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Published on: February 2, 2020
Designing an oral mucositis assessment instrument for use in children: generating items using a nominal group
Deborah Tomlinson1, Faith Gibson, Nathaniel Treister
1Child Health Evaluative Sciences, Hospital for Sick Children, 123 Edward Street, Toronto, Ontario M5G 1E2, Canada. deborah.tomlinson@sickkids.ca
Insights
A new oral mucositis assessment scale for children was developed using expert consensus. The Children's International Mucositis Evaluation Scale includes items on ulcers, pain, medication, and effects on eating and drinking.
Area of Science:
- Pediatric Oncology
- Clinical Assessment Tools
- Oral Medicine
Background:
- Oral mucositis is a common and debilitating side effect of cancer treatment in children.
- Existing mucositis assessment instruments may not be specifically tailored for pediatric use.
- There is a need for a validated tool to accurately measure oral mucositis severity in pediatric patients.
Purpose of the Study:
- To describe the item generation phase for a novel instrument to assess oral mucositis in children.
- To develop a pediatric-specific mucositis assessment scale based on expert opinion.
Main Methods:
- A nominal group technique was employed with nine healthcare professionals specializing in pediatric cancer and mucositis.
- Experts identified and prioritized key items for inclusion in the assessment instrument.
Main Results:
- An initial pool of thirty items was generated.
- Six essential items were selected through a voting process: ulcer presence, pain, pain medication, impact on eating, drooling/saliva pooling, and impact on drinking.
- These six items formed the basis for the Children's International Mucositis Evaluation Scale (CIMES).
Conclusions:
- The developed instrument, CIMES, is based on six core items identified by experts, suggesting it is simple, feasible, and reliable.
- CIMES is crucial for advancing clinical research on interventions for pediatric oral mucositis.
- Further validation and testing of the CIMES are required.
Goals Of Work:
There was a need to develop a mucositis instrument that would be specific for use with children. This paper describes the step of generating items in the process of developing a new instrument for the assessment of oral mucositis in children.
Materials And Methods:
Nine health care professionals with expertise in pediatric cancer, mucositis assessment, and oral assessment in children were invited to participate in a nominal group technique to generate items that should be included in an instrument.
Results:
Thirty items were generated initially. Voting processes established that six of these items were thought to be necessary for inclusion: (1) presence of ulcers, (2) pain assessment, (3) amount of pain medication received, (4) effect on eating, (5) drooling-pooling of saliva, and (6) effect on drinking. Using these six items, an initial draft of an instrument was developed that could be used to assess oral mucositis in children, namely, the Children's International Mucositis Evaluation Scale.
Conclusion:
The six items generated by this process provided the basis for a simple, feasible, and reliable instrument. With increased clinical research investigating interventions to reduce and prevent oral mucositis, such an instrument will be critical to the effective conduct of this research in children. Further testing of this instrument is necessary.
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