Reliability, acceptability, validity and responsiveness of the CHU9D and PedsQL in the measurement of quality of life in children and adolescents with overweight and obesity

Abstract Background There is evidence that childhood overweight and obesity impact negatively on health-related quality of life (HRQoL), using measures including the Paediatric Quality of life Inventory Generic Core Scales (PedsQL) and the Child Health Utilities 9 Dimensions (CHU9D). However, no studies have comprehensively established the psychometric properties of these instruments in the context of paediatric overweight and obesity. The aim of this study was to assess the reliability, acceptability, validity and responsiveness of the PedsQL and the CHU9D in the measurement of HRQoL among children and adolescents with overweight and obesity. Subjects/Methods Subjects were 6544 child participants of the Longitudinal Study of Australian Children, with up to 3 repeated measures of PedsQL and CHU9D and aged between 10 and 17 years. Weight and height were measured objectively by trained operators, and weight status determined using World Health Organisation growth standards. We examined reliability, acceptability, known group and convergent validity and responsiveness, using recognised methods. Results Both PedsQL and CHU9D demonstrated good internal consistency reliability, and high acceptability. Neither instrument showed strong convergent validity, but PedsQL appears to be superior to the CHU9D in known groups validity and responsiveness. Compared with healthy weight, mean (95%CI) differences in PedsQL scores for children with obesity were: boys: -5.6 (-6.2, -4.4) ; girls − 6.7 (-8.1, -5.4) and differences in CHU9D utility were: boys − 0.02 (-0.034, -0.006) ; girls − 0.035 (-0.054, -0.015). Differences in scores for overweight compared with healthy weight were: PedsQL boys − 2.2 (-3.0, -1.4) and girls − 1.3 (-2.0, -0.6) and CHU9D boys: no significant difference; girls − 0.014 (-0.026, -0.003). Conclusion PedsQL and CHU9D overall demonstrated good psychometric properties, supporting their use in measuring HRQoL in paediatric overweight and obesity. CHU9D had poorer responsiveness and did not discriminate between overweight and healthy weight in boys, which may limit its use in economic evaluation.