Improving child health: Insights from pediatric patient-reported outcome measures

Patient-reported outcome measures (PROMs) are crucial tools for assessing the health and well-being of children, yet their application in pediatrics faces unique challenges due to developmental differences. A recent study provides a comprehensive overview of systematic reviews (SRs) on pediatric PROMs, analyzing 44 SRs published between 2006 and 2022. The study highlights the most recommended PROMs, such as the Pediatric Quality of Life Inventory, and identifies gaps in methodological quality and reporting. This research underscores the need for more diverse and high-quality studies to improve the selection and application of PROMs in pediatric healthcare.

Children’s health assessments differ significantly from adults due to varying cognitive abilities, language skills, and developmental stages. Patient-reported outcome measures (PROMs), which are self-reported questionnaires, offer valuable insights into a child’s health status, but their design and implementation in pediatrics are complex. Challenges include determining the appropriate age for self-reporting and ensuring the reliability of proxy reports from parents or caregivers. Previous studies have shown that children as young as 8 can reliably report their health, but younger children often require proxy reports, which may not accurately reflect their experiences. Based on these challenges, there is a pressing need for more in-depth research to optimize the use of PROMs in pediatric healthcare.

A team of researchers from Children’s Hospital of Chongqing Medical University and other institutions published a review (DOI: 10.1002/pdi3.77) on June 1, 2024, in Pediatric Discovery, providing an extensive overview of systematic reviews on pediatric PROMs. The study analyzed 44 SRs, identifying 123 recommended PROMs and evaluating their methodological quality. The research highlights the most frequently used PROMs, such as the Pediatric Quality of Life Inventory, and calls for improvements in the reporting of psychometric properties and the development of tailored tools for assessing pediatric PROMs.

The study reviewed 44 SRs, encompassing 1,888 studies and 635 different PROMs, with 123 PROMs being recommended. The most frequently recommended PROM was the Pediatric Quality of Life Inventory (PedsQL), followed by the EuroQol five-dimension questionnaire. These PROMs were primarily used to assess quality of life, body functions, and emotional functions. The study found that 36 different conditions were addressed, with mental, behavioral, or neurodevelopmental disorders being the most common. However, the methodological quality of the SRs varied, with only 22.7% scoring high on the AMSTAR tool. Key issues included inconsistent reporting of measurement properties, such as content validity and internal consistency, and a lack of clarity on the appropriate age for self-reporting. The study also highlighted the need for more diverse PROMs to cover a broader range of pediatric conditions and improve the evidence base for their use in clinical practice.

Dr. Yaolong Chen, a lead researcher on the study, emphasized, "The findings highlight the importance of improving the methodological quality of systematic reviews on pediatric PROMs. We need more standardized reporting and tailored tools to ensure that clinicians can select the most appropriate measures for children’s health assessments."

The study’s findings have significant implications for pediatric healthcare. By identifying gaps in the current use of PROMs, the research paves the way for more targeted and effective health assessments in children. Improved PROMs can enhance communication between healthcare providers, patients, and caregivers, leading to better long-term care management. Future research should focus on developing more diverse PROMs, standardizing reporting methods, and determining the optimal age for self-reporting to ensure reliable and valid health assessments in pediatric populations. This will ultimately contribute to better health outcomes for children and adolescents worldwide.

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References

DOI

10.1002/pdi3.77

Original Source URL

https://doi.org/10.1002/pdi3.77

About Pediatric Discovery

Pediatric Discovery is a Gold Open Access publication and officially sponsored by The National Clinical Research Center for Child Health and Disorders of China, and Children’s Hospital of Chongqing Medical University. The journal does not charge any submission fees. The Article Publication Charge (APC) is currently waived for accepted manuscripts. Pediatric Discovery is an open access and peer-reviewed international journal. The journal aims to advance the health and well-being of infants, children, and adolescents by disseminating cutting-edge discovery and knowledge in the field. It provides a platform for publishing and discussing the most important and state-of-the-art basic, translational and clinical discoveries affecting child and adolescent health and disorders in all aspects of pediatric medicine. Directory of Open Access Journals (DOAJ).