The construct validity of the Child Health Utility 9D-DK instrument

Karin Dam Petersen, Julie Ratcliffe, Gang Chen, Dorthe Serles, Christine Stampe Frøsig, Anne Vingaard Olesen, Karin Dam Petersen, Julie Ratcliffe, Gang Chen, Dorthe Serles, Christine Stampe Frøsig, Anne Vingaard Olesen

Abstract

Background: Relative to their application with adults there is currently little information about the application of preference-based health-related quality of life (HRQL) instruments among populations of young people. The Child Health Utility 9D (CHU9D) is a paediatric-specific generic preference-based HRQL instrument, recently translated and linguistically validated into Danish (CHU9D-DK). The purpose of this study was to investigate the construct validity of the CHU9D-DK in a sample of Danish high school students.

Methods: All students attending a Danish High School were invited to participate in a web-based survey in January 2018 (N = 272). The survey included the CHU9D-DK, the young adult version of the Pediatric Quality of Life Inventory™ 4.0 Generic Core Scales (PedsQL), self-reported health status, presence/absence of disability/chronic diseases, life satisfaction, and socio-economic questions. CHU9D-DK utility scores were generated by employing the two scoring algorithms developed from adults in the UK and adolescents in Australia, respectively. Internal consistency, reliability and construct validity of the CHU9D-DK instrument were investigated.

Results: Two hundred and twenty-eight (84%) students consented to participate and completed the survey. The mean ± (standard deviation) values of the CHU9D-DK utilities were 0.84 (0.11) when the UK adult algorithm was applied and 0.70 (0.22), when the Australian adolescent algorithm was applied. The mean PedsQL score was 82.32 (13.14). The CHU9D-DK showed good internal consistency reliability (Cronbach's alpha = 0.803). Higher levels of health status and life satisfaction were significantly associated with higher CHU9D-DK utility scores regardless of which scoring algorithm was applied (p-values < 0.001). Students living with a disability/chronic disease exhibited significantly lower utility scores relative to their healthy peers (p-values < 0.05). Higher socio-economic status (approximated by financial situation and frequency of family vacations) was also associated with higher utility scores (p-values < 0.005).

Conclusion: The CHU9D-DK demonstrated good psychometric performance overall and shows potential as a valid and reliable instrument for assessing the HRQL of Danish young people.

Trial registration: ClinicalTrials.gov identifier: NCT03391999, Registered 15 October 2017.

Keywords: Adolescents; CHU9D; Construct validity; Health related quality of life; High school; Outcome assessment; Patient-reported outcomes; PedsQL; Young adults.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Scatter plot of the CHU9D-DK utilities and the PedsQL-scores, lines showing the corresponding fitted values
Fig. 2
Fig. 2
Bland-Altman plot of the CHU9D-utilities and the PedsQL-scores including 95% limits of agreements

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