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A medical record review for functional somatic symptoms in children

Charlotte Ulrikka Rask1, Carsten Borg, Charlotte Søndergaard

  • 1Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus, Denmark. c.rask@dadlnet.dk

Journal of Psychosomatic Research
|March 24, 2010
PubMed

Insights

A new tool, the Medical Record Review for Functional Somatic Symptoms in Children (MRFC), reliably identifies pediatric functional somatic symptoms (FSSs) in research. However, assessing FSS-associated impairment requires further refinement.

Area of Science:

  • Pediatric Health
  • Medical Record Analysis
  • Symptom Classification

Background:

  • Functional somatic symptoms (FSSs) are common in children, presenting diagnostic challenges.
  • Systematic methods are needed to identify FSSs and their impact in pediatric populations for research and clinical practice.

Purpose of the Study:

  • To develop and validate a medical record review tool, the MRFC, for identifying FSSs in pediatric patients.
  • To assess the inter-rater reliability of pediatricians using the MRFC for recognizing FSSs and their associated impairments.

Main Methods:

  • The MRFC tool was developed for retrospective review of medical records.
  • Three pediatricians applied the MRFC to records of children with diagnosed physical diseases or 'symptom' diagnoses.
  • Inter-rater reliability for FSS recognition and impairment assessment was tested on a subset of records.

Main Results:

  • The MRFC effectively identified subgroups of children with multisymptomatic, long-term, or impairing FSSs.
  • Good inter-rater reliability was achieved for FSS recognition (kappa=0.69).
  • Fair inter-rater reliability was observed for associated impairment assessment (kappa=0.29).

Conclusions:

  • The MRFC is a reliable method for identifying pediatric FSSs in clinical research when used by experienced pediatricians.
  • Further development is needed to reliably assess FSS-associated impairment.
  • The MRFC may also be beneficial in clinical settings for managing pediatric FSSs.
Abstract

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