Key result
EQ-5D-Y and PedsQL track worsening childhood CKD comorbidities despite limited convergent validity.
Why the study?
The longitudinal changes, correlations, and associations with clinical changes between EQ-5D-Y and generic PedsQL in pediatric mild-to-moderate CKD needed characterization.
Do EQ-5D-Y and PedsQL correlate and respond to clinical changes in pediatric patients with mild-to-moderate chronic kidney disease?
Cohort (n=121)
No
Do EQ-5D-Y and PedsQL correlate and respond to clinical changes in pediatric patients with mild-to-moderate chronic kidney disease?
Effect estimate: ρ = 0.32
p-value: p=0.0020
Both EQ-5D-Y and PedsQL are responsive to worsened comorbidities in pediatric mild-to-moderate CKD, though convergent validity between them is limited in some domains.
Limited convergent validity cautions against interchangeable use in pediatric CKD; extends responsiveness data but leaves optimal measure selection open.
OBJECTIVE: To characterize longitudinal changes and correlations between the measures of EQ-5D-Y and generic PedsQL and their associations with clinical changes in children and adolescents with mild-to-moderate chronic kidney disease (CKD). METHODS: Participants were recruited from January 2017 to September 2021 in a medical center in Taiwan. Both instruments were administered in their initial visits and every 6-month subsequent visits. Spearman's Rho (ρ) was used to assess correlations between the scores of EQ-5D-Y and PedsQL measures in longitudinal changes. Cohen's effect size (ES) was used to evaluate the changes of scores/subscales over time. In addition, factors associated with longitudinal changes in the score/subscales were explored. RESULTS: A total of 121 participants were enrolled, and 83 with ≥ 3 HRQOL measures during the 3.5 years follow-up were assessed their changes of HRQOL measures. The correlations (ρ > 0.3) appeared between the changes in the visual analog scale (VAS) of EQ-5D-Y and emotional and social subscales of PedsQL. ES was small (< 0.5) in the VAS and level-sum-score (LSS) of EQ-5D-Y scores for the clinical changes in comorbidities, while some PedsQL subscales were medium to high (0.5-0.8 or > 0.8). Hypertension, mineral bone disorder/anemia, and hyperuricemia associated with the changes in both HRQOL scores were varied by their various domains. CONCLUSION: Both EQ-5D-Y and PedsQL of HRQOL measures were responsive to worsened childhood CKD-related comorbidities during the follow-up; however, convergent validity between them was limited in some domains. The LSS of EQ-5D-Y showed greater changes than the VAS by comorbidity status; further comparison with utility weight is needed to determine the better performance of EQ-5D-Y.
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Hsu et al. (2023) conducted a cohort in mild-to-moderate chronic kidney disease (n=121). Worsened CKD-related comorbidities vs. No change or improved comorbidities was evaluated on Correlation between longitudinal changes in EQ-5D-Y VAS and PedsQL total score (ρ = 0.32, p=0.0020). Both EQ-5D-Y and PedsQL measures were responsive to worsened childhood CKD-related comorbidities during follow-up, though convergent validity between them was limited.
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