儿童慢性咳嗽特异性生活质量测试：发展与验证
2016/10/09
摘要
背景：生活质量（QoL）测试是临床研究中重要的病人相关结果的评估措施。咳嗽是导致新医疗咨询的最常见的症状。虽然成人和家长监护的咳嗽特异性生活质量的问卷已被证明是一个有用的咳嗽结果的测试，但对慢性咳嗽持续存在的儿童没有合适的咳嗽特异性生活质量的测试。我们报道了儿童慢性咳嗽特异性生活质量（CC-QoL）问卷的统计特性。
方法：130个孩子（中位数年龄10岁，四分位数间距 8-12岁；女孩65人）参加测试。从与儿童慢性咳嗽（> 4周）的对话中建立了一个初步的37个项目的版本。孩子们也完成了普通的生活质量问卷（儿童生活质量量表4.0（PedsQL4.0）、斯彭斯儿童焦虑量表（SCAS））和咳嗽日记评分。
结果：项目减少的临床影响的方法产生了16个项目，在这些项目之间和项目内部具有良好的内部一致性（Cronbach's α=0.94）。结构和效标效度的证据建立了，儿童慢性咳嗽特异性生活质量（CC-QoL）与咳嗽评分、PedsQL和SCAS评分之间有显著相关性。CC-QoL评分对干预之后的变化敏感，在正在咳嗽和停止咳嗽的儿童间差异显著。全面的和局部的CC-QoL的最重要的区别（MID）从0.37-1.36（distribution-based approach）到1.11-1.58（anchor-based approach）。
结论：慢性咳嗽对儿童生活质量有显著性影响。CC-QoL是一个从儿童的角度评价其生活质量的可靠的、有效的和对结果变化敏感的测试。一个验证性队列的待定数据中，在评估健康状况的变化时建议CC-QoL的MID为1.1。
（苏欣 审校）
Thorax.2016Aug;71(8):695-700.doi:10.1136/thoraxjnl-2015-207473.Epub2016 Feb 3.
A child chronic cough-specific quality of life measure: development and validation.
Newcombe PA1, Sheffield JK1, Petsky HL2, Marchant JM2, Willis C2, Chang AB3.
Author information
Abstract
BACKGROUND:Quality of life (QoL) measures are an important patient-relevant outcome measure for clinical studies. Cough is the most common symptom that results in new medical consultations. Although adult and parent-proxy cough-specific QoL instruments have been shown to be a useful cough outcome measure, no suitable cough-specific QoL measure for children with chronic cough exists. We report on the statistical properties of a chronic cough-specific QoL (CC-QoL) questionnaire for children.
METHOD:130 children (median age 10 years, IQR 8-12 years; 65 girls) participated. A preliminary 37-item version was developed from conversations with children with chronic cough (>4 weeks). Children also completed generic QoL questionnaires (Pediatric QoL Inventory 4.0 (PedsQL4.0), Spence Children's Anxiety Scale (SCAS)) and cough diary scores.
RESULTS:The clinical impact method of item reduction resulted in 16 items that had excellent internal consistency (Cronbach's α=0.94) among these items and also within each domain. Evidence for construct and criterion validity was established with significant correlations between CC-QoL subscales with cough scores, PedsQL and SCAS scores. CC-QoL scores were sensitive to change following an intervention and significant differences were noted between those children coughing and those who had ceased coughing. Minimum important difference (MID) for overall and domain CC-QoL ranged from 0.37-1.36 (distribution-based approach) to 1.11-1.58 (anchor-based approach).
CONCLUSIONS:Chronic cough significantly impacts the QoL of children. The CC-QoL is a reliable, valid and sensitive to change outcome measure that assesses QoL from the child's perspective. Pending data from a confirmatory cohort, a MID for the CC-QoL of 1.1 is recommended when evaluating health status change.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
KEYWORDS:Cough/Mechanisms/Pharmacology; Psychology
Thorax.2016Aug;71(8):695-700.doi:10.1136/thoraxjnl-2015-207473.Epub2016 Feb 3.
