Validity, reliability and discriminative capacity of an electronic quality of life instrument (Pelican) for childhood asthma in the Netherlands
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To assess psychometric properties of the Pelican instrument, an online Dutch self-administered Quality of Life instrument for childhood asthma for scientific and clinical use.
A cohort study was done in two asthma populations and healthy children. One asthma population had assessment at start, 4 and 8 weeks. The other asthma population and healthy children had one assessment. All children were aged 6–12 years. Children completed the Pelican instrument, Paediatric Asthma Quality of Life Questionnaire, feeling thermometer and Childhood Asthma Control Test. Lung function and fraction exhaled nitric oxide were measured. Parents completed Functional Status II, Asthma Control Questionnaire, Childhood Asthma Control Test questionnaires and symptom diaries. We assessed interpretability, structural validity, internal consistency, reliability, construct and discriminative validity of the Pelican instrument.
Eighty-five asthmatic (mean age 8.5 years) and 49 healthy children (mean age 8.4 years) participated. The Pelican instrument has 5 domains with 21 items after factor analysis. Internal consistency was 0.89 (CI 0.85–0.92), domain reliability showed Cronbach’s α’s from 0.64 to 0.76 and item-to-scale correlations from 0.61 to 0.81. Test–retest reliability was confirmed ICC = 0.88 (CI 0.79–0.93). Construct validity was demonstrated by significant moderate correlations with other relevant asthma outcomes like PAQLQ (r = −0.59, p < 0.01). Discriminative capacity between controlled or uncontrolled asthma (t = 3.20, p < 0.01, Δ = 0.64) and asthma versus healthy subjects (t = 6.31, p < 0.01, Δ = 0.94) was found.
The psychometric properties of the Pelican instrument were acceptable in Dutch paediatric asthma patients between 6 and 12 years old.
KeywordsPsychometric properties Asthma Children Health-related Quality of Life (HRQL) Reliability Validity
Asthma Control Questionnaire
American Thoracic Society
Childhood Asthma Questionnaire
Childhood Asthma Control Test
Child Behaviour Checklist for children aged 6–18 years
European Respiratory Society
Fraction exhaled Nitric Oxide
Forced expiratory volume in one second
Functional Status II
Forced vital capacity
How Are You
Health-related quality of life
Paediatric Asthma Quality of Life Instrument
Paediatric Electronic quality of Life Instrument for Childhood Asthma instrument in the Netherlands
Pediatric Quality of Life Inventory
This study was financially supported by the Dutch Lung Foundation (previously Dutch Asthma Foundation). The authors would like to thank all participating children and their parents. We are also grateful to all general practitioners, pharmacists and others who helped recruiting participants and to J. Braspenning, V. Hulsman and P. Madge for the English translation process of the Pelican instrument. Moreover, we would like to thank the ‘Stichting Huisartsenlaboratorium’ (SHL), a regional diagnostic centre, for their help with the data collection. A special thanks goes to Nicol Orbon and Joke Grootens who managed the data collection of this study. Finally, we would like to thank Amadea Gloudemans (AG) and Sabine Wendt (SW), who interviewed the children and helped coding and analysing the interviews with participating children.
Conflict of interest
The authors declare that they have no competing interests.
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