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Identifying common health indicators from paediatric core outcome sets: a systematic review with narrative synthesis
Victoria Harbottle1,2, Bronia Arnott2, Chris Gale3
1Rehabilitation Department, Great North Children's Hospital, Newcastle Upon Tyne, UK Victoria.Harbottle@newcastle.ac.uk.
Insights
Paediatric core outcome sets reveal common health indicators, but often lack child and young person input. Future frameworks need better inclusion of their perspectives for comprehensive child health measurement.
Area of Science:
- Pediatric Health Research
- Outcome Measurement
- Health Indicators
Background:
- Child health indicators are vital for societal discussions and decision-making.
- Paediatric core outcome sets standardize trial outcomes within clinical groups.
- Analyzing commonalities in these sets can reveal universal child health indicators.
Approach:
- A systematic literature search of the Core Outcome Measures in Effectiveness Trial register (2008-2022) was conducted.
- Included studies focused on core outcome sets for individuals aged 0-18 years.
- The International Classification of Functioning, Disability and Health (ICF) framework was used for outcome categorization, alongside an assessment of child/family involvement.
Key Points:
- 206 articles were identified, with 36 included in the analysis, yielding 441 unique outcomes across 22 clusters.
- Medical diagnostics, pain, communication, mobility, self-care, and school were prominent outcome clusters.
- Child and young person perspectives were under-represented, with only 36% of studies involving them in development.
Conclusions:
- Overlapping outcomes in paediatric core sets suggest potential for generic child health measurement frameworks.
- Current sets may not fully capture health dimensions critical to children and young people.
- Enhanced involvement of children and young people is crucial for developing more representative health indicators.
Background:
Indicators of child health have the potential to inform societal conversations, decision-making and prioritisation. Paediatric core outcome sets are an increasingly common way of identifying a minimum set of outcomes for trials within clinical groups. Exploring commonality across existing sets may give insight into universally important and inclusive child health indicators.
Methods:
A search of the Core Outcome Measures in Effectiveness Trial register from 2008 to 2022 was carried out. Eligible articles were those reporting on core outcome sets focused on children and young people aged 0-18 years old. The International Classification of Functioning, Disability and Health (ICF) was used as a framework to categorise extracted outcomes. Information about the involvement of children, young people and their families in the development of sets was also extracted.
Results:
206 articles were identified, of which 36 were included. 441 unique outcomes were extracted, mapping to 22 outcome clusters present across multiple sets. Medical diagnostic outcomes were the biggest cluster, followed by pain, communication and social interaction, mobility, self-care and school. Children and young people's views were under-represented across core outcome sets, with only 36% of reviewed studies including them at any stage of development.
Conclusions:
Existing paediatric core outcome sets show overlap in key outcomes, suggesting the potential for generic child health measurement frameworks. It is unclear whether existing sets best reflect health dimensions important to children and young people, and there is a need for better child and young person involvement in health indicator development to address this.
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