Response Shift in Parents\u27 Assessment of Health-Related Quality of Life of Children with New-onset Epilepsy

Abstract

OBJECTIVE: Diagnosis of epilepsy is known to impact health-related quality of life (HRQOL) of children with new-onset epilepsy and can also influence their conceptualization and valuation of HRQOL construct, also known as response shift. This study investigates the presence of response shift in a cohort of children with new-onset epilepsy. METHODS: Data are from the HEalth-Related QUality of Life in children with Epilepsy Study, a prospective cohort study of 373 children with new-onset epilepsy. Hypotheses about the presence of reconceptualization, reprioritization, and recalibration response shift were tested in the Quality of Life in Childhood Epilepsy (QOLCE-55) Questionnaire, a parent-reported, disease-specific HRQOL measure, using Oort\u27s structural equation model between baseline and 1-year follow-up. Model fit was assessed using log-likelihood ratio test, root mean square error of approximation, and comparative fit index. RESULTS: Small positive uniform recalibration response shift effects were observed on physical, emotional, and social functioning domains of the QOLCE-55, but negligibly small negative nonuniform recalibration response shift effect was observed on social functioning domain. There was no significant change in overall QOLCE-55 scores over time after adjusting for response shift effects. SIGNIFICANCE: Parents of children with new-onset epilepsy are likely to positively recalibrate (upward bias) their assessments of their children\u27s HRQOL over a 1-year period after diagnosis. This study highlights the potential benefits of response shift as a desired consequence in parents\u27 perception of changes in HRQOL of children with new-onset epilepsy