{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T18:37:57Z","timestamp":1765737477989,"version":"3.48.0"},"reference-count":47,"publisher":"BMJ","issue":"12","funder":[{"DOI":"10.13039\/100001547","name":"China Medical Board","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001547","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004543","name":"China Scholarship Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004543","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,10,4]]},"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the feasibility, discriminant validity and concurrent validity of the Health Status Classification System-Preschool (HSCS-PS) in children aged 3\u2009years in a large community sample in the Netherlands.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design\/setting<\/jats:title>\n                    <jats:p>A prospective population-based cohort in Rotterdam, the Netherlands.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A questionnaire was administrated to a sample of parents of 4546 children (36.7\u00b11.5 months).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Health-related quality of life (HRQOL) of children was measured by HSCS-PS. The HSCS-PS consists of 10 original domains. Two single-item measures of \u2018General health\u2019 and \u2018Behavior\u2019 were added. A disability score was calculated by summing up all 10 original domains to describe the overall health status. Feasibility was assessed by the response rate, percentages of missing answers, score distributions and the presence of floor\/ceiling effects. Discriminant validity was analysed between subgroups with predefined conditions: low birth weight, preterm birth, wheezing, Ear-Nose-Throat surgical procedures and behaviour problems. In the absence of another HRQOL measure, this study uses the single-items \u2018General health\u2019 and \u2018Behavior\u2019 as a first step to evaluate concurrent validity of the HSCS-PS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Feasibility: response rate was 69%. Ceiling effects were observed in all domains. Discriminant validity: the disability score discriminated clearly between subgroups of children born with a \u2018very low birth weight\u2019, \u2018very preterm birth\u2019, with \u2018four or more than four times wheezing\u2019, \u2018at least one ear-nose-throat surgical procedures\u2019, \u2018behaviour problems present\u2019 and the \u2018reference\u2019 group. Concurrent validity: HSCS-PS domains correlated better with hypothesised parallel additional domains than with other non-hypothesised original domains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study supports the feasibility and validity of the HSCS-PS among preschoolers in community settings. We recommend developing a utility-based scoring algorithm for the HSCS-PS. Further empirical studies and repeated evaluations in varied populations are recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-022449","type":"journal-article","created":{"date-parts":[[2018,12,19]],"date-time":"2018-12-19T05:55:38Z","timestamp":1545198938000},"page":"e022449","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Feasibility and validity of the Health Status Classification System-Preschool (HSCS-PS) in a large community sample: the Generation R study"],"prefix":"10.1136","volume":"8","author":[{"given":"Xinye","family":"Fang","sequence":"first","affiliation":[{"name":"Shanghai Medical Information Center, Shanghai, China"},{"name":"Shanghai Health Development Research Center, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0619-7580","authenticated-orcid":false,"given":"Guannan","family":"Bai","sequence":"additional","affiliation":[{"name":"Department of Public Health, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands"},{"name":"The Generation R Group, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dafna A","family":"Windhorst","sequence":"additional","affiliation":[{"name":"Department of Public Health, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Feeny","sequence":"additional","affiliation":[{"name":"Department of Economics and Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saroj","family":"Saigal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liesbeth","family":"Duijts","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine and Allergology, Department of Pediatrics, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands"},{"name":"Division of Neonatology, Department of Pediatrics, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent W V","family":"Jaddoe","sequence":"additional","affiliation":[{"name":"The Generation R Group, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands"},{"name":"Department of Pediatrics, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands"},{"name":"Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shanlian","family":"Hu","sequence":"additional","affiliation":[{"name":"Shanghai Health Development Research Center, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunlin","family":"Jin","sequence":"additional","affiliation":[{"name":"Shanghai Medical Information Center, Shanghai, China"},{"name":"Shanghai Health Development Research Center, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hein","family":"Raat","sequence":"additional","affiliation":[{"name":"Department of Public Health, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,12,18]]},"reference":[{"key":"2025121410344393000_8.12.e022449.1","doi-asserted-by":"publisher","DOI":"10.1097\/01.all.0000225157.67897.c2"},{"key":"2025121410344393000_8.12.e022449.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f167"},{"key":"2025121410344393000_8.12.e022449.3","unstructured":"Kaplan RM . 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