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Published on: September 27, 2020
A systematic scoping review and gap analysis of questionnaires to assess multimorbidity among children
Jogesh Murmu1, Abhinav Sinha1, Upasana Nayak1
1ICMR-Regional Medical Research Centre, Bhubaneswar, India.
Insights
Existing tools for assessing childhood multimorbidity are not specifically designed for this purpose, limiting comprehensive care. There is an urgent need for standardized, pediatric-specific assessment instruments to improve accuracy and management.
Area of Science:
- Pediatric Healthcare
- Clinical Assessment Tools
- Chronic Disease Management
Background:
- Children have unique healthcare needs requiring specialized assessment tools.
- Multimorbidity in children presents complex challenges for accurate assessment and care.
- Existing tools often lack the specificity needed for comprehensive pediatric multimorbidity evaluation.
Purpose of the Study:
- To examine existing assessment tools for childhood multimorbidity.
- To identify critical gaps in the current assessment methodologies for pediatric chronic diseases.
- To evaluate the suitability of current tools for assessing multimorbidity in children aged 0-18 years.
Main Methods:
- Systematic review following PRISMA guidelines, registered in PROSPERO.
- Searched major databases (PubMed, Embase, Web of Science, CINAHL).
- Included 11 studies out of 11,876 records, focusing on tools for chronic diseases and multimorbidity in children.
Main Results:
- Identified tools (e.g., CHQ, ISAAC) were designed for single conditions, not multimorbidity.
- Repurposed existing tools lack full understanding of comorbidities and vary in scope.
- No specifically designed tool for childhood multimorbidity was found; existing ones require modification.
Conclusions:
- Current child health questionnaires are inadequate for assessing multimorbidity.
- There is a critical need for standardized, culturally acceptable, pediatric-specific multimorbidity assessment tools.
- Developing multidimensional instruments is essential for improving accuracy, management, and long-term health outcomes in children with multimorbidity.
Abstract:
Assessment tools specifically designed for children are crucial to addressing their unique healthcare needs, enabling more comprehensive and tailored care. This review intends to examine tools that assess multimorbidity in children to uncover critical gaps. This review followed PRISMA guidelines and is registered in PROSPERO (CRD42024520342). This review focused on tools/questionnaires/instruments that assess chronic diseases and multimorbidity among children aged 0-18 years. The search was performed from PubMed, Embase, Web of Science, and CINAHL databases. Eleven studies were included out of 11,876 records screened. The tools (CHQ, ISAAC, DAWBA, and MINI-KID) identified were initially created to assess one condition. They remain widely used in multimorbidity studies because of their validity and common usage, but re-purposing them can restrict full understanding of comorbidities. Other studies used or modified these tools to estimate multimorbidity constructs, with no specifically designed tool employed to estimate childhood multimorbidity. The risk of bias was generally moderate among cross-sectional studies and low among cohort studies. The existing child health questionnaires were not designed for assessing multimorbidity and vary widely in scope and focus. These findings underscore the urgent need for standardized, culturally acceptable, and pediatric-specific tools to assess multimorbidity. IMPACT: This review highlights critical gaps in pediatric multimorbidity assessment tools, emphasizing their limited scope, validity, and cultural adaptability. It analyzes existing methodologies, revealing inconsistencies in chronic condition coverage and a lack of validation across diverse populations. The study underscores the need for standardized, comprehensive tools to improve assessment accuracy and management. Findings suggest that developing multidimensional instruments will enhance precision and inform better healthcare strategies. Addressing these gaps is essential for equitable, evidence-based multimorbidity management in children, ultimately improving long-term health outcomes.
