Enhancing pediatric health evaluations through improved PROMs

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

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

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

The findings highlight the importance of improving the methodological quality of systematic reviews on pediatric PROMs. We need more standardized reporting and tailored tools to ensure that clinicians can select the most appropriate measures for children's health assessments."

Dr. Yaolong Chen, lead researcher on the study

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