Pediatric Quality of Life InventoryTM version 4.0 short form generic core scale across pediatric populations review data

Prevalence of dry eye disease among children: a systematic review and meta-analysis

BACKGROUND

Dry eye disease (DED) is a multifactorial disorder of the tear film and ocular surface instability that causes ocular discomfort and visual impairment. The increasing use of digital devices and changing lifestyle patterns have raised concerns about a potential rise in DED among children. Understanding the prevalence of paediatric DED is crucial for developing effective diagnostic and management strategies tailored to this vulnerable population.

METHOD

An exhaustive literature search was performed on several databases covering the period from 1 January 2001 to 1 April 2024. Prevalence estimates of DED were combined using random effects models, and heterogeneity sources were explored through subgroup and regression analyses.

RESULTS

Our literature search identified 7309 articles, of which 41 articles, representing 42 study cohorts (48 479 participants) included in the systematic review. The estimated prevalence of DED among children was 23.7% (95% CI 18.5% to 28.9%). The prevalence of DED by different diagnostic criteria (clinical signs vs reported symptoms by questionnaire) was 16.6% (95% CI 13.7% to 19.5%; 26 studies; 27 107 children) vs 34.6% (95% CI 23.7% to 45.6%; 16 studies; 21 372 children; p<0.01), respectively. The prevalence of DED after the COVID-19 pandemic outbreak was 44.1% (95% CI 25.5% to 62.7%; 8 studies; 9163 children), which was significantly higher than the 18.7% (95% CI 15.6% to 21.9%; 34studies, 39 316 children; p=0.01) before the COVID-19 outbreak. High between-study heterogeneity was noted (I2>92%). In meta-regression analysis, the prevalence of DED among children increased by 7.1% with each 10° decrease in latitude (p=0.015), and by 10.2% with each 10° increase in mean annual temperature (p=0.024).

CONCLUSIONS

DED is common in children up to 18 years of age and poses a significant disease burden. Standardisation of the diagnosis of DED in children and further study of other risk factors are needed to fully explain the epidemiology of DED in children.

A scoping review of the electronic collection and capture of patient reported outcome measures for children and young people in the hospital setting

Patient reported outcome measures (PROMs) capture patients' views of their health status and the use of PROMs as part of standard care of children and young people has the potential to improve communication between patients/carers and clinicians and the quality of care. Electronic systems for the collection of or access to PROMs and integrating PROMs into electronic health records facilitates their implementation in routine care and could help maximise their value. Yet little is known about the technical aspects of implementation including the electronic systems available for collection and capture and how this may influence the value of PROMs in routine care which this scoping review aims to explore. The Joanna Briggs Institute review process was used. Seven databases were searched (Emcare, Embase MEDLINE, APA PsychInfo, Scopus and Web of Science), initially in February 2021 and updated in April 2023. Only studies that mentioned the use of electronic systems for the collection, storage and/or access of PROMs as part of standard care of children and young people in secondary (or tertiary) care settings were included. Data were analysed using frequency counts and thematically mapped using basic content analysis in relation to the research questions. From the 372 studies that were eligible for full text review, 85 studies met the inclusion criteria. The findings show that there is great variability in the electronic platforms used in the collection, storage and access of PROMs resulting in different configurations and fragmented approaches to implementation. There appears to be a lack of consideration on the technical aspects of the implementation such as the accessibility, useability and interoperability of the data collected. Electronic platforms for the collection and capture of PROMs in routine care of CYP is popular, yet, further understanding of the technical considerations in the use of electronic systems for implementation is needed to maximise the potential value and support the scalability of PROMs in routine care.

Routine use of patient-reported experience and outcome measures for children and young people: a scoping review

BACKGROUND

Patient-reported outcome measures (PROMs) measure people's views of their health status whereas patient-reported experience measures (PREMs) are questionnaires measuring perceptions of their experience whilst receiving healthcare. PROMs/PREMs have the potential to enable children and young people (CYP) to be involved in decisions about their care and improve the quality of their care but it is not clear how often PROMs/PREMs are incorporated as part of standard care of CYP in the hospital setting. The aims of this scoping review were to understand the extent of the literature and map available evidence on the use, benefits, barriers and facilitators of PROMs/PREMs as part of standard care and treatment of CYP in hospitals.

METHODS

The Joanna Briggs Institute review process was used to map existing evidence on the use of PROMs/PREMs in routine care of CYP in different hospital settings worldwide. Key search terms were developed and Ovid (Emcare, Embase MEDLINE, APA PsychInfo), Scopus and Web of Science were searched. Data were analysed using frequency counts and basic content analysis for thematic mapping according to the research questions. We undertook an initial search in February 2021 and updated this in April 2023.

RESULTS

The search yielded 68,004 studies, 388 were eligible for full text review and 172 met the inclusion criteria. PROMs were more commonly used than PREMs in routine care of CYP in hospitals; these were mostly collected using electronic collection and concentrated in specific specialities, settings, contexts and countries. The findings mapped the use of PROMs/PREMs, including how data are applied in clinical practice and used for service development, but this was not consistently reported. There are specific challenges in the implementation of PROMs/PREMs in routine care of CYP that need to be considered.

CONCLUSION

PROMs/PREMs have the potential to improve care for CYP in hospital settings contributing to different aspects of care. A better understanding of their use, how results can be applied in clinical practice and contribute to service development will enable meaningful employment. The popularity of electronically collected and captured PROMS/PREMs warrants further investigation to enable their meaningful use in routine care of CYP.

SYSTEMATIC REVIEW REGISTRATION

Not pre-registered.

Brazilian children's quality of life during the COVID-19 pandemic: analysis of contextual factors and dimensions

OBJECTIVE

The aim of this study was to investigate the contextual factors associated with the quality of life (QOL) of Brazilian children aged 0-12 years during the strict period of social isolation.

METHODS

This observational cross-sectional study was conducted between July and September 2020 using an online questionnaire on QOL-related family factors and the Pediatric Quality of Life Inventory (PedsQL™). Results were analyzed by multinomial logistic regression analysis.

RESULTS

The sample had 849 children, mostly from the South Region of Brazil (75%), white (83%), with typical development (79%), sedentary (68%), using screen (85%) for >3 h/day (44%). Their mothers were their main caregivers (90%). The following variables were significantly associated with high scores of QOL: typical health status (OR 2.38; 95%CI 1.60-3.55; screen time ≤2 h/day (OR 1.62; 95%CI 1.17-2.24); social distancing considered as "easy" (OR 1.67; 95%CI 1.20-2.32), and stimulation of the child by the family (OR 1.93; 95%CI 1.08-3.45).

CONCLUSIONS

This study indicates that the family context can influence children's QOL, especially during the COVID-19 pandemic and home environment reorganization.

Quality of life in children with asthma compared to healthy children: a case-control study

OBJECTIVE

Asthma is a chronic condition characterized by episodic wheezing, cough, and shortness of breath resulting from airway hyperresponsiveness and inflammation. Over 300 million people are affected worldwide, and its prevalence is increasing by 50% every decade. Assessing the quality of life in children with asthma is fundamental, as consistently poor health-related quality of life is associated with poorly controlled asthma. This study is aimed to evaluate and compare factors associated with HRQOL between healthy controls and children with asthma.

METHODS

In the current case-control study, 50 children aged 8-12 years with asthma (cases) enrolled at outpatient hospital clinics by a trained pediatric allergist/immunologist (A.P.) and matched with 50 healthy controls by age and sex. All enrolled subjects were interviewed utilizing the PedsQL questionnaire to assess health-related quality of life; also, patient demographics, including age, sex, and family income status, were obtained from a questionnaire.

RESULTS

A total of 100 children comprising 62 males and 38 females with a mean age of 9.63 ± 1.38 years, participated in this study. The average score of children with asthma was 81.63 ± 9.38, and the average score for healthy participants was 89.58 ± 7.91. We found that asthma was associated with a significant drop in health-related quality of life in this sample.

CONCLUSIONS

The results indicated that the PedsQL score and its subscales, except social functioning, were significantly higher in children with asthma compared to healthy ones. Also, SABA use, nocturnal symptoms, and asthma severity are negatively related to the health-related quality of life.

Safety and Efficacy of Mek Inhibitors in the Treatment of Plexiform Neurofibromas: A Retrospective Study

INTRODUCTION

Plexiform neurofibromas (PN) represent the main cause of morbidity in patients affected by Neurofibromatosis Type 1 (NF1). Until recently, surgery has been the main treatment option in these patients, but it is burdened with a low efficacy rate and a high incidence of side effects as well as recurrence. In recent years, MEK inhibitors (MEKi) such as selumetinib and trametinib have shown great promise.

METHODS

We retrospectively describe a single center cohort of NF1 patients affected by PN1 and treated with MEKi since 2019 to 2021. Patients recruited in the study were affected by PN that were not eligible to complete surgical excision, symptomatic or with major cosmetic deformation or functional neurological deficits.

RESULTS

Most patients experienced improvement in clinical symptoms and quality of life, with reduction or stabilization of lesions. However, no complete response was achieved. The most common adverse effects involved the skin, affecting every patient. Importantly, no life-threatening adverse effects occurred.

CONCLUSIONS

In our experience, MEKi treatment has been shown to be both safe and effective in improving symptomatology and quality of life.