Past Studies
Pediatric Spine Deformity: How Do We Assess Quality of Life Impact?
 Introduction:
The term "quality of life" refers to the physical, psychological and social domains of health. These health-related domains are seen as distinct areas that are influenced by a person's experiences, beliefs, expectations, and perceptions. In the last decade there has been an increasing importance in recognizing the patient's perception of their quality of life, particularly in orthopaedic surgery where intervention is designed not only to lengthen or save a life, but to improve it's quality. However, little has been done to measure health related quality of life in children. Because children are constantly growing and developing they are more difficult to assess. In an effort to address this problem, new instruments including the generic Child Health Questionnaire and the Pediatric Outcomes Data Collection Instrument, were created exclusively for the pediatric population. The goal of this study was to examine the validity, responsiveness to clinical change, and utility of the CHQ and the PODCI for children with scoliosis. Evaluation of these instruments hopes to allow for more accurate determination of health related quality of life in children with scoliosis.
Methods:
There were 755 subjects between the ages of 5 and 18 split into five diagnostic groups; idiopathic scoliosis, kyphosis, neurogenic scoliosis, congenital scoliosis and 'other'. Because many of the patients were too young or otherwise unable to fill out the questionnaires, a version of the questionnaire was given to parents and guardians to complete for their children. In addition, the treating surgeon gave a general physical and psychosocial score, which we compared to the scores from the survey.
Results:
Overall, except for patients with neurogenic scoliosis, patients indicated high level of both physical and psychosocial health based on their CHQ scores. The PODCI revealed similar results as the CHQ for all diagnostic. Based on the data, the PODCI proved to be a stronger instrument.
Conclusion:
It was previously shown that the CHQ and PODCI each have unique advantages in determining quality of life in the general pediatric orthopaedic population. CHQ gave a broader picture of the child's health while the PODCI provided a better focused view of the child's physical functioning. This study demonstrated that PODCI is a slightly stronger instrument. Not only were the physical health domains of the CHQ and PODCI more strongly correlated with each other than the pychosocial counterparts, but the physical health domains of the PODCI were more strongly correlated with the physician's health rating than the CHQ. Because the PODCI does focus mainly on physical functioning, it is less able to quantify emotional or psychosocial status or even how a disease is affecting a family. In conclusion, the investigators believe that the combination of these instruments helped to obtain additional information that would have been missed if either questionnaire were used alone.
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