Abstract
Objectives. The current paper attempts to give an overview on the state of the art of quality of life assessment (HRQoL) in children as it relates to methodological and conceptual challenges, and the instruments available.
Methods. In a literature search, available instruments for the assessment of children and adolescent's HRQoL were identified and evaluated with regards to several problem areas worked out within the literature search.
Results. Several major issues were considered: (1) dimensions of HRQoL relevant for children, (2) cross-culturally comparable assessment, (3) selfrated vs. externally evaluated HRQoL, (4) age-appropriate assessment, (5) disease-specific vs. generic instruments, (6) profile instruments versus index instruments, (7) HRQoL and utility- preference value. Nine generic HRQoL instruments and four utility health state classification systems complied with pre-specified inclusion criteria but met the identified challenges in different extent.
Conclusion. There are instruments available measuring the HRQoL-dimensions relevant to children. If an instrument was constructed appropriately, HRQoL can be measured in an interculturally comparable manner. Selfratings should be ascertained; the children's maturity and cognitive development have to be considered. Generic instruments allow to measure HRQoL across different diseases. The use of singular index values of HRQoL is connected to strict psychometric conditions. How far utility measures are useful for children has to be investigated in further studies.
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