Shortening the questionnaire for identifying children with chronic conditions: What is the consequence?

Objective. To determine whether a reduced item set can identify children wh o have chronic conditions with a level of at least 90% accuracy compared wi th the complete Questionnaire for Identifying Children With Chronic Conditi ons (QuICCC). Background. The QuICCC was developed to operationalize a conceptually based , noncategorical definition of chronic conditions developed by Stein et al. It contains 39 item sequences administered to a parent that assess 3 types of consequences: functional limitations; reliance on compensatory mechanis ms or assistance; and service use or need above usual for age. The QuICCC h as been validated and widely adopted as a means of identifying children wit hout using a diagnosis checklist, but there is considerable interest in sho rtening it. Design/Methods. Through secondary analyses of 3 data sets (Ns = 1265, 1388, and 4831), we identified a short list of items that identified >90% of chi ldren who were identified by the 39-item QuICCC. We administered these 16 i tems to 2 new samples of parents. In Study 1 we administered the 16 items i n the shortened version first, followed by the other 23 items, and compared the results on the short and reordered long versions. In Study 2, the 39- and 16-item versions were each administered, one in person and the other by phone, in random order to the same respondent within a 2-week period. Thes e data were analyzed to compare the short and longer versions at the 2 time points and within the single, longer 39-item format (simultaneous data). Results. In Study 1 (N = 630) only 4 children were missed by the 16-item ve rsion who were identified by the longer version (sensitivity 98.6%; specifi city 100%; positive predictive value 100%; negative predictive value 98.8% kappa 0.987). In Study 2 (N = 552), no children were missed by the 16-item subset of the 39 items when looking at the simultaneous data. When the two forms were administered 2 weeks apart, the 16-item version had a sensitivit y of 87%, specificity of 90%, positive predictive value of 93%, negative pr edictive value of 82%, and kappa of 0.78 compared with the longer QuICCC. T hese results correspond exactly to the data obtained in a 2-week test-retes t study for the QuICCC itself. The new form (the QuICCC-R) takes <2 minutes to administer on average (range 1-4 minutes) compared with 7 to 8 minutes for the full QuICCC. Conclusions. The results met our criteria for agreement, and we conclude th at the QuICCC-R is a satisfactory alternative for screening populations. Ho wever, the full QuICCC has other applications beyond screening that may not apply to the QuICCC-R, the shorter version.