Abstract
BackgroundCaries Impacts and Experiences Questionnaire for Children (CARIES-QC) is a child-centred caries-specific quality of life measure. This study aimed to select, and validate with children, a classification system for a paediatric condition-specific preference-based measure, based on CARIES-QC.MethodsFirst, a provisional classification system for a preference-based measure based on CARIES-QC was identified using Rasch analysis, psychometric testing, involvement of children and parents, and the developer of CARIES-QC. Second, qualitative, semi-structured ‘think aloud’ validation interviews were undertaken with a purposive sample of children with dental caries. The interviewer aimed to identify whether items were considered important and easily understood, whether any were overlapping and if any excluded items should be reintroduced. Interview recordings were transcribed verbatim and thematic analysis conducted.ResultsRasch analysis identified poor item spread for the items ‘cross’ and ‘school’. Items relating to eating were correlated and the better performing items were considered for selection. Children expressed some confusion regarding the items ‘school’ and ‘food stuck’. Parent representatives thought that impacts surrounding toothbrushing (‘brushing’) were encompassed by the item ‘hurt’. Five items were selected from CARIES-QC for inclusion in the provisional classification system; ‘hurt’, ‘annoy’, ‘carefully’, ‘kept awake’ and ‘cried’. Validation interviews were conducted with 20 children aged 5–16 years old. Participants thought the questionnaire was straightforward and covered a range of impacts. Children thought an item about certain foods being ‘hard to eat’ was more relevant than one about having to eat more carefully because of their teeth and so the ‘carefully’ item was replaced with ‘hard to eat’.ConclusionFollowing child-centred modification, the preliminary five-item classification system is considered valid and suitable for use in a valuation survey. The innovative child-centred methods used to both identify and validate the classification system can be applied in the development of other preference-based measures.
Highlights
Caries Impacts and Experiences Questionnaire for Children (CARIES-QC) is a child-centred cariesspecific quality of life measure
A number of studies have highlighted links between dental caries and general health, with higher levels of untreated dental caries reported to be associated with reduced weight and poor growth [6, 7]
This study aimed to identify a classification system for a child-centred preference-based measure using a combination of statistical methodologies and involvement of stakeholders including children, young people and parents
Summary
Caries Impacts and Experiences Questionnaire for Children (CARIES-QC) is a child-centred cariesspecific quality of life measure. Whilst pain is the most common feature of caries, there is a growing body of evidence on the further impacts relating to pain on children’s daily lives [3]. These include time off school, difficulty sleeping, speaking, eating and interference with everyday activities [4, 5]. Dental caries remains the most common reason for children to require hospital admission with an estimated annual cost of £39 million to the National Health Service (NHS) [9]
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