Cross-Cultural Adaptation of a Health-Related Quality-of-Life Questionnaire for Children with Obstructive Sleep Disorders: Spanish Version of the OSD-6

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Abstract
Background/Objectives: To translate the OSD-6 questionnaire (6-item quality of life questionnaire for children with obstructive sleep disorders) to Spanish and analyze the reliability and validity of the Spanish version. Methods: We included children with obstructive sleep apnea (OSA). All underwent polysomnography before and after adenotonsillectomy. Study variables included age, sex, symptoms, polysomnography values, body measurements, and Mallampati and Brodsky classification. Parents or caregivers completed the OSD-6 at baseline and 3 to 6 months after adenotonsillectomy. Following translation and back-translation of the instrument, we evaluated its internal consistency, reliability, construct validity, concurrent validity, predictive validity, and sensitivity to change. Results: We included 45 boys and 15 girls. Mean body mass index was 18 (standard deviation [SD] 4) kg/m2 and mean neck circumference was 28 (SD 5) cm. Seven per cent of children had Brodsky grade 0, 12% had grade 1, 27% had grade 2, 45% had grade 3, and 6% had grade 4. Mean apnea-hypopnea index (AHI) was 12 (SD 7) h-1 before adenotonsillectomy. The overall Cronbach's alpha was 0.8. We found significant concurrent validity in each questionnaire domain and in the overall score. Predictive validity was significant for Mallampati scores (ANOVA p = 0.011) and borderline significant for AHI levels (ANOVA p = 0.069). Sensitivity to change was excellent, both overall (p < 0.001) and in each domain (p < 0.001). Test-retest reliability was also excellent. Conclusions: Our results suggest the Spanish version of the OSD-6 is equivalent to the original and can be used in Spanish-speaking countries.

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