Measuring quality of life in children with obstructive sleep disorders

Objective: To validate a disease-specific health-related quality of life (H RQOL) instrument for children with obstructive sleep disorders (OSDs). Design: Prospective cohort study using a 6-item health-related instrument ( OSD-6). Subjects: One hundred caregivers of patients with OSDs secondary to adenoto nsillar hypertrophy (age range, 2-12 years) from 2 tertiary care, pediatric otolaryngology practices. Intervention: The OSD-6 was administered on initial presentation and 4 to 5 weeks after adenotonsillectomy. A subset of patients repeated the OSD-6 wi thin 3 weeks after presentation to assess test-retest reliability. Main Outcome Measures: Test-retest reliability, internal consistency, const ruct validity, and responsiveness to clinical change of the OSD-6 score. Results: Test-retest reliability was good (intraclass correlation coefficie nt=0.74). Median OSD-6 score was 4.5 (0- to 6-point scale) with higher scor es indicating poorer quality of life (QOL). Construct validity was demonstr ated by the moderate correlation between OSD-6 score and global adenoid and tonsil-related QOL (R=-0.62), strong correlation between the OSD-6 change score and change in global adenoid and tonsil-related QOL (R=-0.63), and th e moderate correlation between the change score and parent estimate of clin ical change (R=0.40). The mean change in OSD-6 score after adenotonsillecto my was 3.0 (95% confidence interval, 2.7-3.4). The mean standardized respon se was 2.3 (95% confidence interval, 1.9-2.7) indicating the instrument's l arge responsiveness to clinical change. The change score was very reliable (R=0.85). Conclusions: The OSD-6 is a reliable, responsive, easily administered instr ument. It is valid for detecting change after adenotonsillectomy in childre n with OSDs.