Quality of Life Research

, Volume 22, Issue 3, pp 635–646 | Cite as

Parent-reported health outcomes in infants/toddlers: measurement properties and clinical validity of the ITQOL-SF47

  • Jeanne M. Landgraf
  • Ineke Vogel
  • Rianne Oostenbrink
  • Margriet E. van Baar
  • Hein Raat



To derive and evaluate a shorter infant/toddler quality of life questionnaire (ITQOL) for use in clinical care.


Stepwise regression, factor analysis, and item-scaling principles were used to derive and guide item selection using data from a large general sample in the Netherlands (n = 5,211) and a “wheezing illness” sample (n = 138). Item internal consistency, discriminant validity, and floor and ceiling effects were evaluated using a general Dutch sample (Salland Region n = 410) and two clinical samples: Functional abdominal pain (FAP, n = 81) and Burn (n = 194). Reliabilities were estimated using Cronbach’s alpha. Relative precision (RP), the ability to distinguish between clinical subgroups, was computed by comparing the proportion of variance explained by the short-form scales versus respective full-length scales.


The ITQOL was reduced from 97 to 47 items. Median alpha coefficients were 0.77 Salland sample, 0.76 (FAP), and 0.84 (Burn). Ninety-one to 100 % scaling successes for item discriminant validity were observed for 21 of 24 tests (8 scales, 3 samples). Floor effects were not observed; some ceiling effects were detected. RP estimates in the Salland sample ranged from 2.40 (physical abilities) to 0.58 (temperament and moods). RP estimates in the FAP sample were 0.85 (bodily pain), 1.36 (temperament and moods) and 1.62 (parental-impact emotional) and for Burn, 1.51 (temperament and moods) and 0.59 (general health perceptions).


The ITQOL-SF47 is reliable and valid and exceeds item-level scaling criteria.


Reliability Psychometrics Outcomes Quality of life Questionnaire PRO’s 



Functional abdominal pain


Health-related quality of life


Infant/toddler quality of life questionnaire


Infant/toddler quality of life questionnaire short form 47


Patient-reported outcomes


Relative precision



None of the authors received financial compensation for this work nor do they have a conflict of interest to report. Ms. Landgraf is the vice president and chief scientific officer at HealthActCHQ, Inc., which owns the intellectual property rights to the ITQOL.


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Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Jeanne M. Landgraf
    • 1
  • Ineke Vogel
    • 2
  • Rianne Oostenbrink
    • 3
  • Margriet E. van Baar
    • 4
  • Hein Raat
    • 2
  1. 1.HealthActCHQCambridgeUSA
  2. 2.Department of Public HealthErasmus MC, University Medical CenterRotterdamThe Netherlands
  3. 3.Department of PediatricsErasmus MC, SophiaRotterdamThe Netherlands
  4. 4.Association of Dutch Burn CentersBurn Centre Maasstad HospitalRotterdamThe Netherlands

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