Screening for health-related quality of life in children and adolescents: Optimal cut points for the KIDSCREEN-10 for epidemiological studies

  • Gerrit HirschfeldEmail author
  • Ruth von Brachel
  • Christian Thiele



Generic measures of health-related quality of life are important in pediatrics. Here, we try to establish optimal cut points for the self-report and parental-report versions of the KIDSCREEN-10.


We re-analyzed data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study. In total, data from 2566 children, 2136 younger adolescents, and 2740 older adolescents were used. The KIDSCREEN-10 was contrasted to three different anchors: the strength and difficulties questionnaire, self-rated general health, and chronic diseases. A kernel-based method and bootstrapping were used to determine the optimal cut points and their variability.


We found large differences in HRQoL between children with vs. without mental health problems but there is only medium-to-small differences in HRQoL between children with vs. without chronic diseases and children with self-rated good vs. poor physical health. Acceptable levels of classification accuracy were found in relation to mental health problems for all versions (AUCs between 0.77 and 0.79), but only for the parental-report version in relation to general health and for no version in relation to chronic diseases. Cut points identified as optimal differed systematically between parental-report versions (cut point = 41.13) and self-report for younger (cut point = 42.52) and older adolescents (cut point = 40.29).


The results aid the interpretation of KIDSCREEN-10 in epidemiological studies. Specifically, we suggest a cut point of 41 should be used to interpret the parental-report version of the KIDSCREEN and 40 and 42, respectively, for young and older adolescents.


Health-related quality of life Diagnostic utility Optimal cut points, boostrapping 



The following data were used in this study: Public Use File KiGGS, German Health Survey for Children and Adolescents, 2003–2006, Robert Koch Institute, Berlin, Germany, 2008.


The study was supported by the German Federal ministry for Education and Research (BMBF #01EK1501).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human and animal participants

This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

Electronic supplementary material 1 (4 kb)


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Faculty of Business and HealthUniversity of Applied Sciences BielefeldBielefeldGermany
  2. 2.Mental Health Research & Treatment CenterRuhr-Universität BochumBochumGermany

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