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Hanlon SL, Bley BC, Silbernagel KG. Determining the feasibility of exercise therapy and activity modification for treating adolescents with heel pain: a study protocol. BMJ Open Sport Exerc Med 2022; 8:e001301. [PMID: 36111126 PMCID: PMC9454050 DOI: 10.1136/bmjsem-2021-001301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2022] [Indexed: 11/05/2022] Open
Abstract
Calcaneal apophysitis and Achilles tendinopathy are common overuse injuries characterised by insidious posterior heel pain with activity. Calcaneal apophysitis is commonly diagnosed in adolescents, although Achilles tendinopathy is understudied in the adolescent population and is therefore rarely considered until adulthood. Exercise therapy and activity modification have the highest level of evidence for treating Achilles tendinopathy, while calcaneal apophysitis is treated with anecdotal and passive treatment or complete rest. It remains unknown whether exercise therapy is effective for adolescents with heel pain related to either diagnosis. This is a pilot and feasibility study. Thirty participants between the ages of 7 years and 17 years with posterior heel pain will be recruited from the local community and club sports team and local physicians, school nurses, and athletic trainers through flyers and social media. Participants will be asked to complete evaluations and treatment sessions every 4 weeks with three virtual visits every 2 weeks in between for 12 weeks. All participants will receive standardised treatment consisting of daily Achilles tendon loading exercises and education on pain-guided activity modification. Feasibility outcomes will include recruitment, enrolment, retention and compliance. Clinical outcomes will include the measures of symptom severity, quality of life, tendon morphology and lower extremity function. This protocol will provide preliminary data to inform a larger clinical trial based on the feasibility of the proposed intervention and methodology. Additionally, the results will provide preliminary evidence on whether Achilles tendon injury occurs in the adolescent population. The trial is registered with clinicaltrials.gov (ID:1652996).
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Affiliation(s)
- Shawn L Hanlon
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
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Robbertz AS, Cohen LL, Armistead LP, Reed B. Pandemic-Related Social Disruption and Well-Being in Pediatric Gastrointestinal Diseases. J Pediatr Psychol 2022; 47:981-990. [PMID: 35730966 PMCID: PMC9384296 DOI: 10.1093/jpepsy/jsac057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/01/2022] [Accepted: 06/01/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic has impacted everyone, but there are few data regarding how the pandemic has influenced the lives of children with gastrointestinal (GI) conditions. This cross-sectional study assessed pandemic-related social disruption (PRSD) in children with inflammatory bowel disease (IBD), celiac disease (CD), and irritable bowel syndrome (IBS), and the potential buffering effect of the parent-child relationship. METHODS A survey completed between September and December 2020 asked 146 children (ages 8-17) diagnosed with IBD (n = 44), CD (n = 81), or IBS (n = 51) and 185 parents how the pandemic has contributed to social disruption (i.e., financial stability, COVID-19 exposure, school changes, GI needs, and isolation) and their social-emotional well-being. Structural equation modeling was used to examine the role of social disruption on well-being, and the moderating effect of the parent-child relationship. RESULTS Increased social disruption predicted worse parent, β = 0.24, p = .02, and child well-being, β = 0.38, p < .01. The parent-child relationship moderated the relationship between parent and child well-being, β = 0.21, p = .03. Strong parent-child relationships predicted a positive association between parent and child well-being, β = 0.23, p = .003, whereas medium, β = 0.09, p = .14, and poor, β = -0.06, p = .52, relationships did not. CONCLUSIONS PRSD negatively impacted the well-being of children with GI conditions, and the parent-child relationship moderated this relationship. These findings are relevant to pediatric psychologists treating the physical and mental health needs of children with GI conditions and their parents.
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Affiliation(s)
| | | | | | - Bonney Reed
- Division of Gastroenterology, Hepatology, & Nutrition, Emory University School of Medicine, USA
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Rodríguez-Mercedes SL, Patel KF, Rencken CA, Grant GG, Surette K, Kinney EM, Brady KJ, Slavin MD, Schneider JC, Stoddard FJ, Kazis LE, Ryan CM. Item Pool Development for the School-Aged Life Impact Burn Recovery Evaluation Profile Computerized Adaptive Test: An Observer-Reported Outcome Assessment Measuring the Impact of Burn Injuries in School-Aged Children. J Burn Care Res 2022; 43:1114-1128. [PMID: 34965302 PMCID: PMC9255664 DOI: 10.1093/jbcr/irab247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The transition from early childhood to teen years (5-12) is a critical time of development, which can be made particularly challenging by a burn injury. Assessing postburn recovery during these years is important for improving pediatric survivors' development and health outcomes. Few validated burn-specific measures exist for this age group. The purpose of this study was to generate item pools that will be used to create a future computerized adaptive test (CAT) assessing postburn recovery in school-aged children. Item pool development was guided by the previously developed School-Aged Life Impact Burn Recovery Evaluation (SA-LIBRE5-12) conceptual framework. The item pool development process involved a systematic literature review, extraction of candidate items from existing legacy measures, iterative item review during expert consensus meetings, and parent cognitive interviews. The iterative item review with experts consisted of six rounds. A total of 10 parent cognitive interviews were conducted. The three broad themes of concern were items that needed 1) clarification, needed context, or were vague, 2) age dependence and relevance, and 3) word choice. The cognitive interviews indicated that survey instructions, recall period, item stem, and response choices were interpretable by respondents. Final item pool based on parental feedback consists of 57, 81, and 60 items in physical, psychological, and family and social functioning, respectively. Developed item pools (n = 198) in three domains are consistent with the existing conceptual framework. The next step involves field testing the item pool and calibration using item response theory to develop and validate the SA-LIBRE5-12 CAT Profile.
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Affiliation(s)
| | - Khushbu F. Patel
- Shriners Hospitals for Children – Boston, Boston, MA
- Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - Camerin A. Rencken
- Shriners Hospitals for Children – Boston, Boston, MA
- Department of Surgery, Massachusetts General Hospital, Boston, MA
| | - Gabrielle G. Grant
- University of North Carolina at Chapel Hill, School of Nursing, Hillman Scholars in Nursing Innovation, Chapel Hill, NC
| | - Kate Surette
- Shriners Hospitals for Children – Boston, Boston, MA
| | | | - Keri J.S. Brady
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA
| | - Mary D. Slavin
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA
| | - Jeffrey C. Schneider
- Harvard Medical School, Boston, MA
- Department of Physical Medicine and Rehabilitation, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, MA
| | - Frederick J. Stoddard
- Shriners Hospitals for Children – Boston, Boston, MA
- Harvard Medical School, Boston, MA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Lewis E. Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA
- Harvard Medical School, Boston, MA
- Department of Physical Medicine and Rehabilitation, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, MA
| | - Colleen M. Ryan
- Shriners Hospitals for Children – Boston, Boston, MA
- Department of Surgery, Massachusetts General Hospital, Boston, MA
- Department of Physical Medicine and Rehabilitation, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, MA
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Readability of Commonly Used Quality of Life Outcome Measures for Youth Self-Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159555. [PMID: 35954923 PMCID: PMC9367855 DOI: 10.3390/ijerph19159555] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/29/2022] [Accepted: 07/29/2022] [Indexed: 12/15/2022]
Abstract
Self-report measures are central in capturing young people’s perspectives on mental health concerns and treatment outcomes. For children and adolescents to complete such measures meaningfully and independently, the reading difficulty must match their reading ability. Prior research suggests a frequent mismatch for mental health symptom measures. Similar analyses are lacking for measures of Quality of Life (QoL). We analysed the readability of 13 commonly used QoL self-report measures for children and adolescents aged 6 to 18 years by computing five readability formulas and a mean reading age across formulas. Across measures, the mean reading age for item sets was 10.7 years (SD = 1.2). For almost two-thirds of the questionnaires, the required reading age exceeded the minimum age of the target group by at least one year, with an average discrepancy of 3.0 years (SD = 1.2). Questionnaires with matching reading ages primarily targeted adolescents. Our study suggests a frequent mismatch between the reading difficulty of QoL self-report measures for pre-adolescent children and this group’s expected reading ability. Such discrepancies risk undermining the validity of measurement, especially where children also have learning or attention difficulties. Readability should be critically considered in measure development, as one aspect of the content validity of self-report measures for youth.
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Schuchard J, Blackwell CK, Ganiban JM, Giardino AP, McGrath M, Sherlock P, Dabelea DM, Deoni SCL, Karr C, McEvoy CT, Patterson B, Santarossa S, Sathyanarayana S, Tung I, Forrest CB. Influences of Chronic Physical and Mental Health Conditions on Child and Adolescent Positive Health. Acad Pediatr 2022; 22:1024-1032. [PMID: 35121190 PMCID: PMC9339582 DOI: 10.1016/j.acap.2022.01.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/14/2022] [Accepted: 01/23/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVE Pediatric positive health refers to children's assessments of their well-being. The purpose of this study was to contrast positive health for children aged 8 to 17 years with and without chronic physical and mental health conditions. METHODS Data were drawn from the National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) research program. Participants included 1764 children ages 8 to 17 years from 13 ECHO cohorts. We measured positive health using the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Global Health and Life Satisfaction patient-reported outcome (PRO) measures. We used multiple regression to examine cross-sectional associations between the PROs and parent-reported health conditions and sociodemographic variables. We defined a meaningful difference in average scores as a PROMIS T-score difference of >3. RESULTS The sample included 45% 13 to 17-year-olds, 50% females, 8% Latinx, and 23% Black/African-American. Fifty-four percent had a chronic health condition. Of the 16 chronic conditions included in the study, only chronic pain (β = -3.5; 95% CI: -5.2 to -1.9) and depression (β = -6.6; 95% CI: -8.5 to -4.6) were associated with scoring >3 points lower on global health. Only depression was associated with >3 points lower on life satisfaction (β = -6.2; 95% CI: -8.1 to -4.3). Among those with depression, 95% also had another chronic condition. CONCLUSIONS Many children with chronic conditions have similar levels of positive health as counterparts without chronic conditions. The study results suggest that negative associations between chronic conditions and positive health may be primarily attributable to presence or co-occurrence of depression.
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Affiliation(s)
- Julia Schuchard
- Department of Pediatrics (J Schuchard, CB Forrest), Children's Hospital of Philadelphia, Philadelphia, Pa.
| | - Courtney K Blackwell
- Department of Medical Social Sciences (CK Blackwell, P Sherlock), Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Jody M Ganiban
- Department of Psychological & Brain Sciences (JM Ganiban), George Washington University, Washington, DC
| | - Angelo P Giardino
- Department of Pediatrics (AP Giardino), University of Utah School of Medicine, Salt Lake City, Utah
| | - Monica McGrath
- Department of Epidemiology (M McGrath), Johns Hopkins University Bloomberg School of Public Health, Baltimore, Md
| | - Phillip Sherlock
- Department of Medical Social Sciences (CK Blackwell, P Sherlock), Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Dana M Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center (DM Dabelea), University of Colorado Anschutz, Aurora, Colo
| | - Sean C L Deoni
- Department of Radiology and Pediatrics, Bill & Melinda Gates Foundation (SCL Deoni), Brown University, Pawtucket, RI
| | - Catherine Karr
- Department of Pediatrics (C Karr, S Sathyanarayana), University of Washington, Seattle, Wash
| | - Cindy T McEvoy
- Department of Pediatrics (CT McEvoy), Oregon Health & Science University, Portland, Ore
| | - Barron Patterson
- Department of Pediatrics (B Patterson), Vanderbilt University Medical Center, Nashville, Tenn
| | - Sara Santarossa
- Department of Public Health Sciences (S Santarossa), Henry Ford Health System, Detroit, Mich
| | - Sheela Sathyanarayana
- Department of Pediatrics (C Karr, S Sathyanarayana), University of Washington, Seattle, Wash
| | - Irene Tung
- Department of Psychiatry (I Tung), University of Pittsburgh, Pittsburgh, Pa
| | - Christopher B Forrest
- Department of Pediatrics (J Schuchard, CB Forrest), Children's Hospital of Philadelphia, Philadelphia, Pa
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Palermo TM, Law EF, Kim A, de la Vega R, Zhou C. Baseline Sleep Disturbances Modify Outcome Trajectories in Adolescents With Chronic Pain Receiving Internet-Delivered Psychological Treatment. THE JOURNAL OF PAIN 2022; 23:1245-1255. [PMID: 35283268 PMCID: PMC9271547 DOI: 10.1016/j.jpain.2022.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/17/2022] [Accepted: 03/02/2022] [Indexed: 06/14/2023]
Abstract
Over 50% of adolescents with chronic pain report comorbid sleep disturbances (eg, difficulties with falling asleep), which is associated with increased pain-related disability and poorer quality of life. However, limited longitudinal data are available to understand how sleep disturbance may impact response to psychological treatment. Our primary hypothesis was that baseline sleep disturbances would significantly modify how adolescents responded to an internet-delivered psychological intervention for chronic pain in terms of outcome trajectories. The sample included 85 adolescents, 12 to 17 years, with chronic pain recruited from a multidisciplinary pain clinic and headache clinic who received access to an internet-delivered psychological intervention for chronic pain. Baseline sleep assessment included actigraphy monitoring for 7 days and survey measures. Outcomes were assessed at baseline, 8 weeks, and 3 months including core pain-related outcomes, executive functioning, fatigue, positive and negative affect. Results demonstrated that greater baseline insomnia and poorer sleep quality was associated with worse outcome trajectories for pain-related disability, depression, anxiety, fatigue, negative affect, and executive functioning. Findings extend the limited studies that examine how sleep disturbance may modify effectiveness of psychological treatments for adolescent chronic pain and emphasize the importance of treating comorbid sleep disturbance. This trial was registered at clinicaltrials.gov (NCT04043962). PERSPECTIVE: Our study suggests that sleep deficiency, in particular insomnia and poor sleep quality, may modify the effectiveness of psychological treatments for chronic pain, highlighting the urgent need to screen youth for sleep problems prior to initiating treatment, and to consider implementation of sleep-specific treatments such as cognitive-behavioral therapy for insomnia.
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Affiliation(s)
- Tonya M Palermo
- Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, Washington; Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, Washington.
| | - Emily F Law
- Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, Washington; Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Agnes Kim
- Medical Scholars Program, Augusta University/University of Georgia Medical Partnership, Athens, Georgia
| | - Rocio de la Vega
- Department of Psychology, University of Málaga, Málaga, Spain; Institute of Biomedical Research in Málaga, Málaga, Spain
| | - Chuan Zhou
- Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, Washington; Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
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Kallen MA, Lai JS, Blackwell CK, Schuchard JR, Forrest CB, Wakschlag LS, Cella D. Measuring PROMIS® Global Health in Early Childhood. J Pediatr Psychol 2022; 47:523-533. [PMID: 35552435 PMCID: PMC9113277 DOI: 10.1093/jpepsy/jsac026] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 03/04/2022] [Accepted: 03/04/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Assessing general ("global") health is important to clinicians caring for patients, researchers studying patient subgroups, and epidemiologists tracking population trends. The Patient-Reported Outcomes Measurement Information System® (PROMIS®) introduced an adult self-report Global Health measure (ages 18+) in 2009 and pediatric versions (ages 5-17 years) in 2014. Our aim was to extend global health assessment to 1-5-year olds. METHODS We used the PROMIS mixed-methods approach to develop PROMIS Early Childhood (EC) Global Health, emphasizing qualitative measure development guidance utilizing input from experts and parents. Quantitatively, we conducted two data collection waves with parents of 1-5-year olds and applied state-of-the-science measure development methods, including exploratory, confirmatory, and bi-factor analytics, particularly regarding potentially multi-dimensional Global Health item content. We conducted a series of hypothesis-based across-domain association analyses, which were more exploratory in nature, and known-groups validity analyses. RESULTS Experts emphasized the physical, mental, and social facets of global health, and parents described the broader, overarching construct. Using Waves 1 (N = 1,400) and 2 (N = 1,057) data, we retained six items directly sourced from the age 5-17 version and two new items. The resulting 8-item PROMIS EC Global Health was sufficiently unidimensional, so we fit item responses to the graded response model for parameter estimation. This produced an 8-item scale with one total score. Across-domain associations and known-groups validity analyses largely supported our hypotheses. CONCLUSIONS We achieved our aim to extend global health assessment to 1-5-year olds and to thereby expand the range of PROMIS life course global health assessment from children aged 1-17 years, to adults of all ages.
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Affiliation(s)
- Michael A Kallen
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, USA
| | - Jin-Shei Lai
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, USA
| | - Courtney K Blackwell
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, USA
| | - Julia R Schuchard
- Applied Clinical Research Center, Children’s Hospital of Philadelphia, USA
| | | | - Lauren S Wakschlag
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, USA
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, USA
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Russo SA, Topley MT, Richardson RT, Richards JG, Chafetz RS, Rapp van Roden EA, Zlotolow DA, Mulcahey MJ, Kozin SH. Assessment of the relationship between Brachial Plexus Profile activity short form scores and modified Mallet scores. J Hand Ther 2022; 35:51-57. [PMID: 33308927 DOI: 10.1016/j.jht.2020.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/19/2020] [Accepted: 10/09/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION This study aims to assess the relationship between the modified Mallet classification and the Brachial Plexus Profile activity short form (BP-PRO activity SF). The therapist or surgeon classifies upper extremity movement for the modified Mallet classification, while the BP-PRO assesses parents' perceptions of difficulty performing activities. PURPOSE To provide a deeper understanding of the relationship of functional and perceived outcome measurements. STUDY DESIGN Prospective, correlational design. METHODS Eighty children with brachial plexus birth injuries were evaluated using the modified Mallet classification, while parents simultaneously answered the BP-PRO activity SF questions. All patients had undergone one of three surgical interventions to improve shoulder function. The relationship between the two measures, patient injury levels, and surgical histories were assessed. RESULTS The average modified Mallet scores and BP-PRO activity SF scores weakly correlated (r = 0.312, P = .005) and both measures differentiated between C5-6 and C5-7 injury levels (P = .03 and P = .02, respectively). Conversely, the modified Mallet scores could differentiate between the three surgical groups (F = 8.2, P < .001), while the BP-PRO activity SF could not (P = .54). CONCLUSION The results suggest that these tools measure different aspects of patient outcomes. The Mallet classification may be more focused on shoulder motion than the BP-PRO activity SF. Additional questions that specifically require shoulder function could be incorporated into the BP-PRO activity SF to improve understanding of patient/parent perceptions of shoulder function for children with brachial plexus injuries. Clinicians should be aware of the strengths, weaknesses, and limitations of each outcome assessment tool for appropriate use and interpretation of results.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Scott H Kozin
- Shriners Hospital for Children, Philadelphia, PA, USA
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Krause KR, Chung S, Rodak T, Cleverley K, Butcher NJ, Szatmari P. Assessing the impact of mental health difficulties on young people's daily lives: protocol for a scoping umbrella review of measurement instruments. BMJ Open 2022; 12:e054679. [PMID: 35487717 PMCID: PMC9058788 DOI: 10.1136/bmjopen-2021-054679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION An important consideration for determining the severity of mental health symptoms is their impact on youth's daily lives. Those wishing to assess 'life impact' face several challenges: First, various measurement instruments are available, including of global functioning, health-related quality of life and well-being. Existing reviews have tended to focus on one of these domains; consequently, a comprehensive overview is lacking. Second, the extent to which such instruments truly capture distinct concepts is unclear. Third, many available scales conflate symptoms and their impact, thus undermining much needed analyses of associations between the two. METHODS AND ANALYSIS A scoping umbrella review will examine existing reviews of life impact measures for use with children and youth aged 6-24 years in the context of mental health and well-being research. We will systematically search six bibliographic databases (MEDLINE, Embase, APA PsycINFO, CINAHL, Web of Science, and the COSMIN database of systematic reviews of outcome measurement instruments), and conduct systematic record screening, data extraction and charting based on methodological guidance by the Joanna Briggs Institute. Data synthesis will involve the tabulation of scale characteristics, feasibility and measurement properties, and the use of summary statistics to synthesise how these instruments operationalise life impact. The protocol was registered prospectively with the Open Science Framework (osf.io/ers48). ETHICS AND DISSEMINATION This study will provide a comprehensive road map for researchers and clinicians seeking to assess life impact in youth mental health, providing guidance in navigating available measurement options. We will seek to publish the findings in a leading peer-reviewed journal in the field. Formal research ethics approval will not be required.
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Affiliation(s)
- Karolin Rose Krause
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Research Department for Clinical, Educational and Health Psychology, University College London, London, UK
| | | | - Terri Rodak
- CAMH Library, Department of Education, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Kristin Cleverley
- Lawrence Bloomberg Faculty of Nursing and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- The Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Nancy J Butcher
- Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Peter Szatmari
- Cundill Centre for Child and Youth Depression, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Kwon J, Freijser L, Huynh E, Howell M, Chen G, Khan K, Daher S, Roberts N, Harrison C, Smith S, Devlin N, Howard K, Lancsar E, Bailey C, Craig J, Dalziel K, Hayes A, Mulhern B, Wong G, Ratcliffe J, Petrou S. Systematic Review of Conceptual, Age, Measurement and Valuation Considerations for Generic Multidimensional Childhood Patient-Reported Outcome Measures. PHARMACOECONOMICS 2022; 40:379-431. [PMID: 35072935 PMCID: PMC9007803 DOI: 10.1007/s40273-021-01128-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/19/2021] [Indexed: 05/20/2023]
Abstract
BACKGROUND AND AIMS Patient-reported outcome measures (PROMs) for children (aged ≤ 18 years) present methodological challenges. PROMs can be categorised by their diverse underlying conceptual bases, including functional, disability and health (FDH) status; quality of life (QoL); and health-related quality of life (HRQoL). Some PROMs are designed to be accompanied by preference weights. PROMs should account for childhood developmental differences by incorporating age-appropriate health/QoL domains, guidance on respondent type(s) and design. This systematic review aims to identify generic multidimensional childhood PROMs and synthesise their characteristics by conceptual basis, target age, measurement considerations, and the preference-based value sets that accompany them. METHODS The study protocol was registered in the Prospective Register of Systematic Reviews (CRD42021230833), and reporting followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted systematic database searches for generic multidimensional childhood PROMs covering the period 2012-2020, which we combined with published PROMs identified by an earlier systematic review that covered the period 1992-2011. A second systematic database search identified preference-based value sets for generic multidimensional PROMs. The PROMs were categorised by conceptual basis (FDH status, QoL and HRQoL) and by target age (namely infants and pre-schoolers aged < 5 years, pre-adolescents aged 5-11, adolescents aged 12-18 and multi-age group coverage). Descriptive statistics assessed how PROM characteristics (domain coverage, respondent type and design) varied by conceptual basis and age categories. Involvement of children in PROM development and testing was assessed to understand content validity. Characteristics of value sets available for the childhood generic multidimensional PROMs were identified and compared. RESULTS We identified 89 PROMs, including 110 versions: 52 FDH, 29 QoL, 12 HRQoL, nine QoL-FDH and eight HRQoL-FDH measures; 20 targeted infants and pre-schoolers, 29 pre-adolescents, 24 adolescents and 37 for multiple age groups. Domain coverage demonstrated development trajectories from observable FDH aspects in infancy through to personal independence and relationships during adolescence. PROMs targeting younger children relied more on informant report, were shorter and had fewer ordinal scale points. One-third of PROMs were developed following qualitative research or surveys with children or parents for concept elicitation. There were 21 preference-based value sets developed by 19 studies of ten generic multidimensional childhood PROMs: seven were based on adolescents' stated preferences, seven were from adults from the perspective of or on behalf of the child, and seven were from adults adopting an adult's perspective. Diverse preference elicitation methods were used to elicit values. Practices with respect to anchoring values on the utility scale also varied considerably. The range and distribution of values reflect these differences, resulting in value sets with notably different properties. CONCLUSION Identification and categorisation of generic multidimensional childhood PROMs and value sets by this review can aid the development, selection and interpretation of appropriate measures for clinical and population research and cost-effectiveness-based decision-making.
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Affiliation(s)
- Joseph Kwon
- School of Health and Related Research, University of Sheffield, Sheffield, England, UK
| | - Louise Freijser
- Centre for Health Policy, University of Melbourne, Melbourne, Australia
| | - Elisabeth Huynh
- Department of Health Services Research and Policy, Australian National University, Canberra, Australia
| | - Martin Howell
- School of Public Health, University of Sydney, Sydney, Australia
| | - Gang Chen
- Centre for Health Economics, Monash University, Melbourne, Australia
| | - Kamran Khan
- Centre for Health Economics at Warwick, University of Warwick, Coventry, England, UK
| | - Shahd Daher
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England, UK
| | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Oxford, England, UK
| | - Conrad Harrison
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, England, UK
| | - Sarah Smith
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, England, UK
| | - Nancy Devlin
- Centre for Health Policy, University of Melbourne, Melbourne, Australia
| | - Kirsten Howard
- School of Public Health, University of Sydney, Sydney, Australia
| | - Emily Lancsar
- Department of Health Services Research and Policy, Australian National University, Canberra, Australia
| | - Cate Bailey
- Centre for Health Policy, University of Melbourne, Melbourne, Australia
| | - Jonathan Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Kim Dalziel
- Health Economics Unit, University of Melbourne, Melbourne, Australia
| | - Alison Hayes
- School of Public Health, University of Sydney, Sydney, Australia
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia
| | - Germaine Wong
- School of Public Health, University of Sydney, Sydney, Australia
| | - Julie Ratcliffe
- Caring, Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, England, UK
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Abstract
Individuals born extremely preterm (before 28 weeks of gestation) comprise only about 0.7% of births in the United States and an even lower proportion in other high resource countries. However, these individuals account for a disproportionate number of children with cerebral palsy, intellectual deficit, autism spectrum disorder, attention deficit hyperactivity disorder, and epilepsy. This review describes two large multiple center cohorts comprised of individuals born extremely preterm: the EPICURE cohort, recruited 1995 in the United Kingdom and the Republic of Ireland, and the Extremely Low Gestational Age Newborn (ELGAN), recruited 2002-2004 in five states in the United States. The primary focus of these studies has been neurodevelopmental disorders, but also of interest are growth, respiratory illness, and parent- and self-reported global health and well-being. Both of these studies indicate that among individuals born extremely preterm the risks of most neurodevelopmental disorders are increased. Early life factors that contribute to this risk include perinatal brain damage, some of which can be identified using neonatal head ultrasound, bronchopulmonary dysplasia, and neonatal systemic inflammation. Prenatal factors, particularly the family's socioeconomic position, also appear to contribute to risk. For most adverse outcomes, the risk is higher in males. Young adults born extremely preterm who have neurodevelopmental impairment, as compared to those without such impairment, rate their quality of life lower. However, young adults born extremely preterm who do not have neurodevelopmental impairments rate their quality of life as being similar to that of young adults born at term. Finally, we summarize the current state of interventions designed to improve the life course of extremely premature infants, with particular focus on efforts to prevent premature birth and on postnatal efforts to prevent adverse neurodevelopmental outcomes.
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Affiliation(s)
- Genevieve L Taylor
- Genevieve L Taylor MD: Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of North Carolina School of Medicine
| | - T Michael O'Shea
- T. Michael O'Shea, MD, MPH: Department of Pediatrics, Division of Neonatal-Perinatal Medicine, University of North Carolina School of Medicine.
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Westwell-Roper C, Best JR, Elbe D, MacFadden M, Baer S, Tucker L, Au A, Naqqash Z, Lin B, Lu C, Stewart SE. Celecoxib versus placebo as an adjunct to treatment-as-usual in children and youth with obsessive-compulsive disorder: protocol for a single-site randomised quadruple-blind phase II study. BMJ Open 2022; 12:e054296. [PMID: 35105633 PMCID: PMC8804641 DOI: 10.1136/bmjopen-2021-054296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 01/05/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Cyclooxygenase (COX) enzymes oxidise arachidonic acid to prostaglandins, which modulate neuronal function and inflammation in the central nervous system. Consensus guidelines suggest non-steroidal anti-inflammatory drugs as a possible adjunctive approach in adults with obsessive-compulsive disorder (OCD) and in children with acute-onset OCD subtypes. However, there is limited evidence to support this approach. The primary objective of this study is to determine the efficacy of the COX-2-selective inhibitor celecoxib as an adjunct to treatment-as-usual in children and youth with moderate-to-severe OCD. The safety of this intervention including adverse events will also be systematically assessed. METHODS The Adjunctive CElecoxib in childhood-onset OCD (ACE-OCD) study is a single-centre randomised, quadruple-blind, placebo-controlled superiority trial with two parallel groups: celecoxib 100 mg twice daily and placebo. Treatments will be added to participants' routine clinical care, which will not change over the course of the study. Target recruitment is 80 participants ages 7-18 with no recent treatment changes. The primary outcome is OCD severity after 12 weeks of treatment, measured by clinician-administered Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS). Secondary outcomes include CY-BOCS score after 6 weeks; difference in the proportion of participants achieving a clinically meaningful response or remission; mean clinical global impression of severity and improvement after 6 and 12 weeks; and proportion of participants reporting adverse events possibly or probably related to the study intervention. The primary analyses, carried out according to intention-to-treat principles, will compare the celecoxib to placebo group on each outcome of interest, adjusting for baseline scores using analysis of covariance or logistic regression. Participants will be offered a 12-week open-label celecoxib extension and will be invited to participate in an ancillary study for biomarker analyses. ETHICS AND DISSEMINATION This protocol has been approved by the University of British Columbia Children's and Women's Research Ethics Board and has received a No Objection Letter from Health Canada. The findings will be disseminated in peer-reviewed journals and presentations to multiple stakeholders including patients, parents and healthcare providers. TRIAL REGISTRATION NUMBER NCT04673578.
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Affiliation(s)
- Clara Westwell-Roper
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Provincial OCD Program, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - John R Best
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Provincial OCD Program, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Dean Elbe
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Department of Pharmacy, Children's and Women's Health Centre of British Columbia, Vancouver, British Columbia, Canada
- BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Megan MacFadden
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Susan Baer
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- BC Children's Hospital, Vancouver, British Columbia, Canada
| | - Lori Tucker
- BC Children's Hospital, Vancouver, British Columbia, Canada
- Division of Rheumatology, Department of Pediatrics, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Antony Au
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Provincial OCD Program, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Zainab Naqqash
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Provincial OCD Program, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Boyee Lin
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Provincial OCD Program, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Cynthia Lu
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Provincial OCD Program, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - S Evelyn Stewart
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Provincial OCD Program, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- BC Children's Hospital, Vancouver, British Columbia, Canada
- British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, British Columbia, Canada
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Advances in measuring pediatric overall health: the PROMIS® Pediatric Global Health scale (PGH-7). Eur J Pediatr 2022; 181:2117-2125. [PMID: 35165756 PMCID: PMC9056445 DOI: 10.1007/s00431-022-04408-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/30/2022] [Accepted: 01/31/2022] [Indexed: 12/04/2022]
Abstract
In this cross-sectional study, we aimed to assess the reliability, validity, and efficiency of the Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric Global Health scale (PGH-7) to reduce patient burden when assessing overall health in clinical practice. In total, 1082 children (8-18), representative of the Dutch population, completed the PGH-7 and the Pediatric Quality of Life Inventory (PedsQL™ 4.0), a common legacy instrument used in clinical practice to assess overall health. The assumptions for fitting an item response theory model were assessed: unidimensionality, local independence, and monotonicity. Subsequently, a model was fitted to the data to assess item fit and cultural differential item functioning (DIF) between Dutch and US children. A strong correlation (> .70) was expected between the PGH-7 and PedsQL, as both instruments measure physical, mental, and social domains of health. Percentages of participants reliably measured (> 0.90) were assessed using the standard error of measurement (SE(θ) < 0.32). Efficiency was calculated ((1 - SE(θ)2)/nitems) to compare how well both measures performed relative to number of items administered. The PGH-7 met all assumptions and displayed good structural and convergent (r = .69) validity. One item displayed cultural DIF. Both questionnaires measured reliably (%nPGH-7 = 73.8%, %nPedsQL = 76.6%) at the mean and 2SD in clinically relevant direction. PGH-7 items were 2.6 times more efficient in measuring overall health than the PedsQL. Conclusion: The PGH-7 displays sufficient validity and reliability in the general Dutch pediatric population and measures more efficiently than the PedsQL, the most commonly used legacy instrument. The PGH-7 can be used in research and clinical practice to reduce patient burden when assessing overall health. What is Known: • Generic instruments which validly and reliably assess overall pediatric health are scarce. • Brief instruments are required for implementation of self-report patient-reported outcomes in clinical practice. What is New: • The PROMIS Pediatric Global Health (PGH-7) can be used in research and clinical practice to briefly assess overall pediatric health, while providing valid and reliable measurements. • The PGH-7 provides more efficient assessment of pediatric overall health than the Pediatric Quality of Life Inventory.
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Gmuca S, Sonagra M, Xiao R, Mendoza E, Miller KS, Thomas NH, Young JF, Weiss PF, Sherry DD, Gerber JS. Characterizing Neurocognitive Impairment in Juvenile Fibromyalgia Syndrome: Subjective and Objective Measures of Dyscognition. Front Pediatr 2022; 10:848009. [PMID: 35281242 PMCID: PMC8908005 DOI: 10.3389/fped.2022.848009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Our understanding of brain fog, or dyscognition, among youth with juvenile fibromyalgia syndrome is limited. We aimed to determine the prevalence of subjective (self-reported) and objective dyscognition, as well as factors associated with subjective dyscognition in juvenile fibromyalgia syndrome. METHODS A cross-sectional cohort study of patients (n = 31) 12-17 years old diagnosed with primary juvenile fibromyalgia syndrome and one of their parents from 2017 to 2019. Subjects completed a series of survey measures and patients completed a brief neurocognitive battery. Subjective dyscognition was determined based on scores on the Pediatric Quality of Life Inventory (PedsQL) Cognitive Functioning Scale and Behavior Rating Inventory of Executive Function (BRIEF-2) global executive composite (GEC). Objective dyscognition was defined as impairment of more than two standard deviations in any of the neurocognitive domains. We used Fisher's exact test or Wilcoxon rank-sum test, as appropriate, to compare clinical patients based on the presence of dyscognition. Multivariable logistic regression modeling was performed to determine factors associated with subjective dyscognition. RESULTS Of the 31 subjects, 65% reported subjective dyscognition and 39% had objective dyscognition, primarily in the domains of psychomotor speed (23%), executive function (23%), and attention (3%). Subjective dyscognition was not indicative of objective dyscognition. Subjective dyscognition was independently associated with functional disability (OR: 1.19 [95% CI: 1.02-1.40]) and anxiety (OR: 1.12 [95% CI: 1.02-1.24]). DISCUSSION Adolescents with fibromyalgia predominantly experience subjective dyscognition but more than 1/3 also experience objective dyscognition. Future research should explore the impact of interdisciplinary rehabilitation programs on the treatment of dyscognition in youth with JFMS.
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Affiliation(s)
- Sabrina Gmuca
- Department of Pediatrics, Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Maitry Sonagra
- Department of Pediatrics, Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Seattle Children's Hospital, University of Washington, Seattle, WA, United States
| | - Rui Xiao
- Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA, United States
| | - Elizabeth Mendoza
- Department of Pediatrics, Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Milken Institute School of Public Health, The George Washington University, Washington, DC, United States
| | - Kimberly S Miller
- Department of Pediatrics, Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Nina H Thomas
- Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.,Center for Human Phenomic Science Behavioral Neuroscience Core, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Department of Child and Adolescent Psychiatry and Behavioral Services, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Jami F Young
- PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.,Department of Child and Adolescent Psychiatry and Behavioral Services, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Pamela F Weiss
- Department of Pediatrics, Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - David D Sherry
- Department of Pediatrics, Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Jeffrey S Gerber
- Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA, United States.,Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.,Department of Pediatrics, Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA, United States
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Truong DT, Trachtenberg FL, Pearson GD, Dionne A, Elias MD, Friedman K, Hayes KH, Mahony L, McCrindle BW, Oster ME, Pemberton V, Powell AJ, Russell MW, Shekerdemian LS, Son MB, Taylor M, Newburger JW. The NHLBI Study on Long-terM OUtcomes after the Multisystem Inflammatory Syndrome In Children (MUSIC): Design and Objectives. Am Heart J 2022; 243:43-53. [PMID: 34418362 PMCID: PMC8710361 DOI: 10.1016/j.ahj.2021.08.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 08/06/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND The Long-terM OUtcomes after the Multisystem Inflammatory Syndrome In Children (MUSIC) study aims to characterize the frequency and time course of acute and long-term cardiac and non-cardiac sequelae in multisystem inflammatory syndrome in children associated with COVID-19 (MIS-C), which are currently poorly understood. METHODS This multicenter observational cohort study will enroll at least 600 patients <21 years old who meet the Centers for Disease Control and Prevention case definition of MIS-C across multiple North American centers over 2 years. The study will collect detailed hospital and follow-up data for up to 5 years, and optional genetic testing. Cardiac imaging at specific time points includes standardized echocardiographic assessment (all participants) and cardiac magnetic resonance imaging (CMR) in those with left ventricular ejection fraction (LVEF) <45% during the acute illness. The primary outcomes are the worst LVEF and the highest coronary artery z-score of the left anterior descending or right coronary artery. Other outcomes include occurrence and course of non-cardiac organ dysfunction, inflammation, and major medical events. Independent adjudication of cases will classify participants as definite, possible, or not MIS-C. Analysis of the outcomes will include descriptive statistics and regression analysis with stratification by definite or possible MIS-C. The MUSIC study will provide phenotypic data to support basic and translational research studies. CONCLUSION The MUSIC study, with the largest cohort of MIS-C patients and the longest follow-up period to date, will make an important contribution to our understanding of the acute cardiac and non-cardiac manifestations of MIS-C and the long-term effects of this public health emergency.
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Affiliation(s)
- Dongngan T Truong
- Department of Pediatrics, Dvision of Cardiology, University of Utah and Primary Children's Hospital, Salt Lake City, UT, USA.
| | | | - Gail D Pearson
- National Heart, Lung, and Blood Institute/NIH, Bethesda, MD, USA
| | - Audrey Dionne
- Department of Cardiology, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Matthew D Elias
- Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kevin Friedman
- Department of Cardiology, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | | | - Lynn Mahony
- Division of Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, TX, USA
| | - Brian W McCrindle
- The Division of Cardiology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Matthew E Oster
- Children's Heart Center, Department of Pediatrics, Children's Healthcare of Atlanta, Emory Unviersity School of Medicine, Atlanta, GA, USA
| | | | - Andrew J Powell
- Department of Cardiology, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Mark W Russell
- Division of Pediatric Cardiology, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI, USA
| | - Lara S Shekerdemian
- Division of Critical Care, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Mary Beth Son
- Department of Cardiology, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Michael Taylor
- The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jane W Newburger
- Department of Cardiology, Boston Children's Hospital and Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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Kumar S, Lee NK, Pinkerton E, Wroblewski KE, Lengyel E, Tobin M. Resilience: a mediator of the negative effects of pandemic-related stress on women's mental health in the USA. Arch Womens Ment Health 2022; 25:137-146. [PMID: 34651237 PMCID: PMC8516405 DOI: 10.1007/s00737-021-01184-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 09/23/2021] [Indexed: 12/23/2022]
Abstract
The role of resilience in mediating the negative effects of the COVID-19 pandemic on the mental health of US women is poorly understood. We examined socioeconomic factors associated with low resilience in women, the relationship of low resilience with psychiatric morbidity, and the mediating role of resilience in the relationship between pandemic-related stress and other coincident psychiatric morbidities. Using a quota-based sample from a national panel, we conducted a web-based survey of 3200 US women in April 2020. Weighted, multivariate logistic regression was used to model the odds of pandemic-related stress, and coincident depression and anxiety symptoms among those with and without low resilience. Structural equation modeling was used to evaluate resilience as a mediator of the relationship between pandemic-related stress and other coincident psychiatric morbidities. Risk factors for low resilience included younger age, lower household income, lower education, unemployment, East/Southeast Asian race, unmarried/unpartnered status, and higher number of medical comorbidities. Low resilience was significantly associated with greater odds of depression symptoms (OR = 3.78, 95% CI [3.10-4.60]), anxiety symptoms (OR = 4.17, 95% CI [3.40-5.11]), and pandemic-related stress (OR = 2.86, 95% CI [2.26-3.26]). Resilience acted as a partial mediator in the association between pandemic-related stress and anxiety symptoms (proportion mediated = 0.23) and depression symptoms (proportion mediated = 0.28). In the early days of the COVID-19 pandemic, low resilience mediated the association between pandemic-related stress and psychiatric morbidity. Strategies proven to enhance resilience, such as cognitive behavioral therapy, mindfulness-based stress reduction, and addressing socioeconomic factors, may help mitigate mental health outcomes.
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Affiliation(s)
- Shivani Kumar
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, 5841 S. Maryland Ave, Chicago, IL, MC307760637, USA
| | - Nita Karnik Lee
- Department of Obstetrics and Gynecology/Section of Gynecologic Oncology, The University of Chicago, Chicago, IL, USA
| | - Elizabeth Pinkerton
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, IL, USA
| | - Kristen E Wroblewski
- Department of Public Health Sciences, The University of Chicago, Chicago, IL, USA
| | - Ernst Lengyel
- Department of Obstetrics and Gynecology/Section of Gynecologic Oncology, The University of Chicago, Chicago, IL, USA
| | - Marie Tobin
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, 5841 S. Maryland Ave, Chicago, IL, MC307760637, USA.
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Młyńczyk J, Abramowicz P, Stawicki MK, Konstantynowicz J. Non-disease specific patient-reported outcome measures of health-related quality of life in juvenile idiopathic arthritis: a systematic review of current research and practice. Rheumatol Int 2021; 42:191-203. [PMID: 34971434 PMCID: PMC8719533 DOI: 10.1007/s00296-021-05077-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/20/2021] [Indexed: 11/28/2022]
Abstract
Juvenile idiopathic arthritis (JIA), as a chronic condition, is associated with symptoms negatively impacting health-related quality of life (HRQL). Regarding growing interest in the implementation of the patient-reported outcome measures (PROMs), we aimed to review the non-disease specific PROMs addressing HRQL assessment, potentially useful in the clinical care of JIA and daily practice. A systematic literature search was conducted using MEDLINE/PubMed, Google Scholar, Scopus and Embase databases (1990 to 2021), with a focus on the recent 5-years period. Entry keywords included the terms: “children”, “adolescents”, “JIA”, “chronic diseases”, “HRQL”, “PROMs” and wordings for the specific tools. Several available PROMs intended to measure HRQL, non-specific to JIA, were identified. The presented outcomes differed in psychometric properties, yet all were feasible in assessing HRQL in healthy children and those with chronic diseases. Both EQ-5D-Y and PedsQL have already been tested in JIA, showing relevant reliability, validity, and similar efficiency as disease-specific measurements. For PROMIS® PGH-7 and PGH-7 + 2, such validation and cross-cultural adaptation need to be performed. Considering the future directions in pediatric rheumatology, the large-scale implementation of PROMIS® PGH-7 and PGH-7 + 2 in JIA offers a particularly valuable opportunity. The PROMs reflect the patient perception of the chronic disease and allow to understand child’s opinions. The PROMs may provide an important element of the holistic medical care of patients with JIA and a standardized tool for clinical outcomes, monitoring disease severity and response to treatment.
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Affiliation(s)
- Justyna Młyńczyk
- Department of Pediatrics, Rheumatology, Immunology, and Metabolic Bone Diseases, University Children's Hospital, Medical University of Bialystok, Waszyngtona Street 17, 15-274, Bialystok, Poland
| | - Paweł Abramowicz
- Department of Pediatrics, Rheumatology, Immunology, and Metabolic Bone Diseases, University Children's Hospital, Medical University of Bialystok, Waszyngtona Street 17, 15-274, Bialystok, Poland
| | - Maciej K Stawicki
- Department of Pediatrics, Rheumatology, Immunology, and Metabolic Bone Diseases, University Children's Hospital, Medical University of Bialystok, Waszyngtona Street 17, 15-274, Bialystok, Poland
| | - Jerzy Konstantynowicz
- Department of Pediatrics, Rheumatology, Immunology, and Metabolic Bone Diseases, University Children's Hospital, Medical University of Bialystok, Waszyngtona Street 17, 15-274, Bialystok, Poland.
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Strisciuglio C, Martinelli M, Lu P, Bar Lev MR, Beinvogl B, Benninga MA, Di Lorenzo C, Fiori Nastro F, Nurko S, Pearlstein H, Rosen R, Shamir R, Staiano A. Overall Impact of Coronavirus Disease 2019 Outbreak in Children With Functional Abdominal Pain Disorders: Results From the First Pandemic Phase. J Pediatr Gastroenterol Nutr 2021; 73:689-694. [PMID: 34417400 DOI: 10.1097/mpg.0000000000003286] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE We aimed to assess how the first phase of coronavirus disease 2019 (COVID-19) pandemic influenced symptoms in children with functional abdominal pain disorders (FAPDs) and to characterize their quality of life (QoL), anxiety and global health. METHODS This was a multicenter, observational, international study conducted between April and July 2020 at six different referral centers. Children diagnosed with FAPDs between October 2019 and February 2020 were enrolled and prospectively interviewed at 4 months of follow-up during the first pandemic phase (Quarantine group). Patients were asked to complete PedsQL 4.0 Generic Core Scale and PROMIS Anxiety and Global Health questionnaires. A cohort of children diagnosed with FAPDs between October 2018 and February 2019 was used as a Control group. RESULTS Three-hundred-fifty-six children were enrolled of whom 180 (mean age at diagnosis: 14 ± 2.8 years) in the Quarantine group and 176 (mean age at diagnosis: 13 ± 2.8 years) in the Control group. At 4 months of follow-up, we observed a significant reduction of children reporting >5 episodes of abdominal pain per month when compared to baseline, in both groups (Quarantine group: 63.9% vs 42.2%, P < 0.001; Control group: 83.5% vs 50%, P < 0.001). The Quarantine group had median QoL values of 84.8 with 16.6% of children showing high anxiety values and 55% having decreased global health score. CONCLUSIONS We demonstrated symptoms' improvement at 4 months of follow-up in both cohorts. During the first months of the COVID-19 quarantine children with FAPDs showed satisfactory QoL and anxiety scores, suggesting positive effects of school closure and increased parental attention.
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Affiliation(s)
- Caterina Strisciuglio
- Department of Woman, Child and General and Specialistic Surgery, University of Campania "Luigi Vanvitelli", Napoli
| | - Massimo Martinelli
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy
| | - Peter Lu
- Division of Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH
| | - Michal Rozenfeld Bar Lev
- Institute of Pediatric Gastroenterology, Nutrition, and Liver Diseases, Schneider Children's Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Beate Beinvogl
- Boston Children's Hospital, Harvard medical School, Boston, MA
| | - Marc A Benninga
- Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital/Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Carlo Di Lorenzo
- Division of Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH
| | - Francesca Fiori Nastro
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy
| | - Samuel Nurko
- Boston Children's Hospital, Harvard medical School, Boston, MA
| | - Haley Pearlstein
- Division of Gastroenterology, Hepatology and Nutrition, Nationwide Children's Hospital, Columbus, OH
| | - Rachel Rosen
- Boston Children's Hospital, Harvard medical School, Boston, MA
| | - Raanan Shamir
- Institute of Pediatric Gastroenterology, Nutrition, and Liver Diseases, Schneider Children's Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Annamaria Staiano
- Department of Translational Medical Science, Section of Pediatrics, University of Naples "Federico II", Naples, Italy
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Otto C, Reiss F, Voss C, Wüstner A, Meyrose AK, Hölling H, Ravens-Sieberer U. Mental health and well-being from childhood to adulthood: design, methods and results of the 11-year follow-up of the BELLA study. Eur Child Adolesc Psychiatry 2021; 30:1559-1577. [PMID: 32918625 PMCID: PMC8505294 DOI: 10.1007/s00787-020-01630-4] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 08/24/2020] [Indexed: 11/30/2022]
Abstract
Mental health and well-being are of great interest in health policy and research. Longitudinal surveys are needed to provide solid population-based data. We describe the design and methods of an 11-year follow-up of the German BELLA study in children, adolescents and young adults, and we report on age- and gender-specific courses of general health and well-being, long-term health-related outcomes of mental health problems, and mental health care use. The BELLA study is the module on mental health and well-being within the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Standardised measures were used at each of the five measurement points of the BELLA study. In the 11-year follow-up, young people aged 7-31 years participated (n = 3492). Individual growth modelling, linear regression and descriptive analyses were conducted. Self-reported general health and well-being were both better in younger (vs. older) and in male (vs. female) participants according to the data from all five measurement points. Mental health problems in childhood and adolescence (measured at baseline) predicted impaired health outcomes at 6-year and 11-year follow-ups. Approximately one out of four children with a diagnosed mental disorder was not undergoing mental health treatment. With its 11-year follow-up, the prospective longitudinal BELLA study provides new and solid data on mental health and well-being from childhood to adulthood in Germany, and these data are important for health promotion and prevention practices. These results are consistent with previous findings. Promising future analyses are planned.
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Affiliation(s)
- Christiane Otto
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Franziska Reiss
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Catharina Voss
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Anne Wüstner
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Ann-Katrin Meyrose
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
- Clinical Psychology, Helmut-Schmidt-University, Holstenhofweg 85, 22043 Hamburg, Germany
| | - Heike Hölling
- Robert Koch-Institute, Nordufer 20, 13353, Berlin, Germany
| | - Ulrike Ravens-Sieberer
- Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
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70
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Holbein CE, Plevinsky J, Patel T, Conrad MC, Kelsen JR. Pediatric Global Health in Children with Very Early-Onset Inflammatory Bowel Disease. J Pediatr Psychol 2021; 46:747-756. [PMID: 34313785 DOI: 10.1093/jpepsy/jsab035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 03/16/2021] [Accepted: 03/16/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Children with very early-onset inflammatory bowel disease (VEO-IBD) represent a distinct group of patients with IBD with unique phenotypic and genetic characteristics; however, they are frequently omitted from psychosocial research. This study used a novel, brief measure of pediatric global health to assess (1) overall health-related quality of life (HRQOL) in children with VEO-IBD, (2) HRQOL compared to healthy children, and (3) whether gastrointestinal symptoms account for the differences in HRQOL between these groups. METHODS Caregivers of 51 children with VEO-IBD (Mage = 4.26 years, 75% male) and 54 healthy children (Mage = 3.50 years, 54% male) completed the PROMIS Pediatric Global Health Scale (PGH-7) parent-proxy form to assess HRQOL and a questionnaire assessing gastrointestinal symptoms. Descriptive statistics, analysis of variance with covariates (ANCOVA), and meditation analyses with bootstrapping were conducted. RESULTS Caregivers of children with VEO-IBD rated their HRQOL as relatively positive, although children with greater disease yielded lower ratings on some PGH-7 items (e.g., fun with friends, physical health, sadness). Compared to healthy youth, children with VEO-IBD scored lower on the PGH-7, with significantly lower item-level scores on overall health, physical health, mental health, and quality of life. Gastrointestinal symptoms mediated the association between health status (i.e., VEO-IBD vs. healthy) and HRQOL, αβ = -2.84, 95% CI = -5.70, -0.34. CONCLUSIONS While some children with VEO-IBD are at risk for deficits in HRQOL, many are quite resilient. Psychosocial screening is necessary for providing appropriate referrals to behavioral health services and learning more about psychosocial adjustment in children with VEO-IBD.
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Affiliation(s)
- Christina E Holbein
- Department of Child & Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia
| | - Jill Plevinsky
- Department of Child & Adolescent Psychiatry and Behavioral Sciences, The Children's Hospital of Philadelphia.,Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania
| | - Trusha Patel
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia.,Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania
| | - Maire C Conrad
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia.,Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania
| | - Judith R Kelsen
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia.,Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania
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71
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Lacey B, West A, Craig S. Parents' and carers' impression of "quality" within a Paediatric Emergency Department. BMC Pediatr 2021; 21:313. [PMID: 34256736 PMCID: PMC8276454 DOI: 10.1186/s12887-021-02752-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 05/27/2021] [Indexed: 11/21/2022] Open
Abstract
Background Quality improvement systems are needed to overcome the ‘Quality Gap’ – difference between evidence-based guidelines and the care delivered. While there are a large array of potential quality assurance measures exists in the Paediatric Emergency Department, parent’s/carer’s perception of these is unknown. This study aimed to identify what ‘quality of care’ means to parents/carers of Paediatric Emergency Department (PED) patients, further determine which aspects of these are most important to them. Also, to identify which of the existing PED quality measures are most important to parents/carers, and their preferred method of providing feedback. Methods A Modified Rand-Delphi study was performed with parents/carers as the expert group and consensus was obtained from them via three web-based surveys. All parents/carers of children attending a tertiary paediatric hospital during six-week in winter were eligible– no exclusions. Quality measures scoring at least 7 on a 9-point Likert scale during the final survey were considered “very important”, while those scoring at least an 8 were considered “extremely important”. Results One hundred four parents/carers responded from a total of 1095 participants. Parents/carers generated 527 free text entries, to the initial survey on what ‘quality of care’ means. These were mapped to 48 quality measure which they ranked on subsequent surveys. Eighteen quality measures were considered very important by at least 90% of respondents. Of these, six were considered extremely important by at least 70% of respondents: ‘Thorough medical assessment’ (84%); ‘A triage system’ (84%); ‘Experienced and knowledgeable staff that are skilled in paediatrics’ (77%); ‘Resources and equipment available to provide care’ (72%); and ‘Clear follow up plans and reviews that are communicated and scheduled’ (72%). Parents/carers considered existing quality measures as important with ‘timely treatment of a critical condition’ as the most important. Most participants preferred to provide anonymous feedback (N = 69, 66%), online (N = 77, 72%) after discharge (N = 82, 70%). Conclusion We have elicited what ‘quality of care’ means to parents/carers, and which aspects are most important to them. Parents/carers consider commonly used PED quality measure as very important. However, they are less important than outcomes generated by themselves. Further parents/carers in this study preferred to provide feedback that was anonymous and electronically distributed after they leave the ED. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02752-7.
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Affiliation(s)
- Brendan Lacey
- Paediatric Emergency Department, Emergency Service, Monash Health, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria, 3168, Australia.
| | - Adam West
- Paediatric Emergency Department, Emergency Service, Monash Health, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria, 3168, Australia
| | - Simon Craig
- Paediatric Emergency Department, Emergency Service, Monash Health, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria, 3168, Australia.,Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia.,Monash Children's Hospital, Locked Bag 29, Clayton South, Victoria, Australia
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72
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COVID-19-Related Food Insecurity Among Households with Dietary Restrictions: A National Survey. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:3323-3330.e3. [PMID: 34174493 PMCID: PMC8421756 DOI: 10.1016/j.jaip.2021.06.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 05/25/2021] [Accepted: 06/07/2021] [Indexed: 11/29/2022]
Abstract
Background Food insecurity dramatically increased because of the COVID-19 pandemic; however, little is known about pandemic-related food insecurity in households with dietary restrictions. Objective To examine pre-pandemic rates of and pandemic-related change in food insecurity among households with and without dietary restrictions. Methods A cross-sectional, panel-based survey of 3200 U.S. women was conducted in April 2020. Pre-pandemic food insecurity and early pandemic-related change in food insecurity were assessed using the adapted Hunger Vital Sign. Weighted, multivariate logistic regression was used to model the odds of pre-pandemic food insecurity and the odds of incident or worsening pandemic-related food insecurity among households with and without dietary restrictions. In models predicting pandemic-related outcomes, interaction effects between race/ethnicity and dietary restrictions were examined. Results Before the COVID-19 pandemic, households with self-reported food allergy (adjusted odds ratio [aOR]: 1.5, 95% confidence interval [CI]: 1.2-1.9), celiac disease (aOR: 2.3, 95% CI: 1.4-3.5), or both (aOR: 2.1, 95% CI: 1.2-3.6) were significantly more likely to be food insecure than households without restrictions. Households with dietary restrictions were also significantly more likely to experience incident or worsening food insecurity during the early pandemic (food allergy: aOR: 1.6, 95% CI: 1.3-2.1) (celiac disease: aOR: 2.3, 95% CI: 1.5-3.5) (both: aOR: 2.0, 95% CI: 1.2-3.4). Race/ethnicity was not a significant moderator of the relationship between dietary restrictions and pandemic-related food insecurity. Conclusion Households with dietary restrictions were more likely to experience both pre-pandemic and pandemic-related incident or worsening food insecurity than households without restrictions. Clinical care for patients with dietary restrictions requires attention to food insecurity.
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73
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Rencken CA, Rodríguez-Mercedes SL, Patel KF, Grant GG, Kinney EM, Sheridan RL, Brady KJS, Palmieri TL, Warner PM, Fabia RB, Schneider JC, Stoddard FJ, Kazis LE, Ryan CM. Development of the School-Aged Life Impact Burn Recovery Evaluation (SA-LIBRE5-12) Profile: A Conceptual Framework. J Burn Care Res 2021; 42:1067-1075. [PMID: 34228121 DOI: 10.1093/jbcr/irab104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Pediatric burn injuries can alter the trajectory of the survivor's entire life. Patient-centered outcome measures are helpful to assess unique physical and psychosocial needs and long-term recovery. This study aimed to develop a conceptual framework to measure pediatric burn outcomes in survivors aged 5 to 12 years as a part of the School-Aged Life Impact Burn Recovery Evaluation Computer Adaptive Test (SA-LIBRE5-12 CAT) development. This study conducted a systematic literature review guided by the WHO International Classification of Functioning - Child and Youth and domains in the American Burn Association/Shriners Hospitals for Children Burn Outcomes Questionnaire5-18. Interviews with eight parents and seven clinicians were conducted to identify important domains in child recovery. One clinician focus group with four clinicians was completed to identify gaps in the preliminary framework, and semi-weekly expert consensus meetings were conducted with three experts to solidify the framework. Qualitative data were analyzed by grounded theory methodology. Three major thematic outcome domains emerged: 1) Physical Functioning: fine motor and upper extremity, gross motor and lower extremity, pain, skin symptoms, sleep and fatigue, and physical resilience; 2) Psychological Functioning: cognitive, behavioral, emotional, resilience, and body image; and 3) Family and Social Functioning: family relationships, and parental satisfaction, school, peer relations and community participation. The framework will be used to develop item banks for a CAT-based assessment of school-aged children's health and developmental outcomes, which will be designed for clinical and research use to optimize interventions, personalize care, and improve long-term health outcomes for burned children.
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Affiliation(s)
| | | | - Khushbu F Patel
- Shriners Hospitals for Children - Boston,® Boston, MA.,Department of General Surgery Research, Massachusetts General Hospital, Boston, MA
| | | | - Erin M Kinney
- Shriners Hospitals for Children - Boston,® Boston, MA
| | | | - Keri J S Brady
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA
| | - Tina L Palmieri
- Division of Burn Surgery, Department of Surgery, University of California Davis.,Shriners Hospital for Children - Northern California®, 2425 Stockton Boulevard, Suite 718, Sacramento, CA 95817, USA
| | - Petra M Warner
- Shriners Hospital for Children - Cincinnati,® Cincinnati, OH.,University of Cincinnati, 3229 Burnet Avenue, Cincinnati, OH 45229, USA
| | - Renata B Fabia
- Nationwide Children's Hospital, General Pediatric Surgery, Director of the Burn Program, Columbus, OH
| | - Jeffrey C Schneider
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA.,Spaulding Research Institute, Boston, MA.,Harvard Medical School, Boston, MA
| | - Frederick J Stoddard
- Harvard Medical School, Boston, MA.,Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Lewis E Kazis
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA
| | - Colleen M Ryan
- Shriners Hospitals for Children - Boston,® Boston, MA.,Harvard Medical School, Boston, MA.,Department of Surgery, Massachusetts General Hospital, Boston, MA
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Lindau ST, Makelarski JA, Boyd K, Doyle KE, Haider S, Kumar S, Lee NK, Pinkerton E, Tobin M, Vu M, Wroblewski KE, Lengyel E. Change in Health-Related Socioeconomic Risk Factors and Mental Health During the Early Phase of the COVID-19 Pandemic: A National Survey of U.S. Women. J Womens Health (Larchmt) 2021; 30:502-513. [PMID: 33818123 DOI: 10.1089/jwh.2020.8879] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: During a pandemic, women may be especially vulnerable to secondary health problems driven by its social and economic effects. We examined the relationship between changes in health-related socioeconomic risks (HRSRs) and mental health. Materials and Methods: A cross-sectional survey of 3,200 women aged 18-90 years was conducted in April 2020 using a quota-based sample from a national panel (88% cooperation rate). Patterns of change in HRSRs (food insecurity, housing instability, interpersonal violence, and difficulties with utilities and transportation) were described. Weighted, multivariate logistic regression was used to model the odds of depression, anxiety, and traumatic stress symptoms among those with and without incident or worsening HRSRs. Results: More than 40% of women had one or more prepandemic HRSRs. In the early pandemic phase, 49% of all women, including 29% with no prepandemic HRSRs, had experienced incident or worsening HRSRs. By April 2020, the rates of depression and anxiety were twice that of prepandemic benchmarks (29%); 17% of women had symptoms of traumatic stress. The odds of depression, anxiety, and posttraumatic stress symptoms were two to three times higher among women who reported at least one incident or worsening HRSR; this finding was similar for women with and without prepandemic HRSRs. Conclusions: Increased health-related socioeconomic vulnerability among U.S. women early in the coronavirus disease 2019 (COVID-19) pandemic was prevalent and associated with alarmingly high rates of mental health problems. Pandemic-related mental health needs are likely to be much greater than currently available resources, especially for vulnerable women.
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Affiliation(s)
- Stacy Tessler Lindau
- Departments of Obstetrics and Gynecology and Medicine-Geriatrics, The University of Chicago, Chicago, Illinois, USA
| | - Jennifer A Makelarski
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, USA
- Benedictine University, College of Education and Health Services, Lisle, Illinois, USA
| | - Kelly Boyd
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, USA
| | - Kate E Doyle
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, USA
| | - Sadia Haider
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, USA
| | - Shivani Kumar
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois, USA
| | - Nita Karnik Lee
- Department of Obstetrics and Gynecology/Section of Gynecologic Oncology, The University of Chicago, Chicago, Illinois, USA
| | - El Pinkerton
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, USA
| | - Marie Tobin
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, Chicago, Illinois, USA
| | - Milkie Vu
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, USA
| | - Kristen E Wroblewski
- Department of Public Health Sciences, The University of Chicago, Chicago, Illinois, USA
| | - Ernst Lengyel
- Department of Obstetrics and Gynecology/Section of Gynecologic Oncology, The University of Chicago, Chicago, Illinois, USA
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Santoro SL, Campbell A, Cottrell C, Donelan K, Majewski B, Oreskovic NM, Patsiogiannis V, Torres A, Skotko BG. Piloting the use of global health measures in a Down syndrome clinic. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:1108-1117. [PMID: 33759305 PMCID: PMC8830489 DOI: 10.1111/jar.12866] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 12/17/2020] [Accepted: 02/09/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE People with Down syndrome (DS) have a unique medical profile which may impact views of health. We aimed to explore the use of global health measures in DS. METHODS Prospective survey in the Mass General Hospital Down Syndrome Program (MGH DSP) from December 2018 to July 2019 with Patient Reported Outcomes Measurement Information System (PROMIS)® instruments of global health. Analyses included use of scoring manuals, descriptive statistics and dependent samples t test. RESULTS Seventeen adolescents, 48 adults with DS and 88 caregivers returned surveys; 137 were complete. Incomplete responses and notes showed limitations of the instruments in this population. Global health T-scores did not differ from the available comparative standardized scores to these measures from PROMIS® reference population (p > 0.05). CONCLUSIONS In the MGH DSP, pilot global health instruments were completed by some adults with DS and caregivers, with some limitations and scores similar to the PROMIS® reference population.
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Affiliation(s)
- Stephanie L Santoro
- Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Ashlee Campbell
- Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - Clorinda Cottrell
- Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - Karen Donelan
- Survey Research and Implementation Unit, Division of Clinical Research, Massachusetts General Hospital, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Ben Majewski
- Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - Nicolas M Oreskovic
- Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Vasiliki Patsiogiannis
- Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - Amy Torres
- Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - Brian G Skotko
- Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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Wong JJ, Hanes S, Iturralde E, Lanning MS, Naranjo D, Tanenbaum M, Hood KK. Do Youth Want Psychosocial Screenings in Diabetes Clinic? Profiles of Acceptability. J Pediatr Psychol 2021; 46:332-340. [PMID: 33316061 DOI: 10.1093/jpepsy/jsaa112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/29/2020] [Accepted: 10/30/2020] [Indexed: 11/13/2022] Open
Abstract
AIMS Psychosocial screenings are recommended and increasingly common in pediatric subspecialty clinics, though little is known about their acceptability. This study seeks to uncover profiles of acceptability and assess demographic and clinical correlates among adolescents with diabetes. METHODS A sample of 124 adolescents (57.7% female) ages 12-21 years (M = 16.2 ± 2.3) completed screenings during routine diabetes appointments. K-means clustering of responses to acceptability items derived profiles; Analysis of Variance (ANOVA) and Chi-square tests assessed correlates. RESULTS Adolescents with the most common profile (72.6%) placed high importance on medical providers' awareness of their emotions and reported no difficulties/discomfort with the screener. These youth had moderate depressive symptoms, low diabetes distress, and low A1c. Those who fit a less common profile (18.5%) were uncomfortable with the screener and had the highest depressive symptoms and lowest A1c. Youth who fit a smaller profile (6.5%) endorsed technical difficulties and had high depressive symptoms and lowest diabetes distress. The smallest profile (2.4%, N = 3) had difficulty understanding and experienced discomfort with the screening and had the lowest depressive symptoms and the highest diabetes distress and A1c. These differences in depressive symptoms (F = 3.54, p = .017), A1c values (F = 4.03, p = .009), and diabetes distress (F = 3.27, p = .036) were significant though differences in age, gender, and diabetes duration were not. CONCLUSIONS Most youth responded favorably to in-clinic psychosocial screenings. Youth who were less satisfied were at increased risk for psychosocial and medical complications. Findings highlight areas of need, such as enhanced support with and an emphasized rationale for screenings, which may improve patient experience in subspecialty care.
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Affiliation(s)
- Jessie J Wong
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University
| | - Sarah Hanes
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University
| | - Esti Iturralde
- Division of Research, Kaiser Permanente Northern California
| | - Monica S Lanning
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University
| | - Diana Naranjo
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University
| | - Molly Tanenbaum
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University
| | - Korey K Hood
- Division of Endocrinology and Diabetes, Department of Pediatrics, Stanford University
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Singh A, Dasgupta M, Retherford D, Fiallo-Scharer R, Simpson PM, Panepinto JA. Measurement properties of Patient Reported Outcomes Measurement Information System domains for children with type 1 diabetes. Pediatr Diabetes 2021; 22:335-344. [PMID: 33026680 PMCID: PMC8185634 DOI: 10.1111/pedi.13134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 09/02/2020] [Accepted: 10/04/2020] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Patient Reported Outcomes Measurement Information System (PROMIS) includes numerous domains to assess functioning among the pediatric population. These domains, however, have not been evaluated for use in children with type 1 diabetes (T1D). The objective of this study was to determine the measurement properties of PROMIS domains (pain behavior, pain quality, physical stress experience, physical activity, strength impact, and profile-25) in children with T1D. METHODS This is a cross-sectional study of children with T1Drecruited from tertiary care facilities. To determine construct validity, we compared PROMIS T-scores between known-groups based on (a) glycemic control, hemoglobin A1c (HbA1c%) and (b) self-reported general health, using t test or analysis of variance. Reliability was determined using Cronbach's alpha and item response theory reliability. We also determined agreement between parent-proxy and child self-report PROMIS scores. RESULTS Our study included 192 children, mean age 12.7 (SD = 2.9) years, eligible to self-report PROMIS surveys. There were significant differences in physical stress experience and pain intensity between children with HbA1c < 10% and those with HbA1c ≥ 10%. There also were significant differences in T-scores for all domains except physical function mobility and strength impact among children with poor/fair, good, very good/excellent general health. All valid domains had reliability >0.70. More than 40% of child-parent pairs were in agreement, with intraclass correlations coefficients (ICC) ranging between 0.41 and 0.63 for all domains, except pain behavior (%agreement = 23%; ICC = 0.29). CONCLUSIONS Most of the PROMIS domains tested are valid, reliable, and able to differentiate children with T1D who report different general health states. There is moderate agreement between child-parent pairs for all domains except pain behavior.
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Affiliation(s)
- Ashima Singh
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Mahua Dasgupta
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Dawn Retherford
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Rosanna Fiallo-Scharer
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin,Children’s Hospital of Wisconsin, Milwaukee, Wisconsin
| | - Pippa M. Simpson
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Julie A. Panepinto
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin,Children’s Hospital of Wisconsin, Milwaukee, Wisconsin
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Cox ED, Dobrozsi SK, Forrest CB, Gerhardt WE, Kliems H, Reeve BB, Rothrock NE, Lai JS, Svenson JM, Thompson LA, Tran TDN, Tucker CA. Considerations to Support Use of Patient-Reported Outcomes Measurement Information System Pediatric Measures in Ambulatory Clinics. J Pediatr 2021; 230:198-206.e2. [PMID: 33271193 PMCID: PMC7914197 DOI: 10.1016/j.jpeds.2020.11.053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 11/19/2020] [Accepted: 11/24/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To identify challenges to the use of Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric measures in the ambulatory pediatric setting and possible solutions to these challenges. STUDY DESIGN Eighteen semistructured telephone interviews of health system leaders, measurement implementers, and ambulatory pediatric clinicians were conducted. Five coders used applied thematic analysis to iteratively identify and refine themes in interview data. RESULTS Most interviewees had roles in leadership or the implementation of patient-centered outcomes; 39% were clinicians. Some had experience using PROMIS clinically (44%) and 6% were considering this use. Analyses yielded 6 themes: (1) selection of PROMIS measures, (2) method of administration, (3) use of PROMIS Parent Proxy measures, (4) privacy and confidentiality of PROMIS responses, (5) interpretation of PROMIS scores, and (6) using PROMIS scores clinically. Within the themes, interviewees illuminated specific unique considerations for using PROMIS with children, including care transitions and privacy. CONCLUSIONS Real-world challenges continue to hamper PROMIS use. Ongoing efforts to disseminate information about the integration of PROMIS measures in clinical care is critical to impacting the health of children.
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Affiliation(s)
- Elizabeth D. Cox
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Sarah K. Dobrozsi
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI
| | | | - Wendy E. Gerhardt
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center (retired), Cincinnati, OH
| | - Harald Kliems
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Bryce B. Reeve
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC
| | - Nan E. Rothrock
- Departments of Medical Social Sciences, Psychiatry and Behavioral Sciences, and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Jin-Shei Lai
- Departments of Medical Social Sciences and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Jacob M. Svenson
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Lindsay A. Thompson
- Departments of Pediatrics and Health Outcomes and Biomedical Informatics, University of Florida College of Medicine, Gainesville, FL
| | - Thuy Dan N. Tran
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Carole A. Tucker
- Department of Health and Rehabilitation Sciences, Temple University College of Public Health, Philadelphia, PA
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Psychometric properties of the Patient-Reported Outcomes Measurement Information System (PROMIS®) pediatric item bank peer relationships in the Dutch general population. Qual Life Res 2021; 30:2061-2070. [PMID: 33606180 PMCID: PMC8233291 DOI: 10.1007/s11136-021-02781-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE This study aimed to validate the PROMIS Pediatric item bank v2.0 Peer Relationships and compare reliability of the full item bank to its short form, computerized adaptive test (CAT) and the social functioning (SF) subscale of the Pediatric Quality of Life Inventory (PedsQL™). METHODS Children aged 8-18 (n = 1327), representative of the Dutch population completed the Peer Relationships item bank. A graded response model (GRM) was fit to the data. Structural validity was assessed by checking item-fit statistics (S-X2, p < 0.001 = misfit). For construct validity, a moderately strong correlation (> 0.50) was expected between Peer Relationships and the PedsQL SF subscale. Cross-cultural DIF between U.S. and NL was assessed using logistic regression, where an item with McFadden's pseudo R2 > 0.02 was considered to have DIF. Percentage of participants reliably measured was assessed using the standard error of measurement (SEM) < 0.32 as a criterion (reliability of 0.90). Relative efficiency ((1-SEM2)/nitems) was calculated to compare how well the instruments performed relative to the amount of items administered. RESULTS In total, 527 (response rate: 39.7%) children completed the PROMIS v2.0 Peer Relationships item bank (nitems = 15) and the PedsQL™ (nitems = 23). Structural validity of the Peer Relationships item bank was sufficient, but one item displayed misfit in the GRM model (S-X2 < 0.001); 5152R1r ("I played alone and kept to myself"). The item 733R1r ("I was a good friend") was the only item that displayed cross-cultural DIF (R2 = 0.0253). The item bank correlated moderately high (r = 0.61) with the PedsQL SF subscale Reliable measurements were obtained at the population mean and > 2SD in the clinically relevant direction. CAT outperformed all other measures in efficiency. Mean T-score of the Dutch general population was 46.9(SD 9.5). CONCLUSION The pediatric PROMIS Peer Relationships item bank was successfully validated for use within the Dutch population and reference data are now available.
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Suicidal risk and resilience in juvenile fibromyalgia syndrome: a cross-sectional cohort study. Pediatr Rheumatol Online J 2021; 19:3. [PMID: 33407630 PMCID: PMC7789563 DOI: 10.1186/s12969-020-00487-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 12/09/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND To characterize suicidality among youth with juvenile fibromyalgia syndrome (JFMS) receiving treatment from pediatric rheumatologists at a tertiary care center in order to determine the prevalence of suicidality in JFMS and to explore risk factors for persistent suicidal ideation. METHODS We performed a cross-sectional cohort study of children 12-17 years old with JFMS seen in a specialty pediatric rheumatology pain clinic from 7/2017-9/2019. All subjects completed patient-reported outcomes measures, complemented by retrospective chart review. Subjects who endorsed item 8 on the Children's Depression Inventory, 2nd Edition (CDI-2) were categorized as endorsing suicidal ideation. We assessed for differences between the suicidal and non-suicidal patients using Wilcoxon-rank sum test. Logistic regression modeling was performed to identify psychosocial factors associated with suicidality. RESULTS Of the 31 subjects, more than one-quarter endorsed suicidality. Nearly 90% of teens with suicidal ideation were established in outpatient counseling. In bivariate analyses, suicidality was associated with lower resilience and greater depression and anxiety (all p < 0.05). Pain intensity trended towards a statistically significant positive association (OR: 1.16 [0.99-1.37]; p = 0.06). Lower resilience was independently associated with suicidality (OR: 0.90 [95% CI: 0.82-0.98]; p < 0.02). CONCLUSIONS Suicidality was prevalent among youth with JFMS and persistent despite concurrent receipt of mental health services. Higher patient-level resilience was independently associated with a reduced odds of suicidality. Future work should examine the role of resilience training on reducing psychological distress and mitigating the risk of suicidality in JFMS.
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Luijten MAJ, van Muilekom MM, Teela L, Polderman TJC, Terwee CB, Zijlmans J, Klaufus L, Popma A, Oostrom KJ, van Oers HA, Haverman L. The impact of lockdown during the COVID-19 pandemic on mental and social health of children and adolescents. Qual Life Res 2021; 30:2795-2804. [PMID: 33991278 PMCID: PMC8122188 DOI: 10.1007/s11136-021-02861-x] [Citation(s) in RCA: 99] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE During the COVID-19 pandemic in the Netherlands, governmental regulations resulted in a lockdown for adults as well as children/adolescents. Schools were closed and contact with other people was limited. In this cross-sectional, population-based study, we aimed to investigate the mental/social health of children/adolescents during COVID-19 lockdown. METHODS Two representative samples of Dutch children/adolescents (8-18 years) before COVID-19 (2018, N = 2401) and during lockdown (April 2020, N = 844) were compared on the Patient-Reported Outcomes Measurement Information System (PROMIS) domains: global health, peer relationships, anxiety, depressive symptoms, anger, sleep-related impairment by linear mixed models and calculating relative risks (RR (95% CI)) for the proportion of severe scores. Variables associated with worse mental/social health during COVID-19 were explored through multivariable regression models. The impact of COVID-19 regulations on the daily life of children was qualitatively analyzed. RESULTS Participants reported worse PROMIS T-scores on all domains during COVID-19 lockdown compared to before (absolute mean difference range 2.1-7.1 (95% CI 1.3-7.9). During lockdown, more children reported severe Anxiety (RR = 1.95 (1.55-2.46) and Sleep-Related Impairment (RR = 1.89 (1.29-2.78) and fewer children reported poor Global Health (RR = 0.36 (0.20-0.65)). Associated factors with worse mental/social health were single-parent family, ≥ three children in the family, negative change in work situation of parents due to COVID-19 regulations, and a relative/friend infected with COVID-19. A large majority (> 90%) reported a negative impact of the COVID-19 regulations on daily life. CONCLUSION This study showed that governmental regulations regarding lockdown pose a serious mental/social health threat on children/adolescents that should be brought to the forefront of political decision-making and mental healthcare policy, intervention, and prevention.
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Affiliation(s)
- Michiel A. J. Luijten
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, G8-136, Meibergdreef 9, Postbox 22660, 1100 DD Amsterdam, The Netherlands ,Epidemiology and Data Science, Vrije Universiteit, Amsterdam UMC, Amsterdam, The Netherlands
| | - Maud M. van Muilekom
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, G8-136, Meibergdreef 9, Postbox 22660, 1100 DD Amsterdam, The Netherlands
| | - Lorynn Teela
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, G8-136, Meibergdreef 9, Postbox 22660, 1100 DD Amsterdam, The Netherlands
| | - Tinca J. C. Polderman
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Caroline B. Terwee
- Epidemiology and Data Science, Vrije Universiteit, Amsterdam UMC, Amsterdam, The Netherlands
| | - Josjan Zijlmans
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Leonie Klaufus
- Department of Public and Occupational Health, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands ,Department of Epidemiology, Health Promotion, and Health Care Innovation, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - Arne Popma
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, G8-136, Meibergdreef 9, Postbox 22660, 1100 DD Amsterdam, The Netherlands ,Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Public Health, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Kim J. Oostrom
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, G8-136, Meibergdreef 9, Postbox 22660, 1100 DD Amsterdam, The Netherlands
| | - Hedy A. van Oers
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, G8-136, Meibergdreef 9, Postbox 22660, 1100 DD Amsterdam, The Netherlands
| | - Lotte Haverman
- Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, G8-136, Meibergdreef 9, Postbox 22660, 1100 DD, Amsterdam, The Netherlands.
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Zijlmans J, Teela L, van Ewijk H, Klip H, van der Mheen M, Ruisch H, Luijten MAJ, van Muilekom MM, Oostrom KJ, Buitelaar J, Hoekstra PJ, Lindauer R, Popma A, Staal W, Vermeiren R, van Oers HA, Haverman L, Polderman TJC. Mental and Social Health of Children and Adolescents With Pre-existing Mental or Somatic Problems During the COVID-19 Pandemic Lockdown. Front Psychiatry 2021; 12:692853. [PMID: 34305685 PMCID: PMC8295554 DOI: 10.3389/fpsyt.2021.692853] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/07/2021] [Indexed: 01/08/2023] Open
Abstract
Background: The COVID-19 lockdown increases psychological problems in children and adolescents from the general population. Here we investigate the mental and social health during the COVID-19 lockdown in children and adolescents with pre-existing mental or somatic problems. Methods: We included participants (8-18 years) from a psychiatric (N = 249) and pediatric (N = 90) sample, and compared them to a general population sample (N = 844). Measures were assessed during the first lockdown (April-May 2020) in the Netherlands. Main outcome measures were Patient-Reported Outcomes Measurement Information System (PROMIS®) domains: Global Health, Peer Relationships, Anxiety, Depressive Symptoms, Anger, and Sleep-Related Impairment, as reported by children and youth. Additionally, socio-demographic variables, COVID-19-related questions, changes in atmosphere at home from a parent and child perspective, and children's experiences of lockdown regulations were reported by parents. Results: On all measures except Global Health, the pediatric sample reported least problems. The psychiatric sample reported significantly more problems than the general population sample on all measures except for Anxiety and Peer Relationships. Having a COVID-19 affected friend/relative and a COVID-19 related change in parental work situation negatively moderated outcome, but not in the samples with pre-existing problems. All parents reported significant decreases in atmosphere at home, as did children from the general population. Conclusion: We observed significant differences in mental and social health between three child and adolescent samples during the COVID-19 pandemic lockdown and identified COVID-19-related factors influencing mental and social health.
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Affiliation(s)
- Josjan Zijlmans
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, Netherlands
| | - Lorynn Teela
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands
| | - Hanneke van Ewijk
- Curium-Leiden University Medical Center, Leiden University Medical Center, Leiden, Netherlands
| | - Helen Klip
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, Netherlands
| | - Malindi van der Mheen
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands.,Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, Netherlands
| | - Hyun Ruisch
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Michiel A J Luijten
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands.,Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Epidemiology and Data Science, Amsterdam Public Health, Amsterdam, Netherlands
| | - Maud M van Muilekom
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands
| | - Kim J Oostrom
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands
| | - Jan Buitelaar
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, Netherlands.,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, Netherlands
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Ramón Lindauer
- Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands.,Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, Netherlands
| | - Arne Popma
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, Netherlands.,Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, Netherlands
| | - Wouter Staal
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, Netherlands
| | - Robert Vermeiren
- Curium-Leiden University Medical Center, Leiden University Medical Center, Leiden, Netherlands
| | - Hedy A van Oers
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands
| | - Lotte Haverman
- Emma Children's Hospital, Amsterdam University Medical Center, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, University of Amsterdam, Amsterdam, Netherlands
| | - Tinca J C Polderman
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam Public Health, Amsterdam, Netherlands.,Curium-Leiden University Medical Center, Leiden University Medical Center, Leiden, Netherlands.,Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, Netherlands.,Department of Child and Adolescent Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands.,Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Ettinger AK, Landsittel D, Abebe KZ, Bey J, Chavis V, Navratil JD, Savage Friedman F, Dermody TS, Miller E. THRIVE Conceptual Framework and Study Protocol: A Community-Partnered Longitudinal Multi-Cohort Study to Promote Child and Youth Thriving, Health Equity, and Community Strength. Front Pediatr 2021; 9:797526. [PMID: 35186824 PMCID: PMC8856106 DOI: 10.3389/fped.2021.797526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Given the profound inequities in maternal and child health along racial, ethnic, and socioeconomic lines, strength-based, community-partnered research is required to foster thriving children, families, and communities, where thriving is defined as optimal development across physical, mental, cognitive, and social domains. The Pittsburgh Study (TPS) is a community-partnered, multi-cohort study designed to understand and promote child and youth thriving, build health equity, and strengthen communities by integrating community partners in study design, implementation, and dissemination. TPS launched the Tracking Health, Relationships, Identity, EnVironment, and Equity (THRIVE) Study to evaluate children's developmental stages and contexts from birth through completion of high school and to inform a child health data hub accessible to advocates, community members, educators, health professionals, and policymakers. METHODS AND ANALYSIS TPS is rooted in community-partnered participatory research (CPPR), health equity, antiracism, and developmental science. Using our community-informed conceptual framework of child thriving, the THRIVE Study will assess cross-cutting measures of place, environment, health service use, and other social determinants of health to provide longitudinal associations with developmentally appropriate child and youth thriving outcomes across participants in six cohorts spanning from pregnancy through adolescence (child ages 0-18 years). Data from electronic health records, school records, and health and human services use are integrated to assess biological and social influences of thriving. We will examine changes over time using paired t-tests and adjusted linear regression models for continuous thriving scores and McNemar tests and adjusted logistic regression models for categorical outcomes (thriving/not thriving). Data analyses will include mixed models with a random intercept (in combination with the previously-specified types of regression models) to account for within-subject correlation. DISCUSSION By enhancing assessment of child and youth well-being, TPS will fill critical gaps in our understanding of the development of child and youth thriving over time and test strategies to support thriving in diverse communities and populations. Through CPPR and co-design, the study aims to improve child health inequities across multiple socioecological levels and developmental domains.
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Affiliation(s)
- Anna K Ettinger
- Department of Psychology, Center for Children and Families, University of Pittsburgh, Pittsburgh, PA, United States
| | - Doug Landsittel
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN, United States
| | - Kaleab Z Abebe
- Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Jamil Bey
- UrbanKind Institute, Pittsburgh, PA, United States
| | - Val Chavis
- Department of Psychology, Center for Children and Families, University of Pittsburgh, Pittsburgh, PA, United States
| | - Judith D Navratil
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | | | - Terence S Dermody
- Departments of Pediatrics and Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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84
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Carle AC, Bevans KB, Tucker CA, Forrest CB. Using nationally representative percentiles to interpret PROMIS pediatric measures. Qual Life Res 2020; 30:997-1004. [PMID: 33201388 DOI: 10.1007/s11136-020-02700-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE This study's aim was to use a representative sample of the US pediatric population to estimate percentiles for several PROMIS pediatric measures: Anger, Anxiety, Depressive Symptoms, Family Relationships, Fatigue, Global Health, Life Satisfaction, Meaning and Purpose, Pain Behavior, Pain Interference, Physical Activity, Physical Function Mobility, Physical Function Upper Extremity, Physical Stress Experiences, Positive Affect, Psychological Stress Experiences, Sleep Disturbance, Sleep Impairment, and Peer Relationships. METHODS We used two separate, nationally representative samples of parents and children aged 5-17 years drawn in different years from the GfK Knowledge Panel, a dual-frame online probability panel. RESULTS All measures that were developed using a representative sample had a median at or near the expected value of 50. For the other measures, the 50th percentile was often 10 points or more from 50. Several domains had high floors or low ceilings. No domain's percentiles completely corresponded to the percentiles associated with a normal distribution with a mean of 50 and standard deviation of 10. CONCLUSIONS This work allows users to interpret a child's self-reported quality of life relative to children in the US general population. When attempting to evaluate whether a child falls above or below other children in the US, one should use the values presented in this study. In addition, we recommend that users should focus on whether a child's score falls into one of a few broad severity groups rather than on specific percentile scores.
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Affiliation(s)
- Adam C Carle
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. .,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. .,Department of Psychology, University of Cincinnati College of Arts and Sciences, Cincinnati, OH, USA.
| | - Katherine B Bevans
- Department of Health and Rehabilitation Sciences, Temple University College of Public Health, Philadelphia, USA
| | - Carole A Tucker
- Department of Health and Rehabilitation Sciences, Temple University College of Public Health, Philadelphia, USA
| | - Christopher B Forrest
- Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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85
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Blackwell CK, Hartstein LE, Elliott AJ, Forrest CB, Ganiban J, Hunt KJ, Camargo CA, LeBourgeois MK. Better sleep, better life? How sleep quality influences children's life satisfaction. Qual Life Res 2020; 29:2465-2474. [PMID: 32399666 PMCID: PMC7442661 DOI: 10.1007/s11136-020-02491-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To assess the association between children's sleep quality and life satisfaction; and to evaluate the underlying mechanisms of this relationship. METHODS Three pediatric cohorts in the National Institutes of Health (NIH) Environmental influences on Child Health (ECHO) Research Program administered Patient-Reported Outcome Measurement Information System (PROMIS®) parent-proxy measures to caregivers (n = 1111) who reported on their 5- to 9-year-old children's (n = 1251) sleep quality, psychological stress, general health, and life satisfaction; extant sociodemographic data were harmonized across cohorts. Bootstrapped path modeling of individual patient data meta-analysis was used to determine whether and to what extent stress and general health mediate the relationship between children's sleep quality and life satisfaction. RESULTS Nonparametric bootstrapped path analyses with 1000 replications suggested children's sleep quality was associated with lower levels of stress and better general health, which, in turn, predicted higher levels of life satisfaction. Family environmental factors (i.e., income and maternal mental health) moderated these relationships. CONCLUSION Children who sleep well have happier lives than those with more disturbed sleep. Given the modifiable nature of children's sleep quality, this study offers evidence to inform future interventional studies on specific mechanisms to improve children's well-being.
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Affiliation(s)
- Courtney K Blackwell
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave, Fl. 2100, Chicago, IL, 60611, USA.
| | | | - Amy J Elliott
- Avera McKennan Hospital & University Medical Center, Sioux Falls, SD, USA
| | | | - Jody Ganiban
- George Washington University, Washington, DC, USA
| | - Kelly J Hunt
- Medical University of South Carolina College of Medicine, Charleston, SC, USA
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Bevans KB, Moon J, Becker BD, Carle A, Forrest CB. Development of patient-reported outcome measures of children's oral health aesthetics. Community Dent Oral Epidemiol 2020; 48:423-432. [PMID: 32776585 DOI: 10.1111/cdoe.12555] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 04/07/2020] [Accepted: 05/27/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To develop and evaluate the psychometric properties of child- and parent-proxy measures of oral health aesthetics. METHODS Items that describe children's perceptions of their oral attractiveness and its impact on social, emotional, and behavioural functioning were developed based on a systematic review of existing measures, clinician feedback (n = 13) and child semi-structured interviews (n = 27). The tools' content validity was assessed in cognitive interviews with 21 children. Items were administered to socio-demographically diverse samples of 998 children aged 8-17 years and 626 parents of children aged 5-17 years. Psychometric methods were used to finalize and calibrate item banks, generate short questionnaire forms, and evaluate the tools' reliability, precision and validity. RESULTS The item banks and their short forms provide precise measurement across a wide range of oral health aesthetic states. They measure relevant and meaningful positive and negative experiences using terminology that most children as young as 8 years of age can understand. Known-group comparisons and convergence with existing measures of oral health-related quality of life, global health and body image provide evidence of construct validity. The scores are interpretable relative to the US general population. CONCLUSIONS The oral health aesthetic item banks and short forms provide precise and valid assessments of children's satisfaction with their oral appearance. They may be useful for targeting and evaluating paediatric dental and orthodontic care in clinical practice and research settings.
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Affiliation(s)
- Katherine B Bevans
- Temple University College of Public Health, Philadelphia, Pennsylvania, USA
| | - Jeanhee Moon
- Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Brandon D Becker
- Value Evidence and Outcomes-Patient Centered Outcomes, GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - Adam Carle
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA.,Department of Psychology, College of Arts and Sciences, University of Cincinnati, Cincinnati, Ohio, USA
| | - Christopher B Forrest
- Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Pignolo RJ, Cheung K, Kile S, Fitzpatrick MA, De Cunto C, Al Mukaddam M, Hsiao EC, Baujat G, Delai P, Eekhoff EMW, Di Rocco M, Grunwald Z, Haga N, Keen R, Levi B, Morhart R, Scott C, Sherman A, Zhang K, Kaplan FS. Self-reported baseline phenotypes from the International Fibrodysplasia Ossificans Progressiva (FOP) Association Global Registry. Bone 2020; 134:115274. [PMID: 32062004 DOI: 10.1016/j.bone.2020.115274] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 02/11/2020] [Accepted: 02/13/2020] [Indexed: 11/21/2022]
Abstract
A global, patient-reported registry has been established to characterize the course of disease and track clinical outcomes in patients with fibrodysplasia ossificans progressiva (FOP), an ultra-rare genetic condition of progressive heterotopic ossification (HO) that results in ankylosis of joints and renders most affected individuals immobile by the second decade of life. Here, we present baseline phenotypes on 299 patients (median age 21 years; range 0.1 to 78 years) from 54 countries based on aggregate data from the International FOP Association (IFOPA) Global Registry (the "FOP Registry"). The mean current age of the patients is 23.7 years (range, 0.1 to 78 years). Baseline characteristics are presented for FOP diagnosis, HO, flare-ups and precedent events, system-based prevalent symptomatology, encounters with medical and dental care providers, Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Scale scores, physical function, as well as the use of aids, assistive devices, and adaptations. Correlations of PROMIS Global Health scores with HO burden and physical function are calculated. Associations of joint mobility with PROMIS Global Health scores, physical function, and use of aids, assistive devices, and adaptations are summarized. Overall, the FOP Registry database contains a broad sample of the global FOP patient population, providing a useful tool for expanding knowledge of FOP, designing clinical trials and facilitating evidence-based decisions about the optimal monitoring and management of affected individuals.
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Affiliation(s)
- Robert J Pignolo
- Department of Medicine, Mayo Clinic School of Medicine, Mayo Clinic, Rochester, MN, United States.
| | - Kin Cheung
- BioSAS Consulting, Inc., Wellesley, MA, United States
| | - Sammi Kile
- International FOP Association, 1520 Clay St, Suite H2, North Kansas City, MO, United States.
| | - Mary Anne Fitzpatrick
- International FOP Association, 1520 Clay St, Suite H2, North Kansas City, MO, United States.
| | - Carmen De Cunto
- Pediatric Rheumatology Section, Department of Pediatrics, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
| | - Mona Al Mukaddam
- Departments of Medicine and Orthopaedic Surgery, The Center for Research in FOP and Related Disorders, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, United States.
| | - Edward C Hsiao
- Division of Endocrinology and Metabolism, The UCSF Metabolic Bone Clinic, The Institute of Human Genetics, the UCSF Program in Craniofacial Biology, Department of Medicine, University of California-San Francisco, San Francisco, CA, United States.
| | - Genevieve Baujat
- Departement de Genetique, Institut IMAGINE, Hôpital Necker-Enfants Malades, Paris, France.
| | - Patricia Delai
- Hospital Israelita Albert Einstein, Instituto de Ensino e Pesquisa, São Paulo, SP, Brazil.
| | - Elisabeth M W Eekhoff
- VU Medical Center Amsterdam, Department of Internal Medicine/Section Endocrinology, Amsterdam, the Netherlands.
| | - Maja Di Rocco
- Unit of Rare Diseases, Department of Pediatrics, Giannina Gaslini Institute, Genoa, Italy.
| | - Zvi Grunwald
- Department of Anesthesiology, Thomas Jefferson University, Philadelphia, PA, United States.
| | - Nobuhiko Haga
- Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Richard Keen
- Centre for Metabolic Bone Disease, Royal National Orthopaedic Hospital, Stanmore, Middlesex, United Kingdom.
| | - Benjamin Levi
- Department of Surgery, University of Michigan, Ann Arbor, MI, United States.
| | - Rolf Morhart
- Department of Pediatrics, Klinikum Garmisch-Partenkirchen GmbH, Garmisch-Partenkirchen, Germany.
| | - Christiaan Scott
- Department of Paediatric Rheumatology, Red Cross Children's Hospital, Cape Town, South Africa.
| | - Adam Sherman
- International FOP Association, 1520 Clay St, Suite H2, North Kansas City, MO, United States.
| | - Keqin Zhang
- Tongji Hospital, Shanghai Tongji University, Shanghai, PR China
| | - Fredrick S Kaplan
- Departments of Orthopaedic Surgery and Medicine, The Center for Research in FOP & Related Disorders, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, United States.
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88
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Anixt JS, Murray DS, Coury DL, Kuhlthau KA, Eskra D, Seide J, Kelly A, Hess A, Lipkin PH, Law JK, Fedele A, Lannon C. Improving Behavior Challenges and Quality of Life in the Autism Learning Health Network. Pediatrics 2020; 145:S20-S29. [PMID: 32238528 DOI: 10.1542/peds.2019-1895e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To summarize baseline data and lessons learned from the Autism Learning Health Network, designed to improve care and outcomes for children with autism spectrum disorder (ASD). We describe challenging behaviors, co-occurring medical conditions, quality of life (QoL), receipt of recommended health services, and next steps. METHODS A cross-sectional study of children 3 to 12 years old with ASD receiving care at 13 sites. Parent-reported characteristics of children with ASD were collected as outcome measures aligned with our network's aims of reducing rates of challenging behaviors, improving QoL, and ensuring receipt of recommended health services. Parents completed a survey about behavioral challenges, co-occurring conditions, health services, and the Patient-Reported Outcomes Measurement Information System Global Health Measure and the Aberrant Behavior Checklist to assess QoL and behavior symptoms, respectively. RESULTS Analysis included 530 children. Challenging behaviors were reported by the majority of parents (93%), frequently noting attention-deficit/hyperactivity disorder symptoms, irritability, and anxiety. Mean (SD) scores on the Aberrant Behavior Checklist hyperactivity and irritability subscales were 17.9 (10.5) and 13.5 (9.2), respectively. The Patient-Reported Outcomes Measurement Information System Global Health Measure total score of 23.6 (3.7) was lower than scores reported in a general pediatric population. Most children had received recommended well-child (94%) and dental (85%) care in the past 12 months. CONCLUSIONS This baseline data (1) affirmed the focus on addressing challenging behaviors; (2) prioritized 3 behavior domains, that of attention-deficit/hyperactivity disorder, irritability, and anxiety; and (3) identified targets for reducing severity of behaviors and strategies to improve data collection.
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Affiliation(s)
- Julia S Anixt
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio; .,Division of Developmental and Behavioral Pediatrics and.,James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Donna S Murray
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio.,Division of Developmental and Behavioral Pediatrics and.,Autism Speaks, New York, New York
| | - Daniel L Coury
- Division of Developmental and Behavioral Pediatrics, Nationwide Children's Hospital, Columbus, Ohio
| | - Karen A Kuhlthau
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children and Department of Pediatrics, Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Diane Eskra
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Janet Seide
- Division of Developmental and Behavioral Pediatrics and.,Curry School of Education and Human Development, University of Virginia, Charlottesville, Virginia
| | - Amy Kelly
- Devereux Advanced Behavioral Health and Family Partners Program, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Amy Hess
- Division of Developmental and Behavioral Pediatrics, Nationwide Children's Hospital, Columbus, Ohio
| | - Paul H Lipkin
- Kennedy Krieger Institute, Baltimore, Maryland; and.,Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - J Kiely Law
- Kennedy Krieger Institute, Baltimore, Maryland; and.,Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | | | - Carole Lannon
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio.,James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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89
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Shesser L, Brodecki D, Lebet R. Family Perceptions of Quality of Life for Pediatric Home Ventilator Patients. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2020. [DOI: 10.1177/1084822320907911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Home mechanical ventilation is an alternative to institutional management for some children with chronic or degenerative respiratory and neuromuscular disorders. Over the past 20 years, Children’s Hospital of Philadelphia has enhanced its Home Care Home Ventilator Program, designed to transition hospitalized children requiring long-term mechanical ventilation safely home. Program goals include supporting patient safety, medical stability, and caregiver competence while promoting quality of life. This longitudinal quality improvement project examined perceived quality of life for families with children discharged home for the first time on mechanical ventilation. We sought to identify unmet needs related to this transition. A self-report quality-of-life survey adapted from several validated tools was completed by the primary caregiver at 3 specific times over 6 months. Repeated-measures general linear modeling examined changes over time in caregivers’ perceptions of quality of life and confidence in meeting their child’s ongoing healthcare needs. After completing the inpatient portion of the program, followed by 6 months caring for their child at home with support from the hospital’s Home Care Department and Technology Dependence Center, caregivers reported more time to attend to their own needs and family activities, less financial burden, less anxiety, and perceived improvements in their child’s health and quality of life compared with hospitalization. Based on our findings, one program change was implemented: the Home Care social worker now meets with the family prior to discharge.
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Affiliation(s)
- Lynn Shesser
- The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Darcy Brodecki
- The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ruth Lebet
- The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
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90
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Graham Holmes L, Zampella CJ, Clements C, McCleery JP, Maddox BB, Parish-Morris J, Udhnani MD, Schultz RT, Miller JS. A Lifespan Approach to Patient-Reported Outcomes and Quality of Life for People on the Autism Spectrum. Autism Res 2020; 13:970-987. [PMID: 32154664 DOI: 10.1002/aur.2275] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 01/11/2020] [Accepted: 01/23/2020] [Indexed: 12/16/2022]
Abstract
Autistic self-advocates, family members, and community organizations have called for greater emphasis on enhancing quality of life (QoL) for people with autism. Doing this is critical to understand how QoL unfolds across the life course and to clarify whether gender affects QoL, health, and functioning for people with autism. The purpose of this study was to curate and test a lifespan QoL measurement tool using freely available and well-constructed National Institutes of Health Parent-Reported Outcomes Measurement Information System (PROMIS). To develop the PROMIS Autism Battery-Lifespan (PAB-L), we identified PROMIS scales relevant for autism, reviewed each item, consulted with a panel of autism experts, and elicited feedback from autistic people and family members. This battery provides a comprehensive portrait of QoL for children ages 5-13 (through parent proxy), teens 14-17 (parent proxy and self-report), and adults 18-65 (self-report) with autism compared to the general population. Participants and parent informants (N = 912) recruited through a children's hospital and nationwide U.S. autism research registry completed the PAB-L online. Results indicate that compared to general population norms, people with autism of all ages (or their proxies) reported less desirable outcomes and lower QoL across all domains. Women and girls experienced greater challenges in some areas compared to men and boys with autism. The PAB-L appears to be a feasible and acceptable method for assessing patient-reported outcomes and QoL for autistic people across the life course. Autism Res 2020, 13: 970-987. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We developed a survey to measure the quality of life of children, teens, and adults with autism using free National Institutes of Health PROMIS questionnaires. People with autism and family members rated the PROMIS Autism Battery-Lifespan as useful and important. Some reported a good quality of life, while many reported that their lives were not going as well as they wanted. Women and girls reported more challenges in some areas of life than men and boys.
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Affiliation(s)
- Laura Graham Holmes
- Children's Hospital of Philadelphia Center for Autism Research, Philadelphia, Pennsylvania.,A. J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania
| | - Casey J Zampella
- Children's Hospital of Philadelphia Center for Autism Research, Philadelphia, Pennsylvania
| | - Caitlin Clements
- Children's Hospital of Philadelphia Center for Autism Research, Philadelphia, Pennsylvania.,Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joseph P McCleery
- Children's Hospital of Philadelphia Center for Autism Research, Philadelphia, Pennsylvania.,Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania.,Department of Psychology and Kinney Center for Autism Education and Support, Saint Joseph's University, Philadelphia, Pennsylvania
| | - Brenna B Maddox
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Julia Parish-Morris
- Children's Hospital of Philadelphia Center for Autism Research, Philadelphia, Pennsylvania.,Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Manisha D Udhnani
- Children's Hospital of Philadelphia Center for Autism Research, Philadelphia, Pennsylvania
| | - Robert T Schultz
- Children's Hospital of Philadelphia Center for Autism Research, Philadelphia, Pennsylvania.,Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Judith S Miller
- Children's Hospital of Philadelphia Center for Autism Research, Philadelphia, Pennsylvania.,Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
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91
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Eichner B, Michaels LAC, Branca K, Ramsey K, Mitchell J, Morris CD, Fagnan LJ, Dolor RJ, Elder N, Hahn DL, Nease DE, Lapidus J, Cibotti R, Block J, Simpson EL. A Community-based Assessment of Skin Care, Allergies, and Eczema (CASCADE): an atopic dermatitis primary prevention study using emollients-protocol for a randomized controlled trial. Trials 2020; 21:243. [PMID: 32131885 PMCID: PMC7057622 DOI: 10.1186/s13063-020-4150-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 02/06/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Atopic dermatitis (AD) is a common, chronic skin disorder often beginning in infancy. Skin barrier dysfunction early in life serves as a central event in the pathogenesis of AD. In infants at high risk of developing AD, preventative application of lipid-rich emollients may reduce the risk of developing AD. This study aims to measure the effectiveness of this intervention in a population not selected for risk via a pragmatic, randomized, physician-blinded trial in the primary care setting. METHODS Infant-parent dyads are recruited from a primary care practice participating through one of four practice-based research networks in Oregon, Colorado, Wisconsin, and North Carolina. Eligible dyads are randomized to the intervention (daily use of lipid-rich emollient) or the control (no emollient) group (n = 625 infants in each) and are followed for 24 months. The primary outcome is the cumulative incidence of physician-diagnosed AD and secondary outcomes include caregiver-reported measures of AD and development of other atopic diseases. Data collection occurs via chart review and surveys, with no study visits required. Data will be analyzed utilizing intention-to-treat principles. DISCUSSION AD is a common skin condition in infants that affects quality of life and is associated with the development of other atopic diseases. If a safe intervention, such as application of lipid-rich emollients, in the general population effectively decreases AD prevalence, this could alter the guidance given by providers regarding routine skin care of infants. Because of the pragmatic design, we anticipate that this trial will yield generalizable results. TRIAL REGISTRATION ClinicalTrials.gov: NCT03409367. Registered on 11 February 2018.
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Affiliation(s)
- Brian Eichner
- Duke Primary Care Research Consortium, Duke University, Durham, NC, USA
| | - Le Ann C Michaels
- Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland, OR, USA
| | - Kelsey Branca
- Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland, OR, USA
| | - Katrina Ramsey
- School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - Julie Mitchell
- School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - Cynthia D Morris
- School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - Lyle J Fagnan
- Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland, OR, USA
| | - Rowena J Dolor
- Duke Primary Care Research Consortium, Duke University, Durham, NC, USA
| | - Nancy Elder
- Oregon Rural Practice-based Research Network, Oregon Health & Science University, Portland, OR, USA
| | - David L Hahn
- Wisconsin Research & Education Network, University of Wisconsin-Madison, Madison, WI, USA
| | - Donald E Nease
- State Networks of Colorado Ambulatory Partners & Practices, University of Colorado-Denver, Denver, CO, USA
| | - Jodi Lapidus
- School of Public Health, Oregon Health & Science University, Portland, OR, USA
| | - Ricardo Cibotti
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institute of Health, Bethesda, MD, USA
| | - Julie Block
- National Eczema Association, San Rafael, CA, USA
| | - Eric L Simpson
- Department of Dermatology, Oregon Health & Science University, Portland, OR, USA.
- Oregon Clinical & Translational Research Institute, Oregon Health & Science University, Portland, OR, USA.
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92
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Butler DP, De la Torre A, Borschel GH, Hadlock TA, Beurskens C, Bogart K, Cárdenas Mejía A, Coombs C, Copeland J, Diels J, González-Otero T, Graham L, Ishii L, Malhotra R, Martinez A, McKinley L, Robinson MW, Suominen S, Takushima A, Vazquez Curiel E, Wachs FL, Grobbelaar AO. An International Collaborative Standardizing Patient-Centered Outcome Measures in Pediatric Facial Palsy. JAMA FACIAL PLAST SU 2020; 21:351-358. [PMID: 31070677 DOI: 10.1001/jamafacial.2019.0224] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Standardization of outcome measurement using a patient-centered approach in pediatric facial palsy may help aid the advancement of clinical care in this population. Objective To develop a standardized outcome measurement set for pediatric patients with facial palsy through an international multidisciplinary group of health care professionals, researchers, and patients and patient representatives. Design, Setting, and Participants A working group of health care experts and patient representatives (n = 21), along with external reviewers, participated in the study. Seven teleconferences were conducted over a 9-month period between December 3, 2016, and September 23, 2017, under the guidance of the International Consortium for Health Outcomes Measurement, each followed with a 2-round Delphi process to develop consensus. This process defined the scope, outcome domains, measurement tools, time points for measurements, and case-mix variables deemed essential to a standardized outcome measurement set. Each teleconference was informed by a comprehensive review of literature and through communication with patient advisory groups. Literature review of PubMed was conducted for research published between January 1, 1981, and November 30, 2016. Main Outcomes and Measures The study aim was to develop the outcomes and measures relevant to children with facial palsy as opposed to studying the effect of a particular intervention. Results The 21 members of the working group included pediatric facial palsy experts from 9 countries. The literature review identified 1628 papers, of which 395 (24.3%) were screened and 83 (5.1%) were included for qualitative evaluation. A standard set of outcome measurements was designed by the working group to allow the recording of outcomes after all forms of surgical and nonsurgical facial palsy treatments among pediatric patients of all ages. Unilateral or bilateral, congenital or acquired, permanent or temporary, and single-territory or multiterritory facial palsy can be evaluated using this standard set. Functional, appearance, psychosocial, and administrative outcomes were selected for inclusion. Clinimetric and psychometric outcome measurement tools (clinician-, patient-, and patient proxy-reported) and time points for measuring patient outcomes were established. Eighty-six independent reviews of the standard set were completed, and 34 (85%) of the 40 patients and patient representatives and 44 (96%) of the 46 health care professionals who participated in the reviews agreed that the standard set would capture the outcomes that matter most to children with facial palsy. Conclusions and Relevance This international collaborative study produced a free standardized set of outcome measures for evaluating the quality of care provided to pediatric patients with facial palsy, allowing benchmarking of clinicians, comparison of treatment pathways, and introduction of value-based reimbursement strategies in the field of pediatric facial palsy. Level of Evidence NA.
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Affiliation(s)
- Daniel P Butler
- Department of Plastic and Reconstructive Surgery, Great Ormond Street Hospital, London, United Kingdom
| | - Alethse De la Torre
- Director of Standardisation and Latin America, International Consortium for Health Outcomes Measurement, Mexico City, Mexico
| | - Gregory H Borschel
- Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Tessa A Hadlock
- Division of Facial Plastic and Reconstructive Surgery, Harvard Medical School, Boston, Massachusetts
| | - Carien Beurskens
- Section of Physical Therapy, Department of Orthopedics, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Alexander Cárdenas Mejía
- Division of Plastic and Reconstructive Surgery, Hospital General Dr Manuel Gea Gonzalez, Postgraduate Division, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
| | - Christopher Coombs
- Department of Plastic and Maxillofacial Surgery, Royal Children's Hospital, Melbourne, Victoria, Australia
| | | | - Jacqueline Diels
- Facial Retraining LLC, Madison, Wisconsin.,Facial Nerve Clinic, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin Hospital and Clinics, Madison
| | | | - Louise Graham
- Patient representative, Brighton, East Sussex, United Kingdom
| | - Lisa Ishii
- Johns Hopkins Hospitals, Baltimore, Maryland
| | - Raman Malhotra
- Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, United Kingdom
| | - Adelaida Martinez
- The Portland Hospital for Women and Children, London, United Kingdom
| | - Lisa McKinley
- Facial Paralysis and Bell's Palsy Foundation, Beverly Hills, California
| | - Mara W Robinson
- Facial Nerve Center, Massachussetts Eye and Ear Infirmary, Boston
| | - Sinikka Suominen
- Department of Plastic Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Akihiko Takushima
- Department of Plastic and Reconstructive Surgery, Kyorin University School of Medicine, Tokyo, Japan
| | | | - Faye L Wachs
- California State Polytechnic University, Los Angeles
| | - Adriaan O Grobbelaar
- University College London, London, United Kingdom.,The Royal Free Hospital, London, United Kingdom.,Great Ormond Street Hospital, London, United Kingdom
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93
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Shen J, Hays RD, Wang Y, Marcus M, Maida CA, Xiong D, Lee SY, Spolsky VW, Coulter ID, Crall JJ, Liu H. Computerized adaptive testing and short form development for child and adolescent oral health patient-reported outcomes measurement. Clin Exp Dent Res 2020; 6:124-133. [PMID: 32067398 PMCID: PMC7025990 DOI: 10.1002/cre2.259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 09/18/2019] [Accepted: 09/24/2019] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To develop computerized adaptive testing (CAT) and short forms of self-report oral health measures that are predictive of both the children's oral health status index (COHSI) and the children's oral health referral recommendation (COHRR) scales, for children and adolescents, ages 8-17. MATERIAL AND METHODS Using final item calibration parameters (discrimination and difficulty parameters) from the item response theory analysis, we performed post hoc CAT simulation. Items most frequently administered in the simulation were incorporated for possible inclusion in final oral health assessment toolkits, to select the best performing eight items for COHSI and COHRR. RESULTS Two previously identified unidimensional sets of self-report items consisting of 19 items for the COHSI and 22 items for the COHRR were administered through CAT resulting in eight-item short forms for both the COHSI and COHRR. Correlations between the simulated CAT scores and the full item bank representing the latent trait are r = .94 for COHSI and r = .96 for COHRR, respectively, which demonstrated high reliability of the CAT and short form. CONCLUSIONS Using established rigorous measurement development standards, the CAT and corresponding eight-item short form items for COHSI and COHRR were developed to assess the oral health status of children and adolescents, ages 8-17. These measures demonstrated good psychometric properties and can have clinical utility in oral health screening and evaluation and clinical referral recommendations.
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Affiliation(s)
- Jie Shen
- Public Health and Community Dentistry, School of DentistryUniversity of California, Los Angeles (UCLA)CaliforniaLos AngelesUSA
| | - Ron D. Hays
- UCLA Department of MedicineDavid Geffen School of MedicineLos Angeles, USA
| | - Yan Wang
- Department of biostatisticsUCLACaliforniaLos AngelesUSA
| | - Marvin Marcus
- Public Health and Community Dentistry, School of DentistryUniversity of California, Los Angeles (UCLA)CaliforniaLos AngelesUSA
| | - Carl A. Maida
- Public Health and Community Dentistry, School of DentistryUniversity of California, Los Angeles (UCLA)CaliforniaLos AngelesUSA
| | - Di Xiong
- Department of biostatisticsUCLACaliforniaLos AngelesUSA
| | - Steve Y. Lee
- Public Health and Community Dentistry, School of DentistryUniversity of California, Los Angeles (UCLA)CaliforniaLos AngelesUSA
| | - Vladimir W. Spolsky
- Public Health and Community Dentistry, School of DentistryUniversity of California, Los Angeles (UCLA)CaliforniaLos AngelesUSA
| | - Ian D. Coulter
- Public Health and Community Dentistry, School of DentistryUniversity of California, Los Angeles (UCLA)CaliforniaLos AngelesUSA
| | - James J. Crall
- Public Health and Community Dentistry, School of DentistryUniversity of California, Los Angeles (UCLA)CaliforniaLos AngelesUSA
| | - Honghu Liu
- Public Health and Community Dentistry, School of DentistryUniversity of California, Los Angeles (UCLA)CaliforniaLos AngelesUSA
- UCLA Department of MedicineDavid Geffen School of MedicineLos Angeles, USA
- Department of biostatisticsUCLACaliforniaLos AngelesUSA
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94
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Wong JJ, Addala A, Abujaradeh H, Adams RN, Barley RC, Hanes SJ, Iturralde E, Lanning MS, Naranjo D, Tanenbaum ML, Hood KK. Depression in context: Important considerations for youth with type 1 vs type 2 diabetes. Pediatr Diabetes 2020; 21:135-142. [PMID: 31644828 DOI: 10.1111/pedi.12939] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 10/01/2019] [Accepted: 10/13/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Youth with diabetes are at increased risk for depression. However, severity and correlates of depressive symptoms may differ by diabetes type. OBJECTIVE Associations of depressive symptoms with global health, diabetes duration, and gender were compared between youth with type 1 and type 2 diabetes. METHODS A sample of 149 youth ages 12 to 21 diagnosed with either type 1 (n = 122) or type 2 (n = 27) diabetes were screened during routine clinic appointments. Regression models were constructed to examine differences by diabetes type. RESULTS Adolescents with type 2 diabetes had significantly higher depressive symptom scores (4.89 vs 2.99, P = .025) than those with type 1 diabetes. A significant interaction between global health and diabetes type on depressive symptoms revealed inverse associations between global health and depressive symptoms that was stronger among youth with type 2 diabetes (β = -.98, P < .001) than type 1 (β = -.48, P < .001). Further probing revealed that among youth with better global health, adolescents with type 1 had more depressive symptoms than those with type 2 diabetes (β = .33, P = .035). Diabetes duration and depressive symptoms were positively associated among individuals with type 2 (β = .86, P = .043), but not type 1 diabetes. No gender differences were detected. CONCLUSION These findings suggest that correlates of depressive symptoms in youth with diabetes differ by diabetes type. Global health appears to be an important correlate among youth with both types, whereas diabetes duration was only a significant factor among those with type 2 diabetes. The current findings can inform future psychosocial intervention efforts within both these populations.
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Affiliation(s)
- Jessie J Wong
- Department of Pediatrics, Stanford University, Palo Alto, California
| | - Ananta Addala
- Department of Pediatrics, Stanford University, Palo Alto, California
| | - Hiba Abujaradeh
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Rebecca N Adams
- Department of Pediatrics, Stanford University, Palo Alto, California
| | - Regan C Barley
- Department of Pediatrics, Stanford University, Palo Alto, California
| | - Sarah J Hanes
- Department of Pediatrics, Stanford University, Palo Alto, California
| | - Esti Iturralde
- Department of Pediatrics, Stanford University, Palo Alto, California
| | - Monica S Lanning
- Department of Pediatrics, Stanford University, Palo Alto, California
| | - Diana Naranjo
- Department of Pediatrics, Stanford University, Palo Alto, California
| | - Molly L Tanenbaum
- Department of Pediatrics, Stanford University, Palo Alto, California
| | - Korey K Hood
- Department of Pediatrics, Stanford University, Palo Alto, California
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95
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Verstraete J, Ramma L, Jelsma J. Item generation for a proxy health related quality of life measure in very young children. Health Qual Life Outcomes 2020; 18:11. [PMID: 31937311 PMCID: PMC6961344 DOI: 10.1186/s12955-020-1271-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 01/08/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AND AIMS Very young children have a relatively high prevalence of morbidity and mortality. Health care and supportive technology has improved but may require difficult choices and decisions regarding the allocation of these resources in this age group. Cost-effective analysis (CEA) can inform these decisions and thus measurement of Health-Related Quality of Life (HRQoL) is becoming increasingly important. However, the components of HRQoL are likely to be specific to infants and young children. This study aimed to develop a bank of items to inform the possible development of a new proxy report instrument. METHODS A review of the literature was done to define the concepts, generate items and identify measures that might be an appropriate starting point of reference. The items generated from the cognitive interviews and systematic review were subsequently pruned by experts in the field of HRQoL and paediatrics over two rounds of a Delphi study. RESULTS Based on the input from the different sources, the greatest need for a new HRQoL measure was in the 0-3-year age group. The item pool identified from the literature consisted of 36 items which was increased to 53 items after the cognitive interviews. The ranking of items from the first round of the Delphi study pruned this pool to 28 items for consideration. The experts further reduced this pool to 15 items for consideration in the second round. The experts also recommended that items could be merged due to their similar nature or construct. This process allowed for further reduction of items to 11 items which showed content validity and no redundancy. CONCLUSION The need for an instrument to measure appropriate aspects of HRQoL in infants and young children became apparent as items included in existing measures did not cover the required spectrum. The identification of the final items was based on a sound conceptual model, acceptability to stakeholders and consideration of the observability of the item selected. The pruned item bank of 11 items needs to be subject to further testing with the target population to ensure validity and reliability before a new measure can be developed.
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Affiliation(s)
- Janine Verstraete
- Faculty of Health and Rehabilitation Sciences, Division of Physiotherapy, Cape Town, South Africa.
| | - Lebogang Ramma
- Faculty of Health and Rehabilitation Sciences, Division of Communication Sciences and Disorders, Cape Town, South Africa
| | - Jennifer Jelsma
- Faculty of Health and Rehabilitation Sciences, Division of Physiotherapy, Cape Town, South Africa
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Prahalad P, Zaharieva DP, Addala A, New C, Scheinker D, Desai M, Hood KK, Maahs DM. Improving Clinical Outcomes in Newly Diagnosed Pediatric Type 1 Diabetes: Teamwork, Targets, Technology, and Tight Control-The 4T Study. Front Endocrinol (Lausanne) 2020; 11:360. [PMID: 32733375 PMCID: PMC7363838 DOI: 10.3389/fendo.2020.00360] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 05/07/2020] [Indexed: 12/12/2022] Open
Abstract
Many youth with type 1 diabetes (T1D) do not achieve hemoglobin A1c (HbA1c) targets. The mean HbA1c of youth in the USA is higher than much of the developed world. Mean HbA1c in other nations has been successfully modified following benchmarking and quality improvement methods. In this review, we describe the novel 4T approach-teamwork, targets, technology, and tight control-to diabetes management in youth with new-onset T1D. In this program, the diabetes care team (physicians, nurse practitioners, certified diabetes educators, dieticians, social workers, psychologists, and exercise physiologists) work closely to deliver diabetes education from diagnosis. Part of the education curriculum involves early integration of technology, specifically continuous glucose monitoring (CGM), and developing a curriculum around using the CGM to maintain tight control and optimize quality of life.
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Affiliation(s)
- Priya Prahalad
- Division of Endocrinology, Department of Pediatrics, Stanford University, Stanford, CA, United States
- *Correspondence: Priya Prahalad
| | - Dessi P. Zaharieva
- Division of Endocrinology, Department of Pediatrics, Stanford University, Stanford, CA, United States
| | - Ananta Addala
- Division of Endocrinology, Department of Pediatrics, Stanford University, Stanford, CA, United States
| | - Christin New
- Division of Endocrinology, Department of Pediatrics, Stanford University, Stanford, CA, United States
| | - David Scheinker
- Division of Endocrinology, Department of Pediatrics, Stanford University, Stanford, CA, United States
- Department of Management Science and Engineering, Stanford University, Stanford, CA, United States
| | - Manisha Desai
- Quantitative Sciences Unit, Division of Biomedical Informatics Research, Stanford University, Stanford, CA, United States
- Stanford Diabetes Research Center, Stanford, CA, United States
| | - Korey K. Hood
- Division of Endocrinology, Department of Pediatrics, Stanford University, Stanford, CA, United States
- Stanford Diabetes Research Center, Stanford, CA, United States
| | - David M. Maahs
- Division of Endocrinology, Department of Pediatrics, Stanford University, Stanford, CA, United States
- Stanford Diabetes Research Center, Stanford, CA, United States
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97
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Gmuca S, Xiao R, Urquhart A, Weiss PF, Gillham JE, Ginsburg KR, Sherry DD, Gerber JS. The Role of Patient and Parental Resilience in Adolescents with Chronic Musculoskeletal Pain. J Pediatr 2019; 210:118-126.e2. [PMID: 30981421 DOI: 10.1016/j.jpeds.2019.03.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 03/07/2019] [Accepted: 03/08/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To assess the level of resilience among patients with chronic musculoskeletal pain and their parents and to determine factors associated with patient and parental resilience. STUDY DESIGN Cross-sectional cohort study of children aged 13-17 years diagnosed with chronic musculoskeletal pain and their parents. Patient-parent pairs were seen for initial consultation in the pediatric rheumatology pain clinic at Children's Hospital of Philadelphia between March and May 2018 and were administered a series of questionnaires including measures of resilience (Connor-Davidson Resilience Scale 10 item, The 14-item Resilience Scale, and the 7Cs of Resilience Tool). We calculated Pearson correlation coefficients to examine the relationship between the variables of interest and resilience. RESULTS According to all resilience measures, patients and parents had low to moderate levels of resilience. These levels were lower than those previously reported among healthy populations, as well as those with chronic medical conditions. According to the Connor-Davidson Resilience Scale 10 item, patient-level resilience was negatively correlated with pain level (r = -0.48), physical disability (r = -0.54), and symptom severity (r = -0.53). The level of resilience among patients was positively correlated with energy level (r = 0.57) and health-related quality of life (r = 0.64). Parental resilience was positively correlated with parental mental health (r = 0.61). CONCLUSIONS Higher patient resilience was correlated with reduced disease severity among adolescents with chronic musculoskeletal pain. Future research should explore whether fostering resilience in adolescents with chronic musculoskeletal pain via the application of resilience-training interventions mitigates disease burden in this vulnerable patient population.
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Affiliation(s)
- Sabrina Gmuca
- Department of Pediatrics, Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, PA; University of Pennsylvania Perelman School of Medicine and Children's Hospital of Philadelphia, Philadelphia, PA; Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA; PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA.
| | - Rui Xiao
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA
| | - Audrey Urquhart
- Department of Pediatrics, Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, PA; Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA; PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Pamela F Weiss
- Department of Pediatrics, Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, PA; University of Pennsylvania Perelman School of Medicine and Children's Hospital of Philadelphia, Philadelphia, PA; Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Jane E Gillham
- Department of Psychology, Swarthmore College, Swarthmore, PA
| | - Kenneth R Ginsburg
- University of Pennsylvania Perelman School of Medicine and Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - David D Sherry
- Department of Pediatrics, Division of Rheumatology, Children's Hospital of Philadelphia, Philadelphia, PA; University of Pennsylvania Perelman School of Medicine and Children's Hospital of Philadelphia, Philadelphia, PA
| | - Jeffrey S Gerber
- University of Pennsylvania Perelman School of Medicine and Children's Hospital of Philadelphia, Philadelphia, PA; Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Division of Infectious Disease, Children's Hospital of Philadelphia, Philadelphia, PA
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98
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Blackwell CK, Elliott AJ, Ganiban J, Herbstman J, Hunt K, Forrest CB, Camargo CA. General Health and Life Satisfaction in Children With Chronic Illness. Pediatrics 2019; 143:peds.2018-2988. [PMID: 31061222 PMCID: PMC6564050 DOI: 10.1542/peds.2018-2988] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/20/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To investigate children's general health and life satisfaction in the context of chronic illness. METHODS Caregivers (n = 1113) from 3 concurrent cohort studies completed the Patient-Reported Outcomes Measurement Information System Parent-Proxy Global Health measure, which is used to assess a child's overall physical, mental, and social health, as well as the Patient-Reported Outcomes Measurement Information System Parent-Proxy Life Satisfaction measure between March 2017 and December 2017 for 1253 children aged 5 to 9 years. We harmonized demographic factors and family environmental stressors (single parent, maternal mental health, and income) to common metrics across the cohorts. To examine associations between chronic illness and children's general health and life satisfaction, we fit linear regression models with cohort fixed effects and accounted for the multilevel data structure of multiple children nested within the same family (ie, twins and other siblings) with generalized estimating equations. RESULTS Children with chronic illness had worse general health than those without illness (adjusted β = -1.20; 95% confidence interval: -2.49 to 0.09). By contrast, children with chronic illness had similar levels of life satisfaction (adjusted β = -.19; 95% confidence interval: -1.25 to 0.87). Additionally, children's psychological stress had the strongest negative association with both outcomes, even after adjusting for demographics and family environmental stressors. CONCLUSIONS Although children with chronic illness have lower parent-reported general health, their life satisfaction appears comparable with that of peers without chronic illness. With this study, we provide evidence that chronic illnesses do not preclude children from leading happy and satisfying lives.
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Affiliation(s)
- Courtney K. Blackwell
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Amy J. Elliott
- Avera McKennan Hospital and University Medical Center, Sioux Falls, South Dakota
| | - Jody Ganiban
- Department of Psychology, Columbian College of Arts and Sciences, The George Washington University, Washington, District of Columbia
| | - Julie Herbstman
- Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Kelly Hunt
- Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, South Carolina
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99
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Schilling S, Jamison S, Wood C, Perrin E, Austin CJ, Sheridan J, Young A, Burchinal M, Flower KB. Health Status of Children Enrolled in a Family Navigator Program to Eliminate Intergenerational Poverty. Clin Pediatr (Phila) 2019; 58:647-655. [PMID: 30789004 DOI: 10.1177/0009922819832026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In 2014, Family Success Alliance (FSA) was formed as a place-based initiative to build a pipeline of programs to reduce the impact of poverty on outcomes for children living in Orange County, North Carolina. In this study, FSA parents' perception of child health, parent and child adverse childhood experiences (ACEs), and resilience were obtained by parent interview. Receipt of recommended health services were abstracted from primary care medical records of FSA children. Correlation coefficients investigated relationships among health, ACEs, and resilience. Among 87 parent-child dyads, 65% were Spanish speaking. At least 1 of the 7 ACEs measured was reported in 37% of children and 70% of parents. Parent perceptions of child health were lower than national averages. Routine preventive services included the following: autism screening at 18 months (15%) and 24 months (31%); ≥4 fluoride varnish applications (10%); lead screening (66%); and receipt of immunizations (94%). Parent perception of child health was moderately correlated with resilience.
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Affiliation(s)
| | | | | | | | | | | | - Allison Young
- 3 Orange County Health Department, Hillsborough, NC, USA
| | | | - Kori B Flower
- 1 University of North Carolina, Chapel Hill, NC, USA
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100
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Victorson D, Schalet BD, Kundu S, Helfand BT, Novakovic K, Penedo F, Cella D. Establishing a common metric for self-reported anxiety in patients with prostate cancer: Linking the Memorial Anxiety Scale for Prostate Cancer with PROMIS Anxiety. Cancer 2019; 125:3249-3258. [PMID: 31090933 DOI: 10.1002/cncr.32189] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/14/2019] [Accepted: 04/02/2019] [Indexed: 01/11/2023]
Abstract
BACKGROUND Anxiety is a common patient concern and clinical endpoint in prostate cancer outcomes research. It is measured using different self-report instruments that are not directly comparable, thereby making clinical trials, clinical performance measurement, and comparative effectiveness research challenging when anxiety is the outcome of interest. The objective of the current study was to enable a common reporting metric of anxiety so that scores on commonly used anxiety measures could be converted into Patient-Reported Outcomes Measurement Information System (PROMIS) scores for ease of application, interpretation, and comparability. METHODS Using an internet health panel, a total of 806 men with clinically localized prostate cancer completed items from the National Institutes of Health PROMIS Anxiety Short Form (version 7a) and the 18-item Memorial Anxiety Scale for Prostate Cancer (MAX-PC). A common metric was created using analyses based on item response theory, producing score crosswalk tables. The linking relationships were evaluated by resampling small subsets and estimating confidence intervals for the differences between the observed and linked PROMIS scores. RESULTS Results of factor analysis and item response theory model fit supported the hypothesis that both scales measure essentially the same concept. Therefore, crosswalk tables appear to be justified and increasingly robust with increasing sample sizes. CONCLUSIONS MAX-PC Anxiety results can be expressed on the PROMIS Anxiety metric for the purposes of clinical performance measurement, clinical trial outcomes, comparative effectiveness research, and other efforts to compare anxiety results across studies that use any one of these measures.
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Affiliation(s)
- David Victorson
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Benjamin D Schalet
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Shilajit Kundu
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Brian T Helfand
- Division of Urology, NorthShore University Health System, Evanston, Illinois
| | - Kristian Novakovic
- Division of Urology, NorthShore University Health System, Evanston, Illinois
| | - Frank Penedo
- Department of Psychology, University of Miami, Miami, Florida.,Department of Medicine, University of Miami, Miami, Florida
| | - David Cella
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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