Reliability and validity of the PedsQL 4.0 Generic Core Scales in pediatric vision impairment

BACKGROUND The PedsQL 4.0 is a generic health-related quality-of-life (HRQoL) instrument that has been used across many pediatric health conditions. The purpose of this study was to investigate its use in children with vision impairment and to test its ability to distinguish between visually impaired and normally sighted children. METHODS Children with vision impairment and age-matched controls underwent vision testing, including binocular best-corrected distance visual acuity. They completed the PedsQL 4.0 Generic Core Scale Child Report (ages 8-12) or Teen Report (ages 13-18), as appropriate. Parents completed the Parent Proxy Report in a room separate from their children. Analyses included descriptive statistics, intraclass correlations, t tests, and determination of Cronbach's a for subscales. RESULTS A total of 70 study subjects and 44 controls were included. Groups were similar with regard to age, race, and sex. PedsQL 4.0 subscales showed no floor effects; however, some scales had ceiling effects of up to 28% in certain groups. Cronbach's a was excellent (0.88) for all subscales and reports. PedsQL 4.0 total score for children with vision impairment differed significantly from that for normally sighted children for both age groups and for both parent and child reports. Total score was also significantly associated with visual acuity. Parent and child reports correlated poorly (ICC, <0.5), highlighting the importance of both perspectives. CONCLUSIONS The PedsQL 4.0 can be used to assess HRQoL in children and teens with low vision. It has internal consistency reliability, and construct validity.