Childhood cancer survivors are at an increased risk for developing psychological problems, yet their problems are often under-diagnosed and under-treated. There is thus a need to identify additional ways to screen for and identify relevant psychological problems. The purpose of the present study was to evaluate the effectiveness of the Pediatric Quality of Life (PedsQL) measure as useful screening tool among childhood cancer survivors.
Participants were sixty-nine adolescent survivors of childhood cancer between ages 11 and 18, referred from the Yonsei Severance Hospital, located in Seoul, Korea. Participants completed the 120-item Korean-Youth Self Report (K-YSR) and the 23-item PedsQL. Receiver operating characteristic (ROC) analysis was applied to examine the assessment precision of the PedsQL with respect to being able to screen for total behavior problems and social competence relative to the K-YSR.
PedsQL Total score identified general behavioral problems among childhood cancer survivors relative to the YSR Total Behavior Problem scale. Specifically, the ROC Area Under the Curve (AUC) value was .848—indicating good diagnostic utility. An optimal cut-off point on the PedsQL Total score was 69 which yielded sensitivity of 100% and specificity of 80%. PedsQL School subscale was also found to be comparable relative to the YSR Social Competence scale. The ROC AUC value was .933— suggesting excellent classification utility. An optimal cut-off point on the PedsQL School subscale was 52.5 which yielded sensitivity of 100% and specificity of 82.5%.
Both PedsQL subscales exceeded the recommended criteria of sensitivity ≥ 0.90 and specificity ≥ 0.75 (Recklitis & Rodriguez, 2007), indicating that the PesQL can successfully identify adolescent cancer survivors identified by the YSR as needing clinical attention. Scoring lower than 52.5 on the PesQL School scale and under 69 on the PedsQL Total score suggests clinical problems pertaining to social competence and behavioral problems, respectively.