Elsevier

Injury

Volume 37, Issue 12, December 2006, Pages 1185-1196
Injury

Assessing outcomes in paediatric trauma populations

https://doi.org/10.1016/j.injury.2006.07.011Get rights and content

Summary

Introduction

Assessing outcomes in the paediatric trauma population is important. Identifying suitable instruments can be problematic. This article highlights the commonly used outcome measures for assessing functional status and health related quality of life in paediatric trauma patients. Child specific characteristics which impact upon instrument development and selection are reviewed.

Methods

An electronic database search was conducted to identify suitable English language measures used for outcome assessment in paediatric trauma patients from 1966 to present.

Results

Nine suitable instruments were identified, the child health questionnaire (CHQ), Glasgow outcome scale (GOS), paediatric overall performance category (POPC), PedsQL™ 4.0 generic core scales, paediatric evaluation of disability inventory (PEDI), functional independence measure (FIM™), WeeFIM™ and an unnamed paediatric trauma specific measure [Gofin R, Hass T, Adler B, The development of disability scales for childhood and adolescent injuries. J Clin Epidemiol 1995;48:977–84]. Each instrument was found to have advantages and disadvantages for assessing outcomes in a paediatric trauma population.

Conclusion

The PedsQL™ 4.0 generic core scale could be feasible for administration as a routine outcome measure for paediatric trauma groups. For very young children an additional measure such as that proposed by Gofin et al. [Gofin R, Hass T, Adler B, The development of disability scales for childhood and adolescent injuries. J Clin Epidemiol 1995;48:977–84] may be indicated. Future use of these instruments in the paediatric population would benefit from further psychometric evaluation.

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

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