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Feasibility and validity of the Health Status Classification System-Preschool (HSCS-PS) in a large community sample: the Generation R study
  1. Xinye Fang1,2,
  2. Guannan Bai3,4,
  3. Dafna A Windhorst3,
  4. David Feeny5,
  5. Saroj Saigal6,
  6. Liesbeth Duijts7,8,
  7. Vincent W V Jaddoe4,9,10,
  8. Shanlian Hu2,
  9. Chunlin Jin1,2,
  10. Hein Raat3
  1. 1 Shanghai Medical Information Center, Shanghai, China
  2. 2 Shanghai Health Development Research Center, Shanghai, China
  3. 3 Department of Public Health, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
  4. 4 The Generation R Group, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
  5. 5 Department of Economics and Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada
  6. 6 Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
  7. 7 Division of Respiratory Medicine and Allergology, Department of Pediatrics, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
  8. 8 Division of Neonatology, Department of Pediatrics, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
  9. 9 Department of Pediatrics, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
  10. 10 Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
  1. Correspondence to Professor Hein Raat; h.raat{at}erasmusmc.nl

Abstract

Objectives To evaluate the feasibility, discriminant validity and concurrent validity of the Health Status Classification System-Preschool (HSCS-PS) in children aged 3 years in a large community sample in the Netherlands.

Design/setting A prospective population-based cohort in Rotterdam, the Netherlands.

Participants A questionnaire was administrated to a sample of parents of 4546 children (36.7±1.5 months).

Outcome measures Health-related quality of life (HRQOL) of children was measured by HSCS-PS. The HSCS-PS consists of 10 original domains. Two single-item measures of ‘General health’ and ‘Behavior’ were added. A disability score was calculated by summing up all 10 original domains to describe the overall health status. Feasibility was assessed by the response rate, percentages of missing answers, score distributions and the presence of floor/ceiling effects. Discriminant validity was analysed between subgroups with predefined conditions: low birth weight, preterm birth, wheezing, Ear-Nose-Throat surgical procedures and behaviour problems. In the absence of another HRQOL measure, this study uses the single-items ‘General health’ and ‘Behavior’ as a first step to evaluate concurrent validity of the HSCS-PS.

Results Feasibility: response rate was 69%. Ceiling effects were observed in all domains. Discriminant validity: the disability score discriminated clearly between subgroups of children born with a ‘very low birth weight’, ‘very preterm birth’, with ‘four or more than four times wheezing’, ‘at least one ear-nose-throat surgical procedures’, ‘behaviour problems present’ and the ‘reference’ group. Concurrent validity: HSCS-PS domains correlated better with hypothesised parallel additional domains than with other non-hypothesised original domains.

Conclusions This study supports the feasibility and validity of the HSCS-PS among preschoolers in community settings. We recommend developing a utility-based scoring algorithm for the HSCS-PS. Further empirical studies and repeated evaluations in varied populations are recommended.

  • concurrent validity
  • discriminant validity
  • quality of llife
  • preschool
  • children

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors XF conceptualised and designed the study, carried out the analyses, interpreted the data, drafted the initial manuscript, critically reviewed and revised the manuscript. GB conceptualised and designed the study, carried out the analyses, interpreted the data, critically reviewed and revised the manuscript. DAW, DF and SS conceptualised and designed the study, interpreted the data, critically reviewed and revised the manuscript. SH and CJ interpreted the data, critically reviewed and revised the manuscript. LD and VWVJ aided in the collection of data, interpreted the data, critically reviewed and revised the manuscript. HR initiated the study, conceptualised and designed the study, collected the data, interpreted the data, and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding XF is supported by a fellowship from the China Medical Board-Collaborating Program in Evidence-based Health Policy-making (grant number: CMB-CP14-190, https://www.chinamedicalboard.org/). GB is supported by a China Scholarship Council (CSC) PhD Fellowship for her PhD study in Erasmus MC, Rotterdam, the Netherlands. The scholarship file number is 201406010271, CSC URL: [http://www.csc.edu.cn/].

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Medical Ethics Committee of the Erasmus University Medical Center, Rotterdam (MEC-2007-413).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data (actual SPPS data) on which our study is based are derived from a large birth cohort in Rotterdam (also known as the Generation R Study). Individual researchers do not have the right to distribute data from the Generation R Study. For the purpose of verification/validation/replication/meta-analyses, the external researcher can contact our data managers (Claudia J. Kruithof, c.kruithof@erasmusmc.nl or datamanagementgenr@erasmusmc.nl) and contact the Director Generation R, Vincent Jaddoe (v.jaddoe@erasmusmc.nl). Postal address: Generation R, Postbox 2040, 3000 CA Rotterdam, the Netherlands. Data will be made available via these contact persons after a written agreement about the use of the data has been made via the Technology Transfer Office of Erasmus MC.

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