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Kalle JPR, Saris TFF, Sierevelt IN, Eygendaal D, van Bergen CJA. Quality of patient- and proxy-reported outcomes for children with impairment of the upper extremity: a systematic review using the COSMIN methodology. J Patient Rep Outcomes 2022; 6:58. [PMID: 35652989 PMCID: PMC9163282 DOI: 10.1186/s41687-022-00469-4] [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: 02/25/2022] [Accepted: 05/19/2022] [Indexed: 11/28/2022] Open
Abstract
Background As patient-reported outcome measures (PROMs) have become of significant importance in patient evaluation, adequately selecting the appropriate instrument is an integral part of pediatric orthopedic research and clinical practice. This systematic review provides a comprehensive overview of PROMs targeted at children with impairment of the upper limb, and critically appraises and summarizes the quality of their measurement properties by applying the COnsensus-based Standards for selection of health Measurement INstruments (COSMIN) methodology. Methods A systematic search of the MEDLINE and EMBASE databases was performed to identify relevant publications reporting on the development and/or validation of PROMs used for evaluating children with impairment of the upper extremity. Data extraction and quality assessment (including a risk of bias evaluation) of the included studies was undertaken by two reviewers independently and in accordance with COSMIN guidelines. Results Out of 6423 screened publications, 32 original articles were eligible for inclusion in this review, reporting evidence on the measurement properties of 22 self- and/or proxy-reported questionnaires (including seven cultural adaptations) for various pediatric orthopedic conditions, including cerebral palsy (CP) and obstetric brachial plexus palsy (OBPP). The measurement property most frequently evaluated was construct validity. No studies evaluating content validity and only four PROM development studies were included. The methodological quality of these development studies was either ‘doubtful’ or ‘inadequate’. The quantity and quality of the evidence on the other measurement properties of the included questionnaires varied substantially with insufficient sample sizes and/or poor methodological quality resulting in significant downgrading of evidence quality. Conclusion This review provides a comprehensive overview of currently available PROMs for evaluation of the pediatric upper limb. Based on our findings, none of the PROMs demonstrated sufficient evidence on their measurement properties to justify recommending the use of these instruments. These findings provide room for validation studies on existing pediatric orthopedic upper limb PROMs (especially on content validity), and/or the development of new instruments. Supplementary Information The online version contains supplementary material available at 10.1186/s41687-022-00469-4.
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Affiliation(s)
- J P Ruben Kalle
- Utrecht University, Heidelberglaan 8, 3584CS, Utrecht, The Netherlands.
| | - Tim F F Saris
- Amphia Hospital, Molengracht 21, 4818CK, Breda, The Netherlands
| | - Inger N Sierevelt
- Stichting SCORE, Laarderhoogtweg 12, 1101AE, Amsterdam, The Netherlands
| | - Denise Eygendaal
- Erasmus MC, Dr. Molewaterplein 40, 3015GD, Rotterdam, The Netherlands
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Vuillermin C, Eisenberg K, Williams D, Tartarilla AB, Bauer A, Waters PM. Comparison of 2 Patient-Reported Outcome Measures in Brachial Plexus Birth Injury: A Systematic Validation Study. J Bone Joint Surg Am 2022; 104:709-715. [PMID: 35192572 DOI: 10.2106/jbjs.20.02197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Patient-reported outcome (PRO) measures are integral to clinical practice. While new instruments bring updated methodology and delivery methods, they must be compared with existing measures to ensure that they are comparable with currently used instruments and allow ongoing comparison. In this study, we evaluated 2 PRO measures for patients with brachial plexus birth injury (BPBI): the legacy Pediatric Outcomes Data Collection Instrument (PODCI) and the newer Patient-Reported Outcomes Measurement Information System (PROMIS). We hypothesized that the PROMIS and PODCI would be correlated, with high convergent validity, and that PROMIS assessment would have higher discriminant validity and take less time to complete than the PODCI. METHODS A cross-sectional prospective study was undertaken at a tertiary referral center. Subjects (n = 50) completed the PODCI and PROMIS, both as short form (SF) and computer-adaptive testing (CAT) measures, in randomized order. Patient and parent questionnaires were completed according to subject age. Physicians completed upper-extremity (UE) physical function tests. Correlations between PODCI and PROMIS scores were analyzed to determine convergent validity, UE subscores were analyzed relative to physical function scores to assess discriminant validity, and completion times were calculated to determine survey time to completion. RESULTS High convergent validity was found between the parent-reported PODCI, PROMIS SF, and PROMIS CAT measures. A ceiling effect was found for the PODCI but not for the PROMIS. The PROMIS CAT had better discriminant validity than either the PROMIS SF or PODCI. Patient and parent outcome scores did not highly correlate. Survey time to completion varied by PRO measure and method of delivery. CONCLUSIONS There was high convergent validity between the UE domains of the PROMIS and PODCI, with a lower time to completion for the PROMIS SF. Although results show that the PROMIS CAT may take longer to complete, there are notable benefits to its adoption, including high convergent validity with the PODCI and better discriminant validity than the PODCI and PROMIS SF measures.
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Affiliation(s)
- Carley Vuillermin
- Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts
| | | | - David Williams
- Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts
| | - Ashley B Tartarilla
- Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts
| | - Andrea Bauer
- Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts
| | - Peter M Waters
- Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts
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Dorich JM, Cornwall R. Evaluation of a Grip-Strengthening Algorithm for the Initial Treatment of Chronic, Nonspecific Wrist Pain in Adolescents. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2022; 4:8-13. [PMID: 35415596 PMCID: PMC8991628 DOI: 10.1016/j.jhsg.2021.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 09/22/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose Chronic, nonspecific wrist pain in adolescents can be challenging to assess and treat. We hypothesized that an algorithmic approach beginning with grip strengthening can alleviate pain, improve function, and identify patients in need of further intervention. Methods We retrospectively reviewed the results of a grip-strengthening protocol for adolescents with chronic, nonspecific wrist pain. Before and after treatment, grip strength was measured using handheld dynamometry, and patient-reported pain and function were measured using the adolescent self-reported Pediatric Outcomes Data Collection Instrument’s (PODCI’s) Pain/Comfort and Upper Extremity Function domains (PODCI/pain and PODCI/UE, respectively). Results Thirty-two patients (28 female, 4 male) were included, with a mean age of 14 years (range, 10–18 years) and the dominant hand affected in 19, nondominant hand in 9, and bilateral impacts in 4. The mean symptom duration prior to presentation was 9 months (range, 1–63 months); 17 patients had undergone prior immobilization and 5 prior occupational/physical therapy. Grip-strengthening treatment, lasting a mean of 40 days (range, 21–82 days) with a median of 4 therapy visits (range, 2–6), was associated with significantly improved grip strength (mean, 32–48 lbs), PODCI/pain scores (mean, 49.0–78.2 points), and PODCI/UE scores (mean, 78.2–91.2 points). Improvements in grip strength correlated with improvements in PODCI/pain and PODCI/UE scores (r = 0.64 and 0.70, respectively). Eight patients (25%) had either no or incomplete pain relief: 5 underwent successful further intervention (2 ganglion cyst excisions, 1 triangular fibrocartilage complex repair, 1 arthroscopic debridement, 1 steroid injection), 2 received ongoing pain management for generalized pain syndromes, and 1 was lost to further follow-up. No pretreatment variables were identified that predicted failure. Conclusions Grip strengthening relieves pain and improves function in the majority of adolescents with chronic, nonspecific wrist pain. Systematic use of this protocol helps to identify patients who require further intervention. Type of study/level of evidence Therapeutic IV.
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Affiliation(s)
- Jenny M. Dorich
- Division of Occupational and Physical Therapy, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Roger Cornwall
- Division of Pediatric Orthopaedic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
- Department of Orthopaedic Surgery, University of Cincinnati College of Medicine, Cincinnati, OH
- Corresponding author: Roger Cornwall, MD, Division of Orthopaedic Surgery, Cincinnati Children’s Hospital, 3333 Burnet Avenue, Cincinnati, OH 45229.
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Dorich JM, Cornwall R. A psychometric comparison of patient-reported outcome measures used in pediatric hand therapy. J Hand Ther 2021; 33:477-483. [PMID: 31477330 DOI: 10.1016/j.jht.2019.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/26/2019] [Accepted: 05/06/2019] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Retrospective case series. INTRODUCTION Patient-reported outcome measures are important for research and also for informing clinical practice. The Pediatric Outcomes Data Collection Instrument (PODCI) and the Canadian Occupational Performance Measure (COPM) are commonly used in pediatric hand therapy. Both are validated in research, but no data exist regarding their relative merits for clinical practice. PURPOSE OF THE STUDY This study compares the psychometric properties of the PODCI and COPM in children receiving hand therapy to examine their relative utility in clinical practice. METHODS We assessed the psychometric properties of the PODCI and COPM in 75 children receiving hand therapy. Treatment outcomes were assessed simultaneously with the PODCI (Upper Extremity Function and Pain and Comfort scales), COPM (Performance and Satisfaction scales) at baseline and posttreatment time points. Interim scores were included for a subset of patients. Each scale was assessed for responsiveness, ceiling effect, and concurrent and discriminate validity. RESULTS All scales, except PODCI/Pain from interim to completion, were able to detect changes over the course of therapy. However, both COPM scales demonstrated greater responsiveness and less severe ceiling effects than both PODCI scales at all time points. All scales had weak concurrent validity and limited discriminate validity. CONCLUSIONS The COPM is more responsive to changes during treatment and less hindered by a ceiling effect than the PODCI. Weak concurrent validity between the PODCI and COPM suggests that they measure different things in this population.
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Affiliation(s)
- Jenny M Dorich
- Division of Occupational Therapy and Physical Therapy, Cincinnati Children's Hospital Medical Center, University of Cincinnati, College of Health Sciences, Cincinnati, OH, USA.
| | - Roger Cornwall
- Division of Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati, College of Medicine, Cincinnati, OH, USA
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Marson BA, Craxford S, Deshmukh SR, Grindlay DJC, Manning JC, Ollivere BJ. Quality of patient-reported outcomes used for quality of life, physical function, and functional capacity in trials of childhood fractures. Bone Joint J 2020; 102-B:1599-1607. [PMID: 33249895 DOI: 10.1302/0301-620x.102b12.bjj-2020-0732.r2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS This study evaluates the quality of patient-reported outcome measures (PROMs) reported in childhood fracture trials and recommends outcome measures to assess and report physical function, functional capacity, and quality of life using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) standards. METHODS A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-compliant systematic review of OVID Medline, Embase, and Cochrane CENTRAL was performed to identify all PROMs reported in trials. A search of OVID Medline, Embase, and PsycINFO was performed to identify all PROMs with validation studies in childhood fractures. Development studies were identified through hand-searching. Data extraction was undertaken by two reviewers. Study quality and risk of bias was evaluated by COSMIN guidelines and recorded on standardized checklists. RESULTS Searches yielded 13,672 studies, which were screened to identify 124 trials and two validation studies. Review of the 124 trials identified 16 reported PROMs, of which two had validation studies. The development papers were retrieved for all PROMs. The quality of the original development studies was adequate for Patient-Reported Outcomes Measurement Information System (PROMIS) Mobility and Upper Extremity and doubtful for the EuroQol Five Dimension Youth questionnaire (EQ-5D-Y). All other PROMs were found to have inadequate development studies. No content validity studies were identified. Reviewer-rated content validity was acceptable for six PROMs: Activity Scale for Kids (ASK), Childhood Health Assessment Questionnaire, PROMIS Upper Extremity, PROMIS Mobility, EQ-5D-Y, and Pediatric Quality of Life Inventory (PedsQL4.0). The Modified Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire was shown to have indeterminate reliability and convergence validity in one study and PROMIS Upper Extremity had insufficient convergence validity in one study. CONCLUSION There is insufficient evidence to recommend strongly the use of any single PROM to assess and report physical function or quality of life following childhood fractures. There is a need to conduct validation studies for PROMs. In the absence of these studies, we cautiously recommend the use of the PROMIS or ASK-P for physical function and the PedsQL4.0 or EQ-5D-Y for quality of life. Cite this article: Bone Joint J 2020;102-B(12):1599-1607.
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Affiliation(s)
- Ben A Marson
- Trauma Outcomes Group, University of Nottingham, Queens' Medical Centre, Nottingham, UK
| | - Simon Craxford
- Trauma Outcomes Group, University of Nottingham, Queens' Medical Centre, Nottingham, UK
| | - Sandeep R Deshmukh
- Trauma Outcomes Group, University of Nottingham, Queens' Medical Centre, Nottingham, UK
| | - Douglas J C Grindlay
- Trauma Outcomes Group, University of Nottingham, Queens' Medical Centre, Nottingham, UK
| | - Joseph C Manning
- School of Health Sciences, University of Nottingham, Nottingham Children's Hospital, Nottingham, UK
| | - Benjamin J Ollivere
- Trauma Outcomes Group, University of Nottingham, Queens' Medical Centre, Nottingham, UK
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Cheng L, Kang Q, Wang Y, Hinds PS. Determining the Effectiveness of Using Patient-Reported Outcomes in Pediatric Clinical Practices. J Pediatr Nurs 2020; 55:100-109. [PMID: 32745906 DOI: 10.1016/j.pedn.2020.07.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/14/2020] [Accepted: 07/14/2020] [Indexed: 11/18/2022]
Abstract
PROBLEM Patient-reported outcomes (PROs) are increasingly recognized in pediatric clinical care as adding essential information relevant to actual care. However, the effectiveness of using PROs in pediatric clinical settings has not been fully explored with synthesized evidence. The aim of this study was to evaluate the effectiveness of using patient-reported outcomes in pediatric clinical practices. ELIGIBILITY CRITERIA We searched four English and three Chinese databases to identify studies that examine the effectiveness of using PROs in pediatric clinical practices published from the inception date of each database to January 2020. SAMPLE Ten articles met the inclusion criteria. RESULTS There was wide a variation in the ten studies' designs, samples, PROs administered (type, length, timing, mode), and type of outcomes evaluated. The effect sizes of using PROs on three categories of outcomes (patient, process of care and health service) were assessed. Of 70 measured outcomes, 32 were positive, 5 were negative, and 33 were mixed. CONCLUSIONS Overall, there is a weak but trending positive impact of using PROs in pediatric clinical practice. IMPLICATIONS More rigorous study designs with sources of bias controlled are needed to more directly assess the impact of using PROs in pediatric care. If findings continue to be positive, then an implementation model addressing the numerous influencing factors is recommended to integrate PROs into pediatric care.
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Affiliation(s)
- Lei Cheng
- School of Nursing, Fudan University, China.
| | - Qiongfang Kang
- Pediatric Surgical Oncology Unit, Children's Hospital of Fudan University, China
| | - Yanqing Wang
- Pediatric Hematology&Oncology Unit, Children's Hospital of Zhejiang University School of Medicine, China
| | - Pamela S Hinds
- Children's National Hospital; Professor, The George Washington University, DC, USA.
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Shotwell C, Moore ES. Assessing reliability and validity of a functional outcome measure for adolescents with hypermobility spectrum disorder. Disabil Rehabil 2020; 44:1123-1128. [PMID: 32649221 DOI: 10.1080/09638288.2020.1788177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To determine the reliability and validity of the upper extremity function and pain scales of the Pediatric Outcomes Data Collecton Instrument (PODCI UEF and PODCI P) as an outcome measure in adolescents with Hypermobility Spectrum Disorder (HSDs). MATERIALS AND METHODS An observational study using a cross-section design was conducted. A convenience sample of 83 adolescents (age 11-18 years) with HSDs were recruited. Test-retest reliability of the PODCI UEF and PODCI P was examined using Lin's concordance correlation coefficient (ρc). Concurrent validity was established by comparing the PODCI UEF to the PROMIS Pediatric Upper Extremity-Short Form (PROMIS PUE-SF) and comparing the PODCI P to Numeric Rating Scale (NRS) using Spearman rho correlations. RESULTS There was high test-retest reliability for the PODCI UEF, ρc = 0.81 (p < 0.001) and moderate test-retest reliability for the PODCI P, ρc = 0.68 (p < 0.001). There was a strong correlation between the PODCI UEF and the PROMIS PUE-SF, rs = 0.80 (p < 0.001) and a moderate inverse relationship rs = -0.73 (p < 0.001) between PODCI P and NRS scores (n = 150). CONCLUSION The PODCI UEF and PODCI P may be a valid and reliable outcome measure in adolescents with HSDs.Implications for rehabilitationAdolescents with joint hypermobility can have chronic pain, fatigue, and decreased participation in daily activities.Clinical use of valid and reliable outcome measures to measure change may assist in planning care and identifying best practice for the management of HSDs.The PODCI was designed to be used as an outcome measure for chronic musculoskeletal conditions and has demonstrated test-retest reliability, validity, and responsiveness to change in other pediatric populations.The PODCI may be a valid and reliable outcome measure in adolescents with HSDs.
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Affiliation(s)
| | - Elizabeth S Moore
- College of Health Science and School of Nursing, University of Indianapolis, Indianapolis, IN, USA
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Kubiak R, Aksakal D, Weiss C, Wessel LM, Lange B. Is there a standard treatment for displaced pediatric diametaphyseal forearm fractures?: A STROBE-compliant retrospective study. Medicine (Baltimore) 2019; 98:e16353. [PMID: 31305426 PMCID: PMC6641800 DOI: 10.1097/md.0000000000016353] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To review our institutional results and assess different surgical and non-surgical techniques for the treatment of displaced diametaphyseal forearm fractures in children and adolescents.Thirty-four children (25M, 9F) with a total of 36 diametaphyseal forearm fractures who underwent treatment under general anesthesia between July 2010 and February 2016 were recruited to this retrospective study. From October 2016 until March 2018 patients and/or parents were contacted by telephone and interviewed using a modified Pediatric Outcomes Data Collection Instrument (PODCI).Median age at the time of injury was 9.1 years (range, 1.9-14.6 years). Initial treatment included manipulation under anesthesia (MUA) and application of plaster of Paris (POP) (n = 9), elastic stable intramedullary nailing (ESIN) (n = 10), percutaneous insertion of at least one Kirschner wire (K-wire) (n = 16), and application of external fixation (n = 1). Eleven children (32%) experienced a total of 22 complications. Seven complications were considered as major, including delayed union (n = 1) and extensor pollicis longus (EPL) tendon injury (n = 1) following ESIN, as well as loss of reduction (n = 2) and refractures (n = 3) after MUA/POP. The median follow-up time was 28.8 months (range, 5.3-85.8 months). In 32 out of 34 cases (94%) patients and/or parents were contacted by telephone and a PODCI score was obtained. Patients who experienced complications in the course of treatment had a significantly lower score compared with those whose fracture healed without any sequelae (P = .001). There was a trend towards an unfavorable outcome following ESIN compared with K-wire fixation (P = .063), but not compared with POP (P = .553). No statistical significance was observed between children who were treated initially with a POP and those who had K-wire fixation (P = .216).There is no standard treatment for displaced pediatric diametaphyseal forearm fractures. Management with MUA/POP only is associated with an increased refracture rate. Based on our experience K-wire fixation including intramedullar positioning of at least one pin seems to be favorable compared with ESIN.
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Affiliation(s)
- Rainer Kubiak
- Department of Pediatric Surgery, Medical Faculty Mannheim (UMM), Heidelberg University
| | - Devrim Aksakal
- Department of Pediatric Surgery, Medical Faculty Mannheim (UMM), Heidelberg University
| | - Christel Weiss
- Department of Medical Statistics and Biomathematics, Mannheim, Germany
| | - Lucas M. Wessel
- Department of Pediatric Surgery, Medical Faculty Mannheim (UMM), Heidelberg University
| | - Bettina Lange
- Department of Pediatric Surgery, Medical Faculty Mannheim (UMM), Heidelberg University
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Merder-Coskun D, Kenis-Coskun O, Celenlioğlu AE, Akman M, Karadag-Saygi E, Uzuner A. Reliability of cross-cultural adapted Turkish version of the Pediatric Outcomes Data Collection Instrument (PODCI). J Pediatr Rehabil Med 2016; 9:101-105. [PMID: 27285802 DOI: 10.3233/prm-160370] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The Pediatric Outcomes Data Collection Instrument (PODCI) has been created to evaluate functional status, to assess therapeutic needs and changes after treatment in 2 to 18 years old children and adolescents who have orthopedic problems. The PODCI has three forms; parent form for children, parent and self report forms for adolescents. Instrument has 86 items assessing `upper extremity and physical function', `transfer and basic mobility', `sports and physical function', `pain/comfort', `happiness', `global functioning' and `expectations from treatment domains'. The PODCI has been validated in multiple languages. The aim of this study was to investigate the reliability of the cross-cultural adapted Turkish version of the PODCI parent forms for children and adolescents in a variety of chronic musculoskeletal disorders. METHOD This was a methodological study. The instrument was translated and cross-culturally adapted into Turkish. Turkish version was called Bedensel İşlevsellik Değerlendirme Aracı (BIDA). It was completed by the parents/caregivers of ninety-eight children and adolescents being treated at Marmara University Medical School Department of Physical Medicine and Rehabilitation outpatient clinics at the baseline and 2-4 weeks after between April 2013-October 2013. Internal consistency and test-retest reliability (ICC) were determined. RESULTS Internal consistency of the subscales and test/retest cronbach alpha values were 0.90-0.91 (r= 0.71, p= 0.000) for ``upper extremity and physical function''; 0.95-0.95 (r= 0.84, p= 0.000) for ``transfer and basic mobility''; 0.93-0.91 (r= 0.78, p= 0.000) for ``sports and physical functioning''; 0.77-0.82 (r= 0.45, p= 0.000) for ``happiness'' and 0.96-0.96 (r= 0.82, p= 0.000) for ``global functioning''. Pain/comfort subscale showed low internal consistency (-0.38-0.49; r= 0.34, p= 0.004). CONCLUSION The Turkish version of the PODCI was found to be a reliable instrument to evaluate functionality of children and adolescents with chronic musculoskeletal disorders.
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Affiliation(s)
- Demet Merder-Coskun
- Department of Family Medicine, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Ozge Kenis-Coskun
- Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Alp Eren Celenlioğlu
- Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Akman
- Department of Family Medicine, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Evrim Karadag-Saygi
- Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine, Istanbul, Turkey
| | - Arzu Uzuner
- Department of Family Medicine, Marmara University Faculty of Medicine, Istanbul, Turkey
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Wall LB, Shen T, Roberts S, Goldfarb CA. Parental Assessment of Status of Congenital Upper Limb Differences: Analysis of the Pediatric Outcomes Data Collection Instrument. J Hand Surg Am 2016; 41:381-6.e1. [PMID: 26787405 PMCID: PMC4769941 DOI: 10.1016/j.jhsa.2015.12.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 11/30/2015] [Accepted: 12/03/2015] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine the range of the Pediatric Outcomes Collection Instrument (PODCI) scores for children with a wide variety of congenital upper limb differences and to examine the scoring effect of the patient's surgical history, family history, severity of involvement, and syndromic associations. METHODS We reviewed the PODCI scores for 109 patients, aged 2-18 years, treated for nontraumatic upper extremity conditions. Charts were reviewed for sex, age, extent of limb involvement, laterality, family history, surgical history, and syndrome association. All patients were classified based on the Oberg, Manske, Tonkin classification with general categories of malformation, deformation, or dysplasia. RESULTS Of 109 patients, 80 (73%) had a malformation, 12 (11%) had a deformation, and 17 (16%) had a dysplasia. The cohort as a whole had a happiness PODCI score that was similar to the normal population, yet a lower (worse) PODCI score for upper extremity and global function. Patients with a dysplasia had a higher upper extremity function scores than those with malformations or deformations, but they had similar happiness and global function scores. Complete upper limb involvement and lower extremity involvement statistically lowered the PODCI score within our study cohort, whereas a positive family history and syndromic association increased PODCI scores. CONCLUSIONS This study showed that there was a similar level of perceived happiness between children/adolescents with congenital upper extremity conditions compared with the normal pediatric population based on PODCI scores. In contrast, the perceived upper extremity and global function was significantly decreased in patients with congenital differences compared with normal individuals. This investigation also revealed that the extent of upper extremity involvement, lower extremity involvement, family history, and syndromic association may affect PODCI scores as independent variables and should be taken into consideration in studies of upper extremity congenital anomalies. TYPE OF STUDY/LEVEL OF EVIDENCE Prognostic IV.
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11
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Mulcahey M, Slavin MD, Ni P, Vogel LC, Kozin SH, Haley SM, Jette AM. Computerized Adaptive Tests Detect Change Following Orthopaedic Surgery in Youth with Cerebral Palsy. J Bone Joint Surg Am 2015; 97:1482-94. [PMID: 26378264 PMCID: PMC6948780 DOI: 10.2106/jbjs.o.00179] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The Cerebral Palsy Computerized Adaptive Test (CP-CAT) is a parent-reported outcomes instrument for measuring lower and upper-extremity function, activity, and global health across impairment levels and a broad age range of children with cerebral palsy (CP). This study was performed to examine whether the Lower Extremity/Mobility (LE) CP-CAT detects change in mobility following orthopaedic surgery in children with CP. METHODS This multicenter, longitudinal study involved administration of the LE CP-CAT, the Pediatric Outcomes Data Collection Instrument (PODCI) Transfer/Mobility and Sports/Physical Functioning domains, and the Timed "Up & Go" test (TUG) before and after elective orthopaedic surgery in a convenience sample of 255 children, four to twenty years of age, who had CP and a Gross Motor Function Classification System (GMFCS) level of I, II, or III. Standardized response means (SRMs) and 95% confidence intervals (CIs) were calculated for all measures at six, twelve, and twenty-four months following surgery. RESULTS SRM estimates for the LE CP-CAT were significantly greater than the SRM estimates for the PODCI Transfer/Mobility domain at twelve months, the PODCI Sports/Physical Functioning domain at twelve months, and the TUG at twelve and twenty-four months. When the results for the children at GMFCS levels I, II, and III were grouped together, the improvements in function detected by the LE CP-CAT at twelve and twenty-four months were found to be greater than the changes detected by the PODCI Transfer/Mobility and Sports/Physical Functioning scales. The LE CP-CAT outperformed the PODCI scales for GMFCS levels I and III at both of these follow-up intervals; none of the scales performed well for patients with GMFCS level II. CONCLUSIONS The results of this study showed that the LE CP-CAT displayed superior sensitivity to change than the PODCI and TUG scales after musculoskeletal surgery in children with CP.
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Affiliation(s)
- M.J. Mulcahey
- Department of Occupational Therapy, School of Health Professions, Thomas Jefferson University, 901 Walnut Street, Philadelphia, PA 19107. E-mail address:
| | - Mary D. Slavin
- Health and Disability Research Institute, School of Public Health, Boston University, 715 Albany Street, Boston, MA 02118
| | - Pengsheng Ni
- Health and Disability Research Institute, School of Public Health, Boston University, 715 Albany Street, Boston, MA 02118
| | - Lawrence C. Vogel
- Shriners Hospitals for Children, 2211 North Oak Park Avenue, Chicago, IL 60707
| | - Scott H. Kozin
- Shriners Hospitals for Children, 3551 North Broad Street, Philadelphia, PA 19438
| | | | - Alan M. Jette
- Health and Disability Research Institute, School of Public Health, Boston University, 715 Albany Street, Boston, MA 02118
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Outcome measures of microsurgical toe transfers for reconstruction of congenital and traumatic hand anomalies. J Pediatr Orthop 2015; 34:362-8. [PMID: 23995145 DOI: 10.1097/bpo.0000000000000088] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Outcomes data for children undergoing surgical reconstruction of their congenital hand anomalies has been used infrequently or not at all. Some surgeons even contend that children with total absence of digits or hands function perfectly well. Therefore, the purpose of this study was to evaluate and compare the functional outcomes of children who have undergone microsurgical toe-to-hand transfers for reconstruction of congenital and traumatic hand anomalies with the normal pediatric population. METHODS A total of 10 adolescents and 15 parents of pediatric and adolescent patients who underwent microsurgical toe-to-hand transfers were assessed using the Pediatric Outcomes Data Collection Instrument (PODCI) survey. Surveys were distributed during routine clinic visits or by mail. Indication and diagnosis were analyzed in relation to the functional outcomes obtained from the survey. Scores of the toe transfer patients group were compared with the scores of the normal pediatric population as well as the effect of patient and parent reporting. RESULTS Of the 3 survey groups and 6 functional dimensions, there was no statistically significant difference in function between the toe transfer children and the normal pediatric population in 13 of the 18 groups (72%). Adolescent toe transfer patients reported decreased upper extremity function and transfer/basic mobility and parents of adolescents reported decreased upper extremity function, sports/physical function, and global function. Parents significantly underestimated their adolescent children's function in terms of sports/physical function and happiness. Scores did not significantly differ between the congenital or traumatic indications for toe-to-hand transfers. CONCLUSIONS Children with congenital or traumatic missing or hypoplastic digits who undergo reconstruction by microsurgical toe-to-hand transfer can achieve remarkable gains in function, sensation and ability to perform daily activities. This study confirms that a significant percentage of children undergoing reconstruction by microsurgical toe-to-hand transfers have similar functional outcomes assessments when compared with the normal pediatric population. LEVEL OF EVIDENCE Level III-Therapeutic study.
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Musculoskeletal function in patients with mucopolysaccharidosis using the pediatric outcomes data collection instrument. J Pediatr Orthop 2014; 34:650-4. [PMID: 24598580 DOI: 10.1097/bpo.0000000000000168] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Musculoskeletal function is often the limiting factor in quality of life in patients with mucopolysaccharidosis (MPS). The Pediatric Outcomes Data Collection Instrument (PODCI) is a validated tool to be used in children aged 2 to 18 years with chronic musculoskeletal disorders and is freely available to any investigator. The goal of this study is to establish normative data for patients with MPS. METHODS Of our 25 patients with MPS, 16 had PODCI's performed at initial evaluation. This included 4 patients with MPS IH (Hurler), 7 patients with MPS II (Hunter), 4 patients with MPS IV (Morquio), and 1 patient with MPS VI (Maroteaux-Lamy). Differences in PODCI scores among children with MPS IH (Hurler), II (Hunter), and IV were estimated using a Kruskal-Wallis test. RESULTS With the exception of upper extremity and physical functioning function in MPS IV, all domains for our MPS patients measured below average for typically developing children. We found a statistically significant difference among the groups in the upper extremity and physical function scale [H (2) = 8.16, P = 0.02]. The single MPS VI patient had the highest scores overall. MPS IV patients scored better than the MPS IH patients, and the MPS II patients scored lowest. CONCLUSIONS This study demonstrates the limited musculoskeletal function in patients with MPS and the differences among different MPS diagnoses. CLINICAL RELEVANCE The data establishes a basic understanding of musculoskeletal function in patients with MPS and should provide comparative data for future studies in which musculoskeletal function is measured as an objective outcome. It can also serve as a better objective measure for interventions, as previous models have only served as proxies to musculoskeletal function.
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Sabatini CS, Curtis TA, Mahan ST. Patient-based outcomes after tibia fracture in children and adolescents. Open Orthop J 2014; 8:41-8. [PMID: 24627732 PMCID: PMC3952204 DOI: 10.2174/1874325001408010041] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Revised: 02/11/2014] [Accepted: 02/11/2014] [Indexed: 11/22/2022] Open
Abstract
Introduction : Tibia fractures are common in pediatric patients and time necessary to return to normal function may be underappreciated. The purpose of this study was to assess functional recovery in pediatric patients who sustain tibia fractures, utilizing the Pediatrics Outcome Data Collection Instrument (PODCI), in order to provide evidence-based information on post-injury functional limitations and anticipated recovery times. Methods : 84patients (out of 264 eligible patients, response rate 32%) age 1.5-18 years treated for a tibia fracture at a large children's hospital between 1/07 and 4/08 completed a PODCI questionnaire at 6 and 12 months post-injury. PODCI questionnaires were compared to previously reportednormal controls using Student's t-test in six categories. Results : At 6 months after injury, the Sports functioning PODCI score was significantly less than healthy controls in both the parent reports for adolescent (mean 88.71 versus 95.4) and adolescent self-report (mean 90.44 versus 97.1); these showed no difference at 12 months. Discussion : For adolescents who sustain fractures of the tibia, there remains a negative impact on their sports functioning after 6 months that resolves by 12 months. Physicians can counsel their patients that although they may be limited in their sports function for some time after injury, it is anticipated that this will resolve by one year from the time of injury. Level of Evidence : Level II.
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Affiliation(s)
- Coleen S Sabatini
- Department of Orthopaedic Surgery, University of California at San Francisco, USA
| | - Tracy A Curtis
- Department of Orthopaedic Surgery, University of California at San Francisco, Benioff Children's Hospital, USA
| | - Susan T Mahan
- Department of Orthopaedic Surgery, Boston Children's Hospital, Orthopaedic Surgery, Harvard Medical School, USA
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do Monte FA, Ferreira MNL, Petribu KCL, Almeida NC, Gomes JB, Mariano MH, Mesquita ZB, Simões DM, Rodrigues AFDA, Souza MAN. Validation of the Brazilian version of the Pediatric Outcomes Data Collection Instrument: a cross-sectional evaluation in children and adolescents with juvenile idiopathic arthritis. BMC Pediatr 2013; 13:177. [PMID: 24171906 PMCID: PMC4228465 DOI: 10.1186/1471-2431-13-177] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 10/28/2013] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND There is a lack of health-related quality of life (HRQOL) questionnaires to evaluate pediatric musculoskeletal diseases in Brazil. The Pediatric Outcome Data Collection Instrument (PODCI) is widely used elsewhere for pediatric patients with musculoskeletal disorders, but it has not been fully validated in Brazil. Validation of the PODCI in the Brazilian Portuguese language is important to improve the assessment of pediatric patients with musculoskeletal diseases and to compare Brazilian study results with results from the international literature. This study aimed to analyze the test-re-test reliability and the convergent validity indicators for the quality of life scores obtained by application of the PODCI to children and adolescents with juvenile idiopathic arthritis (JIA). METHODS The PODCI underwent translation, transcultural adaptation, and field testing. Fifty-seven children and adolescents with JIA were administered the PODCI questionnaire. The Child Health Questionnaire - Parent Form 28 (CHQ PF-28) was used as the gold standard. Pain scales were employed, clinical examinations were performed, and laboratory inflammatory activity tests were conducted. RESULTS The three versions of the PODCI exhibited good internal consistency (Cronbach's alpha coefficient > 0.70), good reproducibility (p < 0.05), and good correlation compared with the gold standard (CHQ), as shown by a Spearman coefficient (Rho) > 0.40 (p < 0.05). CONCLUSIONS The PODCI was validated in patients with JIA in Brazil. This questionnaire was found to be valid, precise, and reliable. It can be successfully applied in research conducted by healthcare professionals who work with children and adolescents with musculoskeletal system disorders.
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Affiliation(s)
- Felipe Alves do Monte
- Clinical Research Unit of Oswaldo Cruz University Hospital and Pernambuco, Cardiologic Emergency at Pernambuco University, Rua Arnóbio Marques, 310, Santo Amaro, Recife, PE 52011-240, Brazil
| | - Moacir Novaes Lima Ferreira
- Clinical Research Unit of Oswaldo Cruz University Hospital and Pernambuco, Cardiologic Emergency at Pernambuco University, Rua Arnóbio Marques, 310, Santo Amaro, Recife, PE 52011-240, Brazil
| | - Kátia Cristina Lima Petribu
- Clinical Research Unit of Oswaldo Cruz University Hospital and Pernambuco, Cardiologic Emergency at Pernambuco University, Rua Arnóbio Marques, 310, Santo Amaro, Recife, PE 52011-240, Brazil
| | - Nair Cristina Almeida
- Clinical Research Unit of Oswaldo Cruz University Hospital and Pernambuco, Cardiologic Emergency at Pernambuco University, Rua Arnóbio Marques, 310, Santo Amaro, Recife, PE 52011-240, Brazil
| | - José Benjamim Gomes
- Clinical Research Unit of Oswaldo Cruz University Hospital and Pernambuco, Cardiologic Emergency at Pernambuco University, Rua Arnóbio Marques, 310, Santo Amaro, Recife, PE 52011-240, Brazil
| | - Maria Helena Mariano
- Clinical Research Unit of Oswaldo Cruz University Hospital and Pernambuco, Cardiologic Emergency at Pernambuco University, Rua Arnóbio Marques, 310, Santo Amaro, Recife, PE 52011-240, Brazil
| | - Zelina Barbosa Mesquita
- Pediatric Rheumatology Unit, Professor Fernando Figueira Institute of Integral Medicine, Rua dos Coelhos, 300, Coelhos, Recife, PE 50070-550, Brazil
| | - Diego Montarroyos Simões
- Clinical Research Unit of Oswaldo Cruz University Hospital and Pernambuco, Cardiologic Emergency at Pernambuco University, Rua Arnóbio Marques, 310, Santo Amaro, Recife, PE 52011-240, Brazil
| | - André Furtado de Ayalla Rodrigues
- Clinical Research Unit of Oswaldo Cruz University Hospital and Pernambuco, Cardiologic Emergency at Pernambuco University, Rua Arnóbio Marques, 310, Santo Amaro, Recife, PE 52011-240, Brazil
| | - Mariana Alves Nogueira Souza
- Clinical Research Unit of Oswaldo Cruz University Hospital and Pernambuco, Cardiologic Emergency at Pernambuco University, Rua Arnóbio Marques, 310, Santo Amaro, Recife, PE 52011-240, Brazil
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Mulcahey MJ, Merenda L, Tian F, Kozin S, James M, Gogola G, Ni P. Computer Adaptive Test Approach to the Assessment of Children and Youth With Brachial Plexus Birth Palsy. Am J Occup Ther 2013; 67:524-33. [DOI: 10.5014/ajot.2013.008037] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
This study examined the psychometric properties of item pools relevant to upper-extremity function and activity performance and evaluated simulated 5-, 10-, and 15-item computer adaptive tests (CATs). In a multicenter, cross-sectional study of 200 children and youth with brachial plexus birth palsy (BPBP), parents responded to upper-extremity (n = 52) and activity (n = 34) items using a 5-point response scale. We used confirmatory and exploratory factor analysis, ordinal logistic regression, item maps, and standard errors to evaluate the psychometric properties of the item banks. Validity was evaluated using analysis of variance and Pearson correlation coefficients. Results show that the two item pools have acceptable model fit, scaled well for children and youth with BPBP, and had good validity, content range, and precision. Simulated CATs performed comparably to the full item banks, suggesting that a reduced number of items provide similar information to the entire set of items.
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Affiliation(s)
- M. J. Mulcahey
- M. J. Mulcahey, PhD, OTR/L, is Professor of Occupational Therapy, Thomas Jefferson University, School of Health Professions, 901 Walnut Street, 6th Floor, Philadelphia, PA 19107, and Scientific Staff, Shriners Hospitals for Children, Philadelphia;
| | - Lisa Merenda
- Lisa Merenda, MSN, is Research Nurse, Shriners Hospitals for Children, Philadelphia
| | - Feng Tian
- Feng Tian, PhD, is Associate Professor, Health and Disability Research Institute, School of Public Health, Boston University, Boston
| | - Scott Kozin
- Scott Kozin, MD, is Chief of Staff, Shriners Hospitals for Children, Philadelphia
| | - Michelle James
- Michelle James, MD, is Chief of Orthopedics, Shriners Hospitals for Children Northern California, Sacramento
| | - Gloria Gogola
- Gloria Gogola, MD, is Medical Staff, Shriners Hospitals for Children, Houston
| | - Pengsheng Ni
- Pengsheng Ni, MD, PhD, is Associate Professor, Health and Disability Research Institute, School of Public Health, Boston University, Boston
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