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  • Open Access

Exploring the ceiling effect of the revised Childhood Health Assessment Questionnaire in a European patient sample

  • 1,
  • 1,
  • 3,
  • 2,
  • 7,
  • 8,
  • 5,
  • 4 and
  • 6
Pediatric Rheumatology20086 (Suppl 1) :P102

https://doi.org/10.1186/1546-0096-6-S1-P102

  • Published:

Keywords

  • Public Health
  • Interquartile Range
  • Response Option
  • Patient Sample
  • Categorical Response

Background

The original version of the Childhood Health Assessment Questionnaire (CHAQ30orig) suffers from a ceiling effect and hence has reduced clinical validity [1]. The effect of adding eight more demanding items and a new continuous response option (CATII) was tested.

Methods

Twenty-four children with JIA [2] were recruited from eight centres across Europe. Demographic, clinical, and CHAQ data were obtained. Five different score calculations were applied: the original method (CHAQ30orig), and the mean item scores for the 30 and 38-question versions with two categorical response options (Chaq30item CAT I and II and Chaq38item CAT I and II).

Descriptive statistics were calculated and CHAQ-data were tested for normality. A ceiling effect was defined by 15% or more patients scoring the best possible score.

Results

(preliminary, based on 30% of total data).

A ceiling effect was observed in CHAQ30orig and CHAQ30item (20.8% for both). The median scores, KS-statistics, p-values, and interquartile range (IQR) are presented in table 1.
Table 1

Median, ceiling effect, KS results, and interquartile range of five CHAQ scoring methods.

 

Scoring method

Median (range)

Ceiling effect (%)

KS-statistic

P-value

IQR

Cat I

Chaq30orig

0.81 (0–2.13)

20.8*

0.87

0.43

1.38

 

Chaq30item

0.36 (0–1.04)

20.8*

0.87

0.50

0.43

 

Chaq38item

0.38 (0–1.26)

8.3

0.86

0.45

0.54

Cat II

Chaq30item

-0.24 (-1.26–0.40)

0

0.84

0.49

0.48

 

Chaq38item

-0.34 (-1.26–0.42)

0

0.69

0.73

0.64

Discussion

The CHAQ38 with CATII scoring showed best overall distribution characteristics: no ceiling effect, more normally distribution, and the second largest IQR. (In September 2008 final results are presented).

Authors’ Affiliations

(1)
University Children's Hospital, Utrecht, Netherlands
(2)
Hacattepe University, School of Physical Therapy and rehabilitation, Ankara, Turkey
(3)
Deptartment of Physiotherapy, Århus University Hospital, Skejby, Århus, Denmark
(4)
Institute of Child Health, Great Ormond Street Childrens Hospital, London, UK
(5)
Birmingham Children's Hospital NHS foundation trust, Birmingham, UK
(6)
Royal Hospital for Sick Children, Glasgow, UK
(7)
Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
(8)
Queen Silvia Children's Hospital, Göteborg, Sweden

References

  1. Lam C, Young N, Marwaha J, Mc Limont M, Feldman BM: Revised Versions of the Childhood Health Assessment Questionnaire (CHAQ) Are More Sensitive and Suffer Less From a Ceiling Effect. Arthritis & Rheumatism (Arthritis Care & Research). 2004, 51: 881-889. 10.1002/art.20820.View ArticleGoogle Scholar
  2. Petty RE, Southwood TR, Manners P, Baum J, Glass DN, Goldenberg J, He X, Maldonado-Cocco J, Orozco-Alcala J, Prieur AM: International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol. 2004, 31: 390-392.PubMedGoogle Scholar

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