Cross-cultural adaptation of a health status classification system in children with cancer. First results of the French adaptation of the Health Utilities Index Marks 2 and 3

Our objective was to adapt and validate the Health Utilities Index Mark 2 ( HUI 2) and HUI 3 hearth status classification systems self-report questionn aire in a population of children with cancer, a group of 42 children alread y included in a multi-centre database designed by the Group on Brain Tumors in Children of the French Society for Pediatric Oncology. Children were re cruited during a routine consultation. Most of them had completed treatment , The version of the questionnaire for French adults was adapted linguistic ally far children, Open-ended queries by children about the comprehensivene ss of the questions and very low non-response rates showed a good acceptabi lity of the questionnaire. The main psychometric properties of the HUI 2 an d HUI 3 classification systems were assessed in 3 groups of raters (child, parent, physician): construct validity was tested against the rating of the child's health state on a Likert scale and through comparison with clinica l data, and internal consistency was determined through multi-trait analysi s, Weighted and unweighted kappa values were used to measure the inter-rate r agreement between the child's, parent's and physician's assessment of the child's health state, The convergent validity was satisfactory, with bette r results when the physician's assessment was used. The most affected attri butes were the expected ones (i.e., cognition, pain and emotion). Disagreem ent was observed between the 3 raters, more often in the same direction: ta king the child's assessment as the reference, the parents tended to under-e stimate the health status while physicians tended to over-estimate it. Int. J. Cancer Suppl, 12:112-118, 1999. (C) 1999 Wiley-Liss, Inc.