Detection of semantic ambiguity in an Italian child-friendly eq-5d version.

RATIONALE: A very difficult objective to be reached in the field of outcome research is to measure Quality of Life (QoL) in paediatric populations. Non negligible semantic ambiguity has been shown to characterize health perceptions and descriptions in developmental age. OBJECTIVE: As a part of the project aimed at developing a valid and reliable Italian version of EQ-5D suitable for children - i.e. the Italian Child-Fiendly EQ-5D (CF-EQ-5D) project - statistically based lexical analyses are applied. The aim of the analyses is to identify the semantic field associated to each item of the instrument, with the final purpose of formulating comprehensible, valid, unambiguous, and reliable items in Italian CF-EQ-5D. METHODS: 30 children/adolescents (aged 8-15 years, all native speakers, resident in different parts of Italy), gave their informed consent and self-completed an Italian version of CF-EQ-5D (from a forward-backward-forward translation method). Then participants were submitted to face-to-face and tape-recorded cognitive interviews and were invited to generate word associations in response to the core words of each item. The resulting textual corpus (normalized and lexicalized) is submitted to descriptive and multivariate statistical analyses fit for textual data. An analysis of lexical specificity is calculated in order to illustrate the general features of the vocabulary generated by respondents. In a second step, Multiple Correspondence Analysis is performed on a words*contexts matrix, with socio-demographic characteristics of the participants as illustrative variables. CONCLUSIONS: Preliminary outcomes suggest that children and adolescents associate non-univocal semantic fields to core aspects of the health-related lexicon. Implications for the developing and improving of the Italian Child-Friendly version of EQ-5D will be discussed to realize the final version of the questionnaire.