Quality of Life Research

, Volume 27, Issue 4, pp 879–890 | Cite as

Predictors of self-reported health-related quality of life according to the EQ-5D-Y in chronically ill children and adolescents with asthma, diabetes, and juvenile arthritis: longitudinal results

  • Christiane Otto
  • Dana Barthel
  • Fionna Klasen
  • Sandra Nolte
  • Matthias Rose
  • Ann-Katrin Meyrose
  • Marcus Klein
  • Ute Thyen
  • Ulrike Ravens-Sieberer



Health-related quality of life (HRQoL) is an important patient-reported outcome in clinical and health research. The EQ-5D-Y assesses child and adolescent HRQoL by five items on mobility, self-care, usual activities, pain/discomfort, and anxiety/depression as well as a visual analogue scale (VAS) on the current health state. This study investigates predictors of self-reported HRQoL according to the EQ-5D-Y in chronically ill children and adolescents using longitudinal data.


Data from the German Kids-CAT study on children and adolescents with asthma, diabetes, and juvenile arthritis gathered over a period of six months were analyzed (n = 310; 7–17 years old; 48% female). Self-, parent-, and pediatrician-reported data were collected from June 2013 to October 2014. Generalized linear mixed models and linear mixed models served to examine effects of socio-demographic as well as disease- and health-specific predictors on the items as well as on the VAS of the EQ-5D-Y.


Ceiling effects for the EQ-5D-Y indicated low burden of disease in the analyzed sample. Longitudinal analyses revealed associations between less health complaints and better HRQoL for all investigated HRQoL domains. Further, age- and gender-specific effects, and associations of better disease control, longer duration of the disease and less mental health problems with better HRQoL were found.


Subjective health complaints and mental health problems should be considered in the care of children and adolescents with asthma, diabetes, and juvenile arthritis. Future research should suggest administering the items of the EQ-5D-Y with five instead of three response options, and investigate HRQoL over a longer period.


Quality of life Children Adolescents EQ-5D-Y Chronic illness 



We thank all children, adolescents and their parents, who participated in the Kids-CAT study. Further, we thank the study nurses Anja Bünte and Andrea Knaak, as well as all involved pediatricians for their valuable contributions to the Kids-CAT project. Moreover, we thank Dr. Claus Barkmann for statistical advice, as well as  all student assistants and interns for their support. The work on the present publication was financially supported by the EuroQol Foundation, but the views expressed by the authors in the present publication do not necessarily reflect the views of the EuroQol Group.


This Kids-CAT study was funded by the German Federal Ministry of Education and Research (Grant No. 0010-01GY1111). The present manuscript was funded by the EuroQol Research Foundation (EQ Project 2016270).

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

11136_2017_1753_MOESM1_ESM.docx (109 kb)
Supplementary material 1 (DOCX 109 KB)
11136_2017_1753_MOESM2_ESM.docx (45 kb)
Supplementary material 2 (DOCX 45 KB)


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Research Unit Child Public Health, Center for Psychosocial MedicineUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Department of Psychosomatic Medicine, Center of Internal Medicine and DermatologyCharité - Universitätsmedizin BerlinBerlinGermany
  3. 3.Population Health Strategic Research Centre, School of Health and Social DevelopmentDeakin UniversityGeelongAustralia
  4. 4.Quantitative Health Sciences, Outcomes Measurement ScienceUniversity of Massachusetts Medical SchoolWorcesterUSA
  5. 5.Department of PediatricsUniversity Medical Center Schleswig-HolsteinKielGermany
  6. 6.Hospital for Pediatrics and Adolescent MedicineUniversity of LübeckLübeckGermany

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