRQOL were noted for those with prolonged fever, child functional impairment, and relapse. Significant correlation was observed between HRQOL at follow-up and days of daycare/school missed (r = 0.35, p = .003) and days of family disruption ( r = -0.43, p <.001). Mean change in HRQOL within subjects, from ED visit to follow-up, was +9.8 (95% CI: 5.6-14.6). Effect size was 0.53, indicating moderate responsiveness. Conclusion: The PedsQL (TM) appears to be a valid and responsive indicator of HRQOL for short-term febrile illnesses evaluated in the ED.