Quality Of Life Measurement Instruments Research Articles

The development of a cryptoglandular anal fistula quality of life scale (AF-QoL).

Quality of life (QoL) is a crucial and core outcome in assessing the effectiveness of treatments for cryptoglandular anal fistula. Despite its extensive impact, there is a lack of patient-centred, disease-specific QoL measurement instruments of adequate quality. The aim of this study is to develop a disease-specific measurement instrument that can accurately measure QoL for patients with cryptoglandular anal fistula. Semi-structured qualitative patient interviews and a systematic review of current instruments were used to generate items for the draft instrument. This underwent successive rounds of cognitive interviews to refine its wording and structure. Individual item and overall scale content validity were determined by asking experts to rate the relevance of each item and those deemed irrelevant were removed. The final instrument then underwent psychometric testing and test-retest analysis to determine its sensitivity and stability. A total of 148 patients were involved in item generation, scale development and psychometric testing. A 22-item measurement instrument has been developed; it is scored on a scale of 0-100, where 0 indicates the worst QoL and 100 demonstrates perfect QoL. The scale demonstrates excellent internal consistency (Cronbach-α = 0.927), strong content and construct validity [correlation with Perianal Disease Activity Index = -0.713, Hospital Anxiety and Depression Anxiety (-0.659) and Depression (-0.673) subscales and Short Form-12 physical (0.609) and mental (0.589) component scales] and strong reliability and responsiveness. We have developed a cryptoglandular Anal Fistula Quality of Life scale (AF-QoL), a comprehensive, disease-specific patient reported outcome measure assessing QoL in patients with cryptoglandular anal fistula.

How do common conditions impact health-related quality of life for children? Providing guidance for validating pediatric preference-based measures

BackgroundThere is increasing interest in the validation of pediatric preference-based health-related quality of life measurement instruments. It is critical that children with various degrees of health-related quality of life (HRQoL) impact are included in validation studies. To inform patient sample selection for validation studies from a pragmatic perspective, this study explored HRQoL impairments between known-groups and HRQoL changes over time across 27 common chronic child health conditions and identified conditions with the largest impact on HRQoL.MethodsThe health dimensions of two common preference-based HRQoL measures, the EQ-5D-Y and CHU9D, were constructed using Pediatric Quality of Life Inventory items that overlap conceptually. Data was from the Longitudinal Study of Australian Children, a nationally representative sample with over 10,000 children at baseline. Seven waves of data were included for the analysis, with child age ranging from 2 to18 years. Impacts to specific health dimensions and overall HRQoL between those having a specific condition versus not were compared using linear mixed effects models. HRQoL changes over time were obtained by calculating the HRQoL differences between two consecutive time points, grouped by “Improved” and “Worsened” health status. Comparison among various health conditions and different age groups (2–4 years, 5–12 years and 13–18 years) were made.ResultsConditions with the largest statistically significant total HRQoL impairments of having a specific condition compared with not having the condition were recurrent chest pain, autism, epilepsy, anxiety/depression, irritable bowel, recurrent back pain, recurrent abdominal pain, and attention deficit hyperactivity disorder (ADHD) for the total sample (2–18 years). Conditions with largest HRQoL improvement over time were anxiety/depression, ADHD, autism, bone/joint/muscle problem, recurrent abdominal pain, recurrent pain in other part, frequent headache, diarrhea and day-wetting. The dimensions included in EQ-5D-Y and CHU9D can generally reflect HRQoL differences and changes. The HRQoL impacts to specific health dimensions differed by condition in the expected direction. The conditions with largest HRQoL impacts differed by age group.ConclusionsThe conditions with largest HRQoL impact were identified. This information is likely to be valuable for recruiting patient samples when validating pediatric preference-based HRQoL instruments pragmatically.

Do Patient-Reported Quality-of-Life (QoL) Scales Provide an Adequate Assessment of Patients with Cryptoglandular Anal Fistulae? A Systematic Review of Measurement Instruments and Their Content Validity.

Background: Cryptoglandular anal fistulae can significantly affect patient quality of life (QoL), making it essential to ensure that any study of fistula treatment assesses the impact on QoL. The aim of this systematic review was to evaluate the content validity of Patient-Reported Outcome Measures (PROMs) that assess QoL in patients with a fistula. Methods: MEDLINE, EMBASE, PsycINFO, and Scopus were searched and studies assessing the content validity of patient-reported QoL measurement instruments, or PROM development studies in patients with cryptoglandular anal fistulae, were included. Data were extracted from eligible studies to determine the instruments’ relevance, comprehensiveness, and comprehensibility, and their quality was assessed according to COnsensus-based Standards for the Selection of health Measurement Instruments (COSMIN). Results: Two PROM development studies were identified, both of which described the development of a disease-specific QoL measurement instrument for patients with cryptoglandular anal fistulae. The overall content validity of these instruments was inconsistent and supported by very low-quality evidence. There were no studies assessing the content validity of established QoL measurement instruments in patients with fistulae. Conclusions: This systematic review could not establish the content validity of the available QoL PROMs for patients with anal fistulae, due either to the absence of designated content validity studies or a lack of comprehensiveness of the available PROMs. This highlights an important gap in the literature that needs to be addressed to ensure high-quality outcome assessment in patients with fistulae.

Cultural and Linguistic Adaptation for the Romanian Language Version of the Cardiff Acne Disability Index: A Pilot Study on the Web-Based Experience of Cognitive Debriefing

Background The Cardiff Acne Disability Index (CADI) is a validated measurement instrument for quality of life evaluation in young patients with acne. The original version was designed in English, and it has been translated to other languages. An adaptation for the Romanian language was lacking. Objective The main objective of this study was to evaluate the comprehensibility of the Romanian language adaptation of the CADI in a small sample of patients with acne. Methods Guided by the team at Cardiff University, we conducted the stages of the standardized translation process—forward translation, the reconciliation of translated versions, back translation, and cognitive debriefing. The cognitive debriefing stage involved applying the CADI to a small sample of patients. This was followed by individual interviews in which each question was discussed. Ethical approval was obtained for the cognitive debriefing stage. We administered this measure as a web-based form. The completion times for each individual question and for the entire survey were automatically recorded. The interviews for assessing comprehensibility and suitability for the Romanian language and culture were also held as live, web-based meetings. Results A total of 7 patients with acne—4 females and 3 males—aged between 19 and 34 years were included. All subjects were native speakers of the Romanian language. They had mild or moderate acne. The mean completion time for the survey was 3.28 minutes. The mean score for the CADI was 5.4286. All participants agreed that the language used in this quality of life measurement instrument was simple, clear, and adequate for their native language. Conclusions Despite the epidemiologic restrictions against COVID-19, through teledermatology, we achieved cultural adaptation for the CADI in a language that previously lacked a specific tool for assessing quality of life impairment in patients with acne. Conflicts of Interest CMS receives royalties from Springer Nature, consulting fees from Vichy International, and support for attending meetings from Leo Pharma. SC has no conflicts of interest.

A systematic review of utility-based and disease-specific quality of life measurement instruments for women with urinary incontinence.

This systematic review aims to identify disease-specific and generic quality of life (QoL) outcome measurement instruments used in populations of women with urinary incontinence (UI) and to determine the most psychometrically robust and appropriate disease-specific and generic tools for measuring the quality of life in this population. A systematic search was conducted of PubMed, Embase, SCIELO, and CINAHL databases for studies evaluating measurement properties of QoL instruments in women with UI. The methodological quality of studies and the quality of measurement properties were evaluated using the COnsensus-based Standards for the selection of health status Measurement INtruments (COSMIN) checklist and quality criteria. Overall, evidence for measurement properties was graded using the modified grading of recommendations, assessment, development & evaluation approach. A total of 73 studies were included, and 27 specific and 6 generic instruments were identified. The Incontinence QoL questionnaire (IQoL) had the highest overall psychometric quality for English-speaking populations and was the most widely translated tool. Evidence for generic QoL tools in this population is limited. Few studies evaluated measurement error or cross-cultural validity. The IQoL is the most psychometrically robust disease-specific tool for use in this population. More research is needed to determine the most psychometrically robust generic tool. Future studies should also evaluate measurement error and cross-cultural validity as evidence for these properties is particularly lacking.

Validity and Reliability Testing of a Quality of Life Measurement Instrument “Child Health and Illness Profile-CHIP-AE” For Adolescents Aged Between 12 and 17

Objective: In this study, it was aimed to make a cultural adaptation of the Child Health and Illness Profile- Adolescents (CHIP-AE) measurement tool for adolescents, which was developed by Starfield in 1993, to analyze whether the Turkish version is reliable, valid and applicable. Material and Methods: The sample of the study consisted of adolescents aged between 12 and 17, receiving inpatient treatment in the Children’s Health and Diseases Clinic in the Faculty of Medicine at Eskisehir Osmangazi University, and adolescents aged between 12 and 17, studying in a private school. The original version of CHIP-AE in English was first translated into Turkish, and then back translated. All stages of the cultural adaptation were performed by a specialized committee. Confirmatory Factor Analysis was conducted on LISREL to test the validity of the instrument. Results: For the purpose of this study, the Turkish version of the CHIP-AE (12-17 years) was administered to 252 adolescents receiving inpatient treatment [148 (58.7%) female; 104 (41.3%) male] and 223 healthy adolescents [109 (48.9%) female; 114 (51.1%) male]. The average age was 14.32±1.70 in the group of ill adolescents, and 14.57±1.51 in the group of healthy adolescents. With regard to reliability, Cronbach’s was 0.852 in the group of ill adolescents, and 0.807 in the group of healthy adolescents. These values refer to perfect reliability. Confirmatory Factor Analysis (CFA) was conducted to test construct validity. Model fit results obtained in CFA were as follows: x2=1622.07, df=1061, p-value=0.000 RMSEA=0.046 in the group of ill adolescents; and x2=2082.33, df=1208, p-value=0.000 RMSEA=0.057 in the group of healthy adolescents. Thus, validity results comply with the standards. Conclusion: This study suggests that the version developed for Turkish adolescents has high validity for the groups of both healthy and ill Turkish adolescents.

Instruments for quality of life assessment in individuals with human papillomavirus.

To identify scientific evidence on quality of life measurement instruments used in individuals with infections caused by human papillomavirus. This was an integrative review carried out from April 1995 to March 2017 in the LILACS, SciVerse Scopus, ISI Web of Science, CINAHL, and PubMed databases. The controlled descriptors adopted were: Infecções por Papilomavirus; Qualidade de Vida; Papillomavirus Infections; and Quality of Life. Of the 416 articles found, 12 were selected. Thirteen different types of instruments to evaluate the quality of life of individuals with human papillomavirus were identified, in that nine were generic and four specific. Different generic and specific instruments were used to evaluate the quality of life of individuals with human papillomavirus, which means no consensus or preference among the studies was identified. However, a lack of use of specific instruments to evaluate this construct in this population was observed.

Deriving Core Patient-Reported Outcomes in Patients with Myelodysplastic Syndromes — a Delphi Survey from the European-MDS Registry

Deriving Core Patient-Reported Outcomes in Patients with Myelodysplastic Syndromes — a Delphi Survey from the European-MDS Registry

Impact of blindness, visual impairment and cataract surgery on quality of life and visual functioning among adults aged 40 years and above in Sri Lanka

Aims To assess associations of visual function (VF) and quality of life (QOL) by presenting visual acuity (PVA) and causes of blindness and visual impairment. Methods Multi-stage cluster random sampling was used to identify a nationally representative sample of persons aged ≥ 40 years in Sri Lanka. Previously validated VF and QOL measurement instruments were administered to participants who were blind or severely visually impaired due to cataract, or refractive errors, those with moderate severe visual impairment of any cause and a sample of those with normal/near normal vision (VA ≥6/12 in the better eye). Questionnaires were also administered to persons who had undergone cataract surgery in one or both eyes and had a post-operative vision ≥ 6/60. Results The Cronbach α coefficients showed that the VF and QOL subscales had satisfactory internal consistency and reliability. Mean VF/QOL scores of individuals who were blind (presenting VA Conclusions VF and QOL self-reported questionnaires are very useful to monitor patient-reported functional benefit from blindness control interventions in low and middle- income countries like Sri Lanka.

The relationship between children's overweight and quality of life: A comparison of Sizing Me Up, PedsQL and Kid-KINDL

Background/Objective: Overweight and obese children are likely to encounter negative impact on psychological well-being and quality of life (QoL). Hence, for overweight and obese children, measuring QoL could go beyond simply assessing objective medical parameters and cover their physical health, psychological well-being, and social interaction. Generic (Kid-KINDL and Pediatric Quality of Life Inventory [PedsQL]) and weight-related (Sizing Me Up) measures are two major types of QoL measurement instruments; however, little is known about the differences between them. Method: We recruited 569 3rd to 6th graders from eleven schools in Southern Taiwan. In addition to the three QoL questionnaires, the Child Depression Inventory and Rosenberg Self-Esteem Scale were applied. Results: Depression had significantly negative associations with all three QoL questionnaires. Self-esteem was only associated with Kid-KINDL. Body mass index had a significantly stronger relationship with Sizing Me Up than its relationships with PedsQL and Kid-KINDL. In other words, the items related to body size concerns in Size Me Up significantly contributed to impaired overweight/obese children’s QoL. Conclusions: The study further identified the characters and strength of these QoL measures for better suggestions on evaluating physical and psychological issues for overweight/obese children.

Measurement tools of resource use and quality of life in clinical trials for dementia or cognitive impairment interventions: A systematically conducted narrative review.

Knowledge is limited about the standardised instruments used to collect resource use and quality of life data alongside trials of dementia interventions. This review aimed to identify the trials using such instruments in order to guide the design of future trial-based cost-effectiveness studies. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement, this review examined all original, peer-reviewed research in major databases and general searches published until June 2017, including randomised clinical trials, pilot studies, or feasibility studies about interventions for older adults with dementia or cognitive impairment. Forty-one studies were identified. Only 8 collected the resource use data using adapted Client Service Receipt Inventory (CSRI), Resource Use Inventory (RUI), cost diary, or study-specific questionnaire. Quality of life was assessed using a wide range of instruments. The most frequently used dementia-specific instrument was Quality of Life in Alzheimer's Disease (QOL-AD) and Dementia Quality of Life questionnaire (DEMQOL). Among the generic measures, EuroQol 5-dimentison (EQ-5D) was mostly used to collect health utility data, and Short Form surveys (SF-36 or SF-12) were widely to measure general health. Several useful resource use and quality of life measurement instruments have been identified by this review. For resource use, CSRI was mostly used, but no studies have used Resource Utilisation in Dementia (RUD); for quality of life, we recommend the inclusion of dementia-specific DEMQOL, generic SF-12, and health utility EQ-5D-5L, based on both self-report and proxy-report.

Measurement properties of quality-of-life measurement instruments for infants, children and adolescents with eczema: a systematic review.

Quality of life (QoL) is one of the core outcome domains identified by the Harmonising Outcome Measures for Eczema (HOME) initiative to be assessed in every eczema trial. There is uncertainty about the most appropriate QoL instrument to measure this domain in infants, children and adolescents. To systematically evaluate the measurement properties of existing measurement instruments developed and/or validated for the measurement of QoL in infants, children and adolescents with eczema. A systematic literature search in PubMed and Embase, complemented by a thorough hand search of reference lists, retrieved studies on measurement properties of eczema QoL instruments for infants, children and adolescents. For all eligible studies, we judged the adequacy of the measurement properties and the methodological study quality with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Results from different studies were summarized in a best-evidence synthesis and formed the basis to assign four degrees of recommendation. Seventeen articles, three of which were found by hand search, were included. These 17 articles reported on 24 instruments. No instrument can be recommended for use in all eczema trials because none fulfilled all required adequacy criteria. With adequate internal consistency, reliability and hypothesis testing, the U.S. version of the Childhood Atopic Dermatitis Impact Scale (CADIS), a proxy-reported instrument, has the potential to be recommended depending on the results of further validation studies. All other instruments, including all self-reported ones, lacked significant validation data. Currently, no QoL instrument for infants, children and adolescents with eczema can be highly recommended. Future validation research should primarily focus on the CADIS, but also attempt to broaden the evidence base for the validity of self-reported instruments.

Validation of the Spanish Version of the ICECAP-O for Nursing Home Residents with Dementia.

BackgroundMeasurement of health-related quality of life (HRQoL) is important for a chronic disease, such as dementia, which impairs the quality of life of affected patients in addition to their length of life. This is important in the context of economic evaluations when interventions do not (only) affect HRQoL and these other factors also affect overall quality of life.ObjectiveTo validate the Spanish translation of the ICECAP-O’s capability to measure Health-related quality of life in elderly with dementia who live in nursing homes.MethodCross-sectional study. For 217 residents living in 8 Spanish nursing homes, questionnaires were completed by nursing professionals serving as proxy respondents. We analyzed the internal consistency and other psychometric properties. We investigated the convergent validity of the ICECAP-O with other HRQoL instruments, the EQ-5D extended with a cognitive dimension (EQ-5D+C), the Alzheimer’s Disease Related Quality of Life (ADRQL) measures, and the Barthel Index measure of activities of daily living (ADL).ResultsThe ICECAP-O presents satisfactory internal consistency (alpha 0.820). The factorial analysis indicated a structure of five principal dimensions that explain 66.57% of the total variance. Convergent validity between the ICECAP-O, EQ-5D+C, ADRQL, and Barthel Index scores was moderate to good (with correlations of 0.62, 0.61, and 0.68, respectively), but differed between dimensions of the instruments. Discriminant validity was confirmed by finding differences in ICECAP-O scores between subgroups based on ADL scores (0.70 low, 0.59 medium, and 0.39 high level care), dementia severity (0.72 mild, 0.63 medium, and 0.50 severe), and ages (0.59 below 75 years and 0.84 above 75 years).ConclusionsThis study presented the first use of a Spanish version of the ICECAP-O. The results indicate that the ICECAP-O appears to be a reliable Health-related quality of life measurement instrument showing good convergent and discriminant validity for people with dementia.

PSY119 - Systematic Review of Quality of Life Measurement Instruments and Response Criteria Among Patients with Myelodysplastic Syndromes

PSY119 - Systematic Review of Quality of Life Measurement Instruments and Response Criteria Among Patients with Myelodysplastic Syndromes

Measurement properties of quality of life measurement instruments for infants, children and adolescents with eczema: protocol for a systematic review.

BackgroundEczema is a common chronic or chronically relapsing, inflammatory skin disease that exerts a substantial negative impact on quality of life (QoL). The Harmonising Outcome Measures for Eczema (HOME) initiative has used a consensus-based process which identified QoL as one of the four core outcome domains to be assessed in all eczema clinical trials. A number of measurement instruments exist to measure QoL in infants, children, and adolescents with eczema, and there is a great variability in both content and quality of the instruments used. Therefore, the objective of the proposed research is to comprehensively and systematically assess the measurement properties of the existing measurement instruments that were developed and/or validated for the measurement of patient-reported QoL in infants, children, and adolescents with eczema.Methods/designThis study is a systematic review of the measurement properties of patient-reported measures of QoL developed and/or validated for infants, children, and adolescents with eczema. A systematic literature search will be carried out in MEDLINE via PubMed and EMBASE using a selection of relevant search terms. Eligible studies will be primary empirical studies evaluating, describing, or comparing measurement properties of QoL instruments for infants, children, and adolescents with eczema. Two reviewers will independently perform eligibility assessment and data abstraction. Evidence tables will be used to record study characteristics, instrument characteristics, measurement properties, and interpretability. The adequacy of the measurement properties will be assessed using predefined criteria. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist will be used to evaluate the methodological quality of included studies. A best evidence synthesis will be undertaken if more than one study has examined a particular measurement property.DiscussionThe proposed systematic review will yield a comprehensive assessment of measurement properties of existing QoL instruments in infants, children, and adolescents with eczema. The results will serve as a basis to recommend a QoL measurement instrument for infants, one for children, and one for adolescents for use in future clinical trials.Systematic review registrationPROSPERO CRD42015023483Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0202-z) contains supplementary material, which is available to authorized users.

Quality of life measurement instrument for thyroid cancer and its application

The study was to introduce quality of life measurement instruments for thyroid cancer, as well as the application of these scales. (1)Quality of life scales such as generic scale SF-36, tumor-specific scale EORTC QLQ-C30 were used in previous studies. (2)In these studies, the quality of life assessment was mainly used for measurement of quality of life in patients with thyroid cancer, comparative effectiveness research and specific psychological intervention evaluation, analysis of relevant factors affecting quality of life in patients with thyroid cancer.(Chin J Endocrinol Metab, 2015, 31: 1074-1077) Key words: Thyroid cancer; Quality of life; Instrument

Poster Abstracts

Aim: This study contributes to the accuracy of the Quality of Life (QoL) measurement in people with intellectual disabilities (ID) by exploring the content and face validity of the different angular points (client, family, caregiver) with the use of selected existing measurement instruments. Methods: First, literature and an expert meeting were used to identify QoL instruments used in the Netherlands. Domains covered by these instruments were compared with domains from the WHO QoL framework. Second, data was collected by means of interviews. Participants were: 6 clients with mild to moderate ID, and complemented each with a family member and their professional caregiver. Participants were recruited through care provider ‘s Heeren Loo. Interviews were done with a carefully designed interviewguide. Participants were asked about the importance of QoL domains and individual items for QoL for the person with ID. The interviews were analyzed using content and domain analysis taking into account that client, family and caregiver were talking about the same client. Recruitment started May 2013. Interviews took place in May – June 2013. Results: Different QoL measurement instruments are used in the Netherlands. Most of these are based on Schalock’s work and include the domains: interpersonal relations, social inclusion, personal devolopment, physical wellbeing, self-dertermination, material wellbeing, emotional wellbeing, rigths and religion. Religion is part of the WHO framework but not of Schalock’s. Conclusion: Despite the paradigm that QoL for people with ID ought not differ from that of the general Dutch population, not all domains from the WHO QoL-framework and the Schalock QoL framework were covered in the QoL instruments used for people with ID. The combination of literature study and interviews suggest the content validity of currently used QoL instruments might be limited. The interviews in this study will help to further investigate the face validity of items included in QoL instruments.

Health-related quality of life questionnaires in lung cancer trials: a systematic literature review.

BackgroundLung cancer is one of the leading causes of cancer deaths. Treatment goals are the relief of symptoms and the increase of overall survival. With the rising number of treatment alternatives, the need for comparable assessments of health-related quality of life (HRQoL) parameters grows. The aim of this paper was to identify and describe measurement instruments applied in lung cancer patients under drug therapy.MethodsWe conducted a systematic literature review at the beginning of 2011 using the electronic database Pubmed.ResultsA total of 43 studies were included in the review. About 17 different measurement instruments were identified, including 5 generic, 5 cancer-specific, 4 lung cancer-specific and 3 symptom-specific questionnaires. In 29 studies at least 2 instruments were used. In most cases these were cancer and lung cancer-specific ones. The most frequently used instruments are the EORTC QLQ-C30 and its lung cancer modules LC13 or LC17. Only 5 studies combined (lung) cancer-specific questionnaires with generic instruments.ConclusionsThe EORTC-C30 and EORTC-LC13 are the most frequently used health-related quality of life measurement instruments in pharmacological lung cancer trials.

Quality of Life

The focus of this column is to provide a brief overview of several conceptual analyses of quality of life along with their resulting definitions. A discussion of the more specific construct of health-related quality of life in terms of chronic illness is considered followed by an in-depth review of health-related quality of life measurement instruments. Finally, the idea of health-related quality of life considered as input to decision-making instead of designated as an outcome measure is proposed.

Quality of life in transplant recipients

For decades, our “success” in kidney transplantation has been measured by numbers (eg, 1- and 5-year patient survival, 1- and 5-year graft survival, blood pressure control, markers of cardiovascular morbidity). Lost in these numbers is the answer to a simple question: “How are these kids doing?” According to a study in the current issue of The Journal by Tong et al in Australia, the answer is “pretty darn good!” Recruiting from five major kidney transplant centers in the country, the authors used sophisticated quality of life measurement instruments that went far beyond simple questionnaires. Drawing from the toolbox of health economists, the investigators employed validated “utility-based” quality of life measures. In most of the domains measured, the children perceived themselves as having near perfect health. Many of them did, however, experience some emotional difficulties, including anxiety, which could be tied to concerns about the long-term function of their grafts. These data should reassure us that the investments in pediatric kidney transplantation appear to pay off for the recipients. Tong et al remind us that this group of children also would benefit from continuing psychosocial support. Article page 670▶ Quality of Life of Adolescent Kidney Transplant RecipientsThe Journal of PediatricsVol. 159Issue 4PreviewTo elicit utility-based quality of life (QOL) of adolescent kidney transplant recipients. Full-Text PDF