Assessing outcomes in paediatric trauma populations
Section snippets
Issues in measuring outcomes in children
Marked differences exist between how children and adults interpret and report on their health. These differences need to be considered when designing or choosing an outcome instrument.
Outcome measures used in paediatric trauma
While a range of instruments exist for assessing outcomes in paediatric populations, this review aimed to identify instruments used for the assessment of outcomes in paediatric trauma patients.
Search strategy
A search of the Medline database (from January 1966 to August 2005) was performed. Combinations of key-words used to identify potential measures of interest were: paediatric, child*, outcome, disability, function*, quality of life, measure*, instrument, index, assessment, scale, profile, score, rating, questionnaire, trauma, injury and emergency medicine. Instruments were limited to English language. Instruments were selected for review if they had been previously used in a paediatric trauma
Conclusion
None of the named measures (FIM™, WeeFIM™, CHQ, GOS, POPC, PEDI or PedsQL™ 4.0) have been rigorously validated for use in the paediatric trauma population and all have potential barriers to application either due to the number of items, the age of appropriate respondents, or the mode of administration. Despite these limitations and the financial costs associated with administration, the PedsQL™ 4.0 generic core scale could be feasible for administration as a routine outcome measure for
References (51)
- et al.
Functional outcome in children with multiple trauma without significant head injury
Arch Phys Med Rehabil
(1999) - et al.
Outcome instruments for the assessment of the upper extremity following trauma: a review
Injury
(2005) Assessing the outcome of pediatric intensive care
J Pediatr
(1992)- et al.
The development of disability scales for childhood and adolescent injuries
J Clin Epidemiol
(1995) - et al.
Pediatric physical functioning reference curves
Pediatr Neurol
(2004) - et al.
Assessing traumatic brain injury outcome measures for long-term follow-up of community-based individuals
Arch Phys Med Rehabil
(2001) - et al.
Glasgow Outcome Scale: research scale or blunt instrument?
Lancet
(2000) - et al.
Assessment of health-related quality of life in children: a review of conceptual, methodological, and regulatory issues
Value Health
(2004) - et al.
Interrater agreement and stability of the Functional Independence Measure for Children (WeeFIM): use in children with developmental disabilities
Arch Phys Med Rehabil
(1997) - et al.
Reliability and validity of comprehensive health status measures in children: The Child Health Questionnaire in relation to the Health Utilities Index
J Clin Epidemiol
(2002)
The PedsQL 4.0 as a pediatric population health measure: feasibility, reliability, and validity
Ambul Pediatr
Health status of children after admission for injury
Pediatrics
Late neurologic and cognitive sequelae of inflicted traumatic brain injury in infancy
Pediatrics
Reliability of the Pediatric Evaluation of Disability Inventory (PEDI)
Phys Occup Ther Pediatr
Cronbach's α
BMJ
Measuring quality of life in paediatric patients
Pharmacoeconomics
Long-term outcomes of seriously injured children: a study using the Child Health Questionnaire
J Paediatr Child Health
Social function changes in children and adolescents with acquired brain injury during inpatient rehabilitation
Pediatr Rehabil
Self-care recovery of children with brain injury: descriptive analysis using the Pediatric Evaluation of Disability Inventory (PEDI) functional classification levels
Phys Occup Ther Pediatr
The measurement of quality of life in young children
Child Care Health Dev
Can parents rate their child's health-related quality of life? Results of a systematic review
Qual Life Res
Concurrent and construct validity of the Pediatric Evaluation of Disability Inventory
Phys Ther
Relationship of illness severity and length of stay to functional outcomes in the pediatric intensive care unit: a multi-institutional study
Crit Care Med
Relationship of Pediatric Overall Performance Category and Pediatric Cerebral Performance Category scores at pediatric intensive care unit discharge with outcome measures collected at hospital discharge and 1- and 6-month follow-up assessments
Crit Care Med
Evaluating patient-based outcome measures for use in clinical trials
Health Technol Assess
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