OBJECT: The Hydrocephalus Outcome Questionnaire (HOQ) is an established means of 
measuring quality of life, but the cognitive component of this questionnaire has 
never been formally compared with gold-standard neuropsychological test scores. 
The authors hypothesized that the HOQ Cognitive Health score would demonstrate a 
relatively strong correlation with neuropsychological test scores, whereas much 
weaker correlations would be seen for HOQ Physical and Social-Emotional Health 
scores.
METHODS: A cross-sectional study of children with long-standing hydrocephalus 
presenting to The Hospital for Sick Children's Neurosurgery Clinic was performed 
between July 2006 and September 2008. Participating children and families 
completed the HOQ and a battery of 21 standard neuropsychological tests and 
questionnaires. Pearson correlation analysis was then performed.
RESULTS: A total of 83 patients (81% participation) was accrued; the mean age 
was 11.5 ± 3.4 years (mean ± SD) at the time of assessment. The mean age at 
hydrocephalus treatment was 1.3 ± 2.6 years. The mean overall HOQ score was 0.69 
± 0.21. The HOQ Cognitive score had a moderate or strong correlation with 19 
(90%) of 21 neuropsychological test scores, much more so than the HOQ 
Social-Emotional score (5 moderate or strong correlations, 24%) and the HOQ 
Physical score (1 moderate correlation, 5%). For 19 neuropsychological tests 
(90%), the HOQ Cognitive score had a stronger correlation than the other scores. 
The HOQ Cognitive score had particularly strong correlations with the Verbal IQ, 
List Learning, Behavior Problems, and Metacognitive Abilities components.
CONCLUSIONS: Data from a wide-ranging representative sample of children with 
long-standing hydrocephalus provide added evidence of the validity of the HOQ 
Cognitive score and the overall domain structure of the HOQ itself.