Differences in Child versus Parent Reports of the Child's Health-Related Quality of Life in Children with Epilepsy and Healthy Siblings

• Published in: Value in health Vol. 13; no. 6; pp. 778 - 786
• Main Authors: Baca, Christine Bower, MD, Vickrey, Barbara G., MD, MPH, Hays, Ron D., PhD, Vassar, Stefanie D., MS, Berg, Anne T., PhD
• Format: Journal Article
• Language: English
• Published: Malden, USA Elsevier Inc 01.09.2010; Blackwell Publishing Inc
• Subjects: Adolescent; Adult; Case-Control Studies; Child; child and adolescent health; Child Health Questionnaire (CHQ); Children; Epilepsy; Epilepsy - psychology; Female; Health status; health-related quality of life (HRQOL); Humans; Internal Medicine; Male; outcomes research; Parents; Parents - psychology; patient-reported outcomes; Prospective Studies; proxy; Proxy - psychology; Quality of Life; Self-Assessment; Siblings; Siblings - psychology; Sickness Impact Profile; epilepsy; patient-reported outcomes; proxy; child and adolescent health; outcomes research; Child Health Questionnaire (CHQ); health-related quality of life (HRQOL)
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1111/j.1524-4733.2010.00732.x

Abstract Objectives Self versus proxy perspectives may produce different results that are important for clinical decision-making and for assessing outcomes in research studies. We examined differences in child versus parent report of the child's health-related quality of life (HRQOL) in a large prospective, community-based study of newly diagnosed childhood epilepsy that included children with epilepsy (case) and sibling controls. Methods HRQOL was assessed 8 to 9 years after initial diagnosis of epilepsy in a subset of 143 case-control matched pairs using the Child Health Questionnaire (CHQ), a generic HRQOL measure with child (CHQ-CF87), and parent (CHQ-PF50) versions. Results There were no significant differences between self-reported case and sibling control HRQOL scores on 9 of 11 scales or 2 global items. Nevertheless, parent ratings were significantly better (higher HRQOL) for sibling controls compared with epilepsy cases on 10 of 12 scales, global behavior and general health items, and the physical and psychosocial summary scores ( P ≤ 0.05). Parent–child agreement was low for cases and controls (kappa 0.27–0.33) for three single-item questions with the same wording on parent and child versions. Parent ratings of the case's HRQOL were often significantly associated with 5-year remission status and current antiepileptic drug use, but the case's self-reported HRQOL scores were not. In contrast, current pharmacoresistance was often associated with the child and parent ratings of the child's HRQOL. Conclusion Children with epilepsy report HRQOL that is comparable to that of sibling controls, while parents rate children with epilepsy as having lower HRQOL than sibling controls. Measuring outcomes in studies of this population should incorporate both perspectives.