Performance of the Experimental EuroQol Toddler and Infant Populations (EQ-TIPS) and PedsQL in Infants and Toddlers with a Health Condition

TL;DR

This study compares two tools for measuring health-related quality of life in infants and toddlers, finding differences in how they capture issues like eating, pain, and school functioning.

Contribution

The study provides empirical evidence comparing the EQ-TIPS and PedsQL instruments in infants and toddlers with health conditions.

Findings

EQ-TIPS-3L reported high problems with eating and pain across age groups.

PedsQL had significant missing data in school functioning items for older children.

Both measures differentiated by severity but not by age group.

Abstract

Health-related quality of life measurement in infants and toddlers is increasingly important, but generic preference-weighted instruments lack evidence. This study compared the experimental EuroQol Toddler and Infant Populations (EQ-TIPS) and PedsQL in children 0 to 4 years.

EQ-TIPS-3L v2.0 and PedsQL response distributions were compared by frequency. Item and dimension/summary score associations were computed using Pearson and intra-class correlation coefficient. Age and severity groups (EQ VAS ≥80) were compared with Mann-Whitney U tests.

Cross-sectional data from 260 children were analyzed: 0 to 24 months (n = 111) and 2 to 4 years (n = 149). Most caregivers were mothers, spending significantly more time (≥10 hours) with younger children χ2 = 18.12, P = .001). The EQ-TIPS-3L had the highest problems with eating (27%-31%) and pain (23%-25%) across age groups, with minimal missing data (≤1%). Younger children most frequently had problems with PedsQL: “tired” (54%), “resting a lot” (52%), “crying or fussing when left alone” (61%) and “difficulty soothing when upset” (51%). Older children’s main problems were “hurts or aches” (54%), “afraid or scared” (53%), “sad or blue” (50%), “angry” (64%) and “missing school” (56%-65%). All 3 of the PedsQL school items had missing data for older children (27%-30%). Hypothesized item correlations were reached for 30 of 35 and 11 of 12 items in the younger and older groups, respectively. EQ-TIPS-3L LSS showed moderate to strong correlations with all PedsQL scores except for cognitive (0-24 months) and school functioning (2-4 years). Both measures significantly differentiated by severity groups (EQ VAS ≥80) but not by age group.

Both measures showed similar response distributions despite different time frames and response scales. EQ-TIPS-3L eating and pain reported high problems, with eating strongly associated only with PedsQL physical symptoms. The 2- to 4-year PedsQL version had many missing school functioning items; the 13- to 24-month PedsQL may suit older 2- to 4-year-olds better. Low association between PedsQL cognitive functioning and EQ-TIPS-3L suggests further research is needed on this potentially missing construct.

Figures