COMPREHENSIVE ASSESSMENT OF THE HEALTH-STATUS OF EXTREMELY LOW-BIRTH-WEIGHT CHILDREN AT 8 YEARS OF AGE - COMPARISON WITH A REFERENCE GROUP

Objective: To apply a multiattribute health status (MAHS) classificati on system to data available on two cohorts of school-aged children to describe several dimensions of health simultaneously. The MAHS system describes both-the type and severity of functional limitations accordi ng to seven attributes: sensation, mobility, emotion, cognition, self- care, pain, and fertility (fertility not applicable in this study), wi th four or five levels of function within each attribute. Design: The MAHS system was applied retrospectively to clinical and psychometric d ata collected prospectively at age 8 years. MAHS application was by se lection of items from the database and development of computer-assiste d algorithms to assign functional levels within each attribute. Settin g: Geographically defined region in central-west Ontario, Canada. Part icipants: One hundred fifty-six extremely low birth weight (ELBW) surv ivors born between 1977 and 1982 (follow-up rate 90%) and 145 referenc e children matched for age, sex, and socioeconomic status. Results: 14 % of ELBW subjects had no functional limitations, 58% had reduced func tion for one or two attributes, and 28% had at least three affected. T he corresponding figures for the reference group were 50%, 48%, and 2% (p <0.0001). The limitations were more severe and complex in the ELBW group, and were notably in cognition (58%), sensation (48%), mobility (21%), and self-care (17%), compared with 28%, 11%, 1%, and 0% for re ference children (all p <0.0001). Conclusions: These data indicate tha t fewer ELBW than reference children were free of functional limitatio ns and a significantly higher proportion had multiple attributes affec ted. The MAHS classification approach is ii useful instrument to compa re the health status of different groups and populations, and to monit or changes with time.