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Chozie NA, Ayu DR, Medise BE, Marsubrin PMT, Sari TT, Yuniar I, Wahyuni LK. Validity and reliability test of the Indonesian version of the PedHALshort questionnaire. Haemophilia 2024; 30:728-732. [PMID: 38578181 DOI: 10.1111/hae.15000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 03/04/2024] [Accepted: 03/11/2024] [Indexed: 04/06/2024]
Abstract
INTRODUCTION The PedHAL questionnaire is employed in measuring the activities of haemophilia children. The PedHALshort was developed in 2022 to determine the most relevant item for the assessment. Haemo-QoL questionnaire assesses the quality of life of haemophilia children. AIM Determine the validity and reliability of the PedHALshort Indonesia language version compared to the Haemo-QoL in the Indonesian population. METHODS A cross-sectional study was conducted in Jakarta, Indonesia. The subjects were children (4-16 years old) with moderate or severe haemophilia A or B with repeated joint bleeding. The daily activity was assessed using the PedHALshorts and Haemo-QoL. The validity and reliability were tested. The validity was determined with Pearson correlation test, construct validity was assessed using convergent and discriminant validity. The Spearman correlation was used to determine which domains of Haemo-QoL correlated with PedHALshort. The reliability was analyzed using test-retest reliability. Cronbach's α was used to determined internal consistency. RESULTS Fifty children were included in the study (78% haemophilia A, 70% severe group). All domains were valid (r > .284). The convergent validity test showed PedHALshort had a moderate negative correlation with physical health and sports school domain of Haemo-QoL (r = -.479, p < .001). The discriminant validity test showed the PedHALshort demonstrated a moderate negative correlation with physical health (r = -.585), view (r = -.590), sport school domain (r = -.430) in severe haemophilia subjects. The internal consistency of the PedHALshort questionnaire was high (Cronbach's α of .85 (.74-.92)). CONCLUSION The PedHALshort is valid and reliable, hence, it can be used to measure the functional physical activity of children with haemophilia.
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Affiliation(s)
- Novie Amelia Chozie
- Departement of Child Health, Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Dewi Rosariah Ayu
- Pediatric Subspecialist Consultant Program, Departement of Child Health, Cipto Mangunkusumo General hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Department of Child Health, Mohammad Hoesin General Hospital, Universitas Sriwijaya Medical School, Palembang, Indonesia
| | - Bernie Endyarni Medise
- Departement of Child Health, Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | | | - Teny Tjitra Sari
- Departement of Child Health, Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Irene Yuniar
- Departement of Child Health, Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Luh Karunia Wahyuni
- Department of Physical Medicine and Rehabilitation, Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
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Teela L, Luijten MA, Kuijlaars IA, van Gastel TC, van Hoorn ES, Gouw SC, Fijnvandraat KC, Fischer K, Cnossen MH, Andeweg S, van der Velden – van ‘t Hoff C, Liem C, Jansen-Zijlstra ME, Peters M, Haverman L. Psychometrics of the patient-reported outcomes measurement information system measures in hemophilia: the applicability of the pediatric item banks. Res Pract Thromb Haemost 2023; 7:102159. [PMID: 37753226 PMCID: PMC10518485 DOI: 10.1016/j.rpth.2023.102159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 09/28/2023] Open
Abstract
Background The use of patient-reported outcomes measures (PROMs) is important in hemophilia care, as it facilitates communication between patients and clinicians and promotes patient-centered care. Currently, a variety of PROMs with insufficient psychometric properties are used. Patient-reported outcomes measurement information system (PROMIS) measures, including Computer Adaptive Tests, were designed to measure generically and more efficiently and, therefore, are an alternative for the existing PROMs. Objectives To assess the feasibility, measurement properties, and outcomes of 8 PROMIS pediatric measures for boys with hemophilia. Methods In this multicenter study, boys with hemophilia completed 8 PROMIS measures and 2 legacy instruments. Feasibility was determined by the number of completed items and floor or ceiling effects (percentage of participants that achieved the lowest or highest possible score). Reliability was assessed as the percentage of scores with a SE ≤ 4.5. Construct validity was evaluated by comparing the PROMIS measures with the legacy instruments. Mean PROMIS T-scores were calculated and compared with the Dutch general population. Results In total, 77 boys with hemophilia participated. Reliability was good for almost all PROMIS measures and legacy instruments. The total number of completed items varied from 49 to 90 for the PROMIS pediatric measures, while the legacy instruments contained 117 to 130 items. Floor and ceiling effects were observed in both the PROMIS measures (0-39.5%) and legacy instruments (0-66.7%), but were higher for the legacy instruments. Conclusions The PROMIS pediatric measures are feasible to use for boys with hemophilia. With the use of the PROMIS measures in clinical care and research, a step toward worldwide standardization of PROM administration can be taken.
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Affiliation(s)
- Lorynn Teela
- Amsterdam UMC location University of Amsterdam, Emma Children’s Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental health and Digital health, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Child development, Amsterdam, The Netherlands
| | - Michiel A.J. Luijten
- Amsterdam UMC location University of Amsterdam, Emma Children’s Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Child development, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental health and Methodology, Amsterdam, The Netherlands
- Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Isolde A.R. Kuijlaars
- Centre for Benign Haematology, Thrombosis and Haemostasis, Van Creveldkliniek, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Tessa C.M. van Gastel
- Amsterdam UMC location University of Amsterdam, Emma Children’s Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Child development, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental health and Health Behaviours & Chronic Diseases, Amsterdam, The Netherlands
| | - Evelien S. van Hoorn
- Department of Public Health, Erasmus MC, Erasmus University Medical Centre Rotterdam, The Netherlands
| | - Samantha C. Gouw
- Amsterdam UMC location University of Amsterdam, Emma Children’s Hospital, Paediatric Haematology, Amsterdam, The Netherlands
| | - Karin C.J. Fijnvandraat
- Amsterdam UMC location University of Amsterdam, Emma Children’s Hospital, Paediatric Haematology, Amsterdam, The Netherlands
| | - Kathelijn Fischer
- Centre for Benign Haematology, Thrombosis and Haemostasis, Van Creveldkliniek, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Marjon H. Cnossen
- Department of Paediatric Haematology, Erasmus MC Sophia Children’s Hospital, Erasmus University Medical Centre Rotterdam, The Netherlands
| | - Sasja Andeweg
- Department of Paediatric Haematology, Erasmus MC Sophia Children’s Hospital, Erasmus University Medical Centre Rotterdam, The Netherlands
| | | | - Corinne Liem
- Department of Pediatric Haemato-Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Marjolein Peters
- Amsterdam UMC location University of Amsterdam, Emma Children’s Hospital, Paediatric Haematology, Amsterdam, The Netherlands
| | - Lotte Haverman
- Amsterdam UMC location University of Amsterdam, Emma Children’s Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental health and Digital health, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Child development, Amsterdam, The Netherlands
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Kuijlaars IAR, van der Net J, van Vulpen LFD, Driessens MHE, Schols SEM, Tan M, Gouw SC, Fischer K. Validation of the pedHAL short and HAL short in Dutch children and adults with haemophilia. Haemophilia 2022; 28:1007-1015. [PMID: 35905309 PMCID: PMC9796045 DOI: 10.1111/hae.14628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION The Haemophilia Activities List (HAL) and paediatric HAL assess self-reported limitations in various daily activities. To reduce patient burden, shorter versions of the pedHAL (22 items) and HAL (18 items) have been developed. AIM This study aimed to determine the agreement between the pedHAL/HALfull and pedHAL/HALshort and construct validity and internal consistency of the pedHAL/ HALshort in persons with haemophilia (PWH). METHODS A cross-sectional secondary analysis of the Hemophilia in the Netherlands-6 national survey was performed. Adult and paediatric PWH completed the original pedHAL/HALfull , from which pedHAL/ HALshort were derived. Score differences between the original and short versions were calculated. Construct validity was studied by testing hypotheses regarding the relationship of the pedHAL/HALshort with the pedHAL/HALfull , Haemophilia & Exercise Project Test-Questionnaire (HEP-Test-Q), Canadian Haemophilia Outcomes-Kids' Life Assessment Tool (CHO-KLAT) and RAND 36-item Health Survey (RAND-36) (convergent/discriminant validity) as well as its ability to discriminate between subgroups (known-group validity). Internal consistency was assessed with Cronbach's α. RESULTS We included 113 children (median 10y [range 4-17], 53% severe haemophilia) and 691 adults (median 51y [range 18-88], 35% severe). Scores of the pedHAL/HALfull and pedHAL/HALshort were similar with high correlations (>0.9). Construct validity was confirmed for the pedHAL/HALshort . The HALshort was able to discriminate between different disease severities and ages. Cronbach's α of the pedHAL/HALshort was 0.95-0.97. CONCLUSION This study confirmed the agreement between the pedHAL/HALfull and the pedHAL/HALshort and the construct validity of the pedHAL/HALshort . The next step is to study construct validity of the pedHAL/HALshort when administered as short forms.
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Affiliation(s)
- Isolde A. R. Kuijlaars
- Center for Benign HaematologyThrombosis and HaemostasisVan CreveldkliniekUniversity Medical Center UtrechtUtrecht UniversityUtrechtthe Netherlands
| | - Janjaap van der Net
- Center for Child DevelopmentExercise and Physical LiteracyUniversity Medical Center UtrechtUtrecht UniversityUniversity Children's HospitalUtrechtthe Netherlands
| | - Lize F. D. van Vulpen
- Center for Benign HaematologyThrombosis and HaemostasisVan CreveldkliniekUniversity Medical Center UtrechtUtrecht UniversityUtrechtthe Netherlands
| | | | - Saskia E. M. Schols
- Department of HaematologyRadboud University Medical CenterNijmegenthe Netherlands,Haemophilia Treatment Center Nijmegen‐Eindhoven‐MaastrichtRadboud University Medical CenterNijmegenthe Netherlands
| | - Melanie Tan
- Department of Vascular MedicineAmsterdam Cardiovascular SciencesAmsterdam University Medical CentersUniversity of AmsterdamAmsterdamthe Netherlands
| | - Samantha C. Gouw
- Emma Children's HospitalAmsterdam UMCUniversity of AmsterdamPediatric HematologyAmsterdamthe Netherlands,Department of Clinical EpidemiologyLeiden University Medical CenterLeidenthe Netherlands
| | - Kathelijn Fischer
- Center for Benign HaematologyThrombosis and HaemostasisVan CreveldkliniekUniversity Medical Center UtrechtUtrecht UniversityUtrechtthe Netherlands
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Kuijlaars IAR, van der Net J, Buckner TW, Kempton CL, Schutgens REG, Fischer K. Shortening the Haemophilia Activities List (HAL) from 42 items to 18 items. Haemophilia 2021; 27:1062-1070. [PMID: 34498348 PMCID: PMC9293145 DOI: 10.1111/hae.14408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/09/2021] [Accepted: 08/24/2021] [Indexed: 01/22/2023]
Abstract
Introduction The Haemophilia Activities List (HAL) was developed to measure activities and participation in persons with haemophilia (PWH). Shortening the questionnaire may facilitate use of the HAL. Aim The aim of this study was to determine which items of the HAL are redundant, to construct a shorter version of the HAL, and to determine the construct validity of the HALshort. Methods A secondary analysis was performed on pooled data of two published studies using the HAL (seven domains, 42 items, optimum score: 100) in adults with haemophilia A/B. Data were divided into a derivation (62%) and a validation set (38%). Redundant items were identified by evaluation of: floor and ceiling effects, proportions of missing and ‘not applicable’ responses, inter‐item correlations, component loadings in an exploratory factor analysis, internal consistency, and item‐total correlations. Correlations with the SF‐36 and EQ‐5D‐5L were used to determine construct validity of the HALshort. Results Data on 680 PWH were evaluated. In the derivation dataset (n = 420), median age was 30 years (range 18–80), 43% had severe haemophilia and 61% received prophylaxis. Median (IQR) HAL sum score was 65.0 (55.7–88.8). The stepwise procedure resulted in a HALshort of 18 items with a median sum score of 63.3 (54.4–86.7). Construct validity was similar for the HAL and HALshort in the validation dataset (n = 260). Conclusion This clinimetric study resulted in a >50% shortening of the HAL. The 18‐item HALshort reduces patient burden and is expected to capture the information on activities and participation. The HALshort needs further validation.
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Affiliation(s)
- Isolde A R Kuijlaars
- Van Creveldkliniek, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Janjaap van der Net
- Center for Child Development, Exercise and Physical Literacy, University Medical Centre Utrecht, Utrecht University, University Children's Hospital, Utrecht, The Netherlands
| | - Tyler W Buckner
- University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Christine L Kempton
- Hemophilia of Georgia Centre for Bleeding & Clotting Disorders of Emory, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Roger E G Schutgens
- Van Creveldkliniek, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Kathelijn Fischer
- Van Creveldkliniek, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
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