Psychometric performance of EQ-TIPS experimental version 2.0 and PedsQL in infants and toddlers with congenital anomalies post-surgery in China

Abstract

This study aimed to evaluate and compare the psychometric performance of the experimental EuroQol Toddler and Infant Populations version 2.0 (EQ-TIPS) and the Paediatric Quality of Life Inventory (PedsQL) in Chinese infants and toddlers with omphalocele or Tetralogy of Fallot (TOF) following surgical repair. Parents of children with omphalocele or ToF who attended the Children’s Hospital, Zhejiang University School of Medicine in China from 2018 onwards were contacted and recruited in September and October 2023. In this cross-sectional study, EQ-TIPS-3L experimental version EV2.0 and PedsQL were administered online, in a fixed order, to parents of children aged 1 month to 4 years via proxy report. Response distribution, known-group and convergent validity were assessed for both instruments by clinical sample and by child age (1–12 months, 13–24 months, 2–4 years). EQ-TIPS level sum scores (LSS), EQ VAS and PedsQL total scores were used as outcomes. Participants included 115 parents of children with omphalocele (mean age = 1.73 years) and 123 parents of children with TOF (mean age = 1.73 years) cases. Over 95% of parents reported good post-surgical recovery. 65.2% of patients with omphalocele and 72.4% of patients with TOF had no problems in any EQ-TIPS dimensions; and 19.1% and 12.2% had the maximum PedsQL score. Mean EQ VAS scores were 87.1 (omphalocele) and 90.0 (TOF); PedsQL total scores were 82.0 and 81.8, respectively. Only PedsQL scores varied between patients based on age ( p < 0.05). EQ-TIPS LSS, EQ VAS and PedsQL showed small-to-large effect sizes between groups expected to differ a priori, with EQ-TIPS and EQ VAS performing better in the omphalocele sample, and PedsQL better in the TOF sample. Moderate correlations were observed between EQ-TIPS LSS and PedsQL total scores whereas correlations between hypothesised item pairs ranged from small to moderate. Our study demonstrates relatively high EQ-TIPS and PedsQL scores in the two patient groups at the time of assessment indicating high levels of health-related quality of life (HRQoL), which may reflect good post-surgical recovery as perceived by parents. EQ-TIPS and PedsQL demonstrated comparable known-group validity with some differences across conditions. While moderate convergence was observed between the summary scores, convergence between hypothesised item pairs ranged from small to moderate, suggesting that the two instruments capture overlapping but distinct aspects of HRQoL. Further research is needed to better understand the relationships between dimensions measured by the two instruments.