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09-11-2016 | Uitgave 5/2017

Quality of Life Research 5/2017

The validation of a computer-adaptive test (CAT) for assessing health-related quality of life in children and adolescents in a clinical sample: study design, methods and first results of the Kids-CAT study

Quality of Life Research > Uitgave 5/2017
D. Barthel, C. Otto, S. Nolte, A.-K. Meyrose, F. Fischer, J. Devine, O. Walter, A. Mierke, K. I. Fischer, U. Thyen, M. Klein, T. Ankermann, M. Rose, U. Ravens-Sieberer
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The online version of this article (doi:10.​1007/​s11136-016-1437-9) contains supplementary material, which is available to authorized users.



Recently, we developed a computer-adaptive test (CAT) for assessing health-related quality of life (HRQoL) in children and adolescents: the Kids-CAT. It measures five generic HRQoL dimensions. The aims of this article were (1) to present the study design and (2) to investigate its psychometric properties in a clinical setting.


The Kids-CAT study is a longitudinal prospective study with eight measurements over one year at two University Medical Centers in Germany. For validating the Kids-CAT, 270 consecutive 7- to 17-year-old patients with asthma (n = 52), diabetes (n = 182) or juvenile arthritis (n = 36) answered well-established HRQoL instruments (Pediatric Quality of Life Inventory™ (PedsQL), KIDSCREEN-27) and scales measuring related constructs (e.g., social support, self-efficacy). Measurement precision, test–retest reliability, convergent and discriminant validity were investigated.


The mean standard error of measurement ranged between .38 and .49 for the five dimensions, which equals a reliability between .86 and .76, respectively. The Kids-CAT measured most reliably in the lower HRQoL range. Convergent validity was supported by moderate to high correlations of the Kids-CAT dimensions with corresponding PedsQL dimensions ranging between .52 and .72. A lower correlation was found between the social dimensions of both instruments. Discriminant validity was confirmed by lower correlations with non-corresponding subscales of the PedsQL.


The Kids-CAT measures pediatric HRQoL reliably, particularly in lower areas of HRQoL. Its test–retest reliability should be re-investigated in future studies. The validity of the instrument was demonstrated. Overall, results suggest that the Kids-CAT is a promising candidate for detecting psychosocial needs in chronically ill children.

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