Helen Rodgers, Fiona Gilchrist, Zoe Marshman, Helen Rodd and Donna Rowen
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| Dr Donna Rowen |
Methods:
First, a provisional classification system for a preference-based measure based
on CARIES-QC was developed using Rasch analysis, psychometric testing, involvement
of children and parents, and the developer of CARIES-QC. Second, qualitative,
semi-structured ‘think aloud’ validation interviews were undertaken with a
purposive sample of children with dental caries. The interviewer aimed to
identify whether items were considered important and easily understood, whether
any were overlapping and if any excluded items should be reintroduced.
Interview recordings were transcribed verbatim and thematic analysis conducted.
Results:
Rasch analysis identified poor item spread for the items ‘cross’ and ‘school’.
Items relating to eating were correlated and the better performing items were
considered for selection. Children expressed some confusion regarding the items
‘school’ and ‘food stuck’. Parent representatives thought that impacts
surrounding toothbrushing (‘brushing’) were encompassed by the item ‘hurt’.
Five items were selected from CARIES-QC for inclusion in the provisional
classification system; ‘hurt’, ‘annoy’, ‘carefully’, ‘kept awake’ and ‘cried’.
Validation interviews were conducted with 20 children aged 5-16 years old.
Participants thought the questionnaire was straightforward and covered a range
of impacts. Children thought an item about certain foods being ‘hard to eat’
was more relevant than one about having to eat more carefully because of their
teeth and so the ‘carefully’ item was replaced with ‘hard to eat’.
Conclusion: Following child-centred modification, the preliminary five-item classification system is considered valid and suitable for use in a valuation survey. The innovative child-centred methods used to both identify and validate the classification system can be applied in the development of other preference-based measures.