MEASURING QUALITY-OF-LIFE IN CHILDREN WITH RHINOCONJUNCTIVITIS

Objective: The objective of this study was to develop, pretest, and va lidate a questionnaire to measure quality of life in children with sea sonal allergic rhinoconjunctivitis (SAR). Methods (development study): Thirty-four children with SAR were enrolled from summer camps, notice s in the media, and an allergy clinic (Southern Ontario). After genera ting a pool of 48 potentially important quality of life items, the chi ldren identified the ones that they experienced with their SAR and sco red each for bother (1 = a little bothered to 4 = extremely bothered). Items identified most frequently and with the highest bother score we re included in the Paediatric Rhinoconjunctivitis Quality of Life Ques tionnaire (PRQLQ). The PRQLQ was pretested for ease completion and acc uracy of understanding. Results (development study): The PRQLQ has 23 items in five domains (nose symptoms, eye symptoms, practical problems , other symptoms, and activities). Responses are given on a seven-poin t scale, and children are asked to score their experiences during the previous 7 days. Methods (validation study): Seventy-five children wit h symptomatic SAR mere enrolled from notices in the media and a pediat ric allergy clinic (Austin, Tex.). A single cohort design was used, wi th children assessed at 0, 1, and 3 weeks. The PRQLQ was administered to the children by a trained interviewer at 1 and 3 weeks. A conventio nal nasal symptom daily diary was completed for 1 week before each of these clinic visits. Global ratings were completed at the final visit. Results (validation study): In patients who were stable between clini c visits, the PRQLQ demonstrated good reliability (intraclass correlat ion coefficient = 0.93). The questionnaire was very responsive to chan ge (p < 0.001) and was able to differentiate between patients who were in a stable clinical state and those whose clinical state changed bet ween visits (p = 0.005). Correlations between the PRQLQ and diary scor es were close to predicted and supported both the cross-sectional and longitudinal validity of the PRQLQ. Conclusions: The PRQLQ measures th e quality of life impairments important to children with SAR. Children provide reliable and accurate responses, the measurement properties a re strong, and the questionnaire can be used with confidence in clinic al trials, clinical practice, and surveys.