Article

Measures of pediatric function: Child Health Assessment Questionnaire (C‐HAQ), Juvenile Arthritis Functional Assessment Scale (JAFAS), Pediatric Outcomes Data Collection Instrument (PODCI), and Activities Scale for Kids (ASK)

Clinical Physical Therapy, Columbia University, New York, New York 10032, USA.
Arthritis care & research 11/2011; 63 Suppl 11(S11):S371-82. DOI: 10.1002/acr.20635
Source: PubMed

ABSTRACT Sensitivity of the PODCI scales to detect change over time was evaluated in several ways: 1) By correlation of change scores on the parent and physician questionnaire with parent and physician scores on a 5-point transition scale indicating change in the child's health status (much better to much worse) over a 9-month time period. Results indicated both parent and physician change score were almost completely uncorrelated with their transition scores. Higher correlations were found between change scores on the adolescent self-report and adolescent and physician transition scores. Adolescent PODCI global scores and two subscale scores correlated better with the adolescent and physician transition scores than the CHQ. However, based on regression analysis to understand the basis of parents' and adolescents' assessment of overall change in the patient's global health and orthopedic condition, the authors concluded that much of parent and adolescent judgment of improvement or decline in function was unrelated to self-perceived measures of current function or change from baseline. Parents and adolescents appear to base their judgments of change on different areas; 2) by sensitivity to change among a subset of patients who should change the most from baseline to followup assessment (score of ≤80 on a composite score of 0–100, consisting of physician-rated function, PODCI global function, and CHQ physical function). Comparing outcomes in a sample of 113 subjects with data on all key patient-report outcomes scales using t-tests, all PODCI scales, except upper extremity function, ranked higher on sensitivity than the CHQ physical function scale. The PODCI global score was 2.9 times more efficient than the CHQ at detecting change in this sample. In 49 adolescents with baseline composite scores of ≤80 and complete data for key scales, the most sensitive scale was the PODCI physical sports and activities scale, followed closely by the CHQ physical function and PODCI global score; and 3) By t-scores for sensitivity based on the severity of baseline diagnosis. Change scores were greatest for patients with diagnoses rated as most severe (n = 34). PODCI global score and 2 subscales were more sensitive to change than the CHQ physical function scale. The PODCI upper extremity function scale discriminated best between subjects with and without upper extremity impairments, 6.8 times more efficient than the CHQ global function. PODCI transfers and mobility scale was the best discriminator of function between groups with and without lower extremity impairments, being 2.6 times more efficient than the CHQ physical function scale.

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