Elsevier

Value in Health

Volume 11, Issue 4, July–August 2008, Pages 659-668
Value in Health

Factorial Invariance of Child Self-Report across Age Subgroups: A Confirmatory Factor Analysis of Ages 5 to 16 Years Utilizing the PedsQL 4.0 Generic Core Scales

https://doi.org/10.1111/j.1524-4733.2007.00289.xGet rights and content
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Abstract

Background

The utilization of health-related quality of life (HRQOL) measurement in an effort to improve pediatric health and well-being and determine the value of health care services has grown dramatically over the past decade. The paradigm shift toward patient-reported outcomes (PROs) in clinical trials has provided the opportunity to emphasize the value and essential need for pediatric patient self-report. In order for HRQOL/PRO comparisons to be meaningful for subgroup analyses, it is essential to demonstrate factorial invariance. This study examined age subgroup factorial invariance of child self-report for ages 5 to 16 years on more than 8500 children utilizing the PedsQL™ 4.0 Generic Core Scales.

Method

Multigroup Confirmatory Factor Analysis (MGCFA) was performed specifying a five-factor model. Two multigroup structural equation models, one with constrained parameters and the other with unconstrained parameters, were proposed to compare the factor loadings across the age subgroups.

Results

Metric invariance (i.e., equal factor loadings) across the age subgroups was demonstrated based on stability of the Comparative Fit Index between the two models, and several additional indices of practical fit including the Root Mean Squared Error of Approximation, the Non-Normed Fit Index, and the Parsimony Normed Fit Index.

Conclusion

The findings support an equivalent five-factor structure across the age subgroups. Based on these data, it can be concluded that children across the age subgroups in this study interpreted items on the PedsQL 4.0 Generic Core Scales in a similar manner regardless of their age.

Keywords

child self-report
children
Confirmatory Factor Analysis
factorial invariance
health-related quality of life
patient-reported outcomes
PedsQL

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