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M. Sacchetti, I. Baiardini, A. Silvia, A. Lambiase, O. Fassio, S. Bonini, S. Bonini; Development and Testing of the Quality of Life in Children with Keratoconjunctivitis (QUICK) Questionnaire. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1567.
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© ARVO (1962-2015); The Authors (2016-present)
Health related quality of life (HRQL) assessment in children with vernal keratoconjunctivitis (VKC) is an unstudied area, and no disease-specific tool for measuring HRQL has been developed for children with severe chronic allergic conjunctivitis. The aim of this study is to develop and validate a questionnaire that measures HRQL in children with severe allergic keratoconjunctivitis.
In the development phase, an initial list of 42 items covering the main symptoms and problems related to VKC was compiled and administered to 30 children with VKC in the active phase (6F, 24M; mean age 9±2 years). The 30 most significant items were selected and converted into questions on a Likert scale of 3 steps for validation. The validation procedure involved 41 children with VKC in the active phase (8F, 33M; mean age 9.4±2 years). 22 children (5F, 17M) also completed the generic KINDL® questionnaire. Clinical signs were evaluated and scored from 0 to 3 (0=absent, 1=mild, 2=moderate, 3 =severe) to correlate the QUICK scores to clinical findings. The total signs score was calculated. The validation analysis was performed by factorial analysis and Pearson’s correlation. Internal consistency was computed by Chronbach’s alpha on the extracted factors.
factorial analysis extracted 3 factors with a good internal consistency: Symptoms (0.89), Mood (0.56) and Daily Activities (0.77). Correlations of the final version of QUICK, (19 items) to KINDL® scores were in the expected direction. Most patients complained of itching (93%), burning (90%), redness (90%), the need to use eye-drops (90%), tearing (83%) and photophobia (80%). The children’s biggest concerns were problems at school (41%) and limitations on going to the pool (71%), playing sports (58%), meeting friends (58%) or playing outdoors (42%). The QUICK Symptoms score was significantly correlated to clinical signs scores: conjunctival hyperemia (p<0.001), secretion (p=0.042), chemosis (p=0.012), superficial punctuate keratopathy (p<0.001) and to the total signs score (p=0.010).
QUICK questionnaire represents a new instrument to measure HRQL in children with severe allergic conjunctivitis. It provides a short and simple assessment useful for the global evaluation of VKC’s impact on children’s daily life.
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