FURTHER VALIDATION OF THE PATIENT/PARENT-REPORTED OUTCOME MEASURE OF FRACTURE HEALING (PROOF-LE) QUESTIONNAIRE FOR LOWER EXTREMITY FRACTURES IN CHILDREN
Notice bibliographique
Résumé
Clinical trials of pediatric fractures seldom show differences based on patient-reported outcome measures (PROMs), possibly because the PROMs do not adequately capture patients’/parents’ perspectives about outcomes that matter. The Patient Reported Outcomes of Fracture Healing (PROOF) questionnaires are a new set of PROMs designed specifically for children's fractures. Derived from parents and patients, the PROOF includes 4 domains (Scores:0-100): “How it Looks’; “How it Feels”; “How it Works”; and “How it Healed”, which captures the overall recovery experience. This project evaluates the reliability, validity and responsiveness of the PROOF-LE for lower extremity fractures in children. Children with lower extremity fractures were prospectively enrolled. Parents and children (> 8yrs) completed the parent & child versions of the PROOF-LE respectively, at 3 time-points from treatment until full recovery. Test-retest reliability (2-weeks apart) was determined at final healing using intraclass correlation coefficient (ICC); and internal consistency using Cronbach's Alpha. Convergent validity was assessed comparing the total and domain scores of the PROOF-LE to realted domains of the PODCI using Pearson correlation. Construct validity was evaluated by comparing fractures with and without complications. Responsiveness (sensitivity to change) was evaluated over 3 time-points using standardized response means (SRM). Finally, parents’ scores were compared with their respective children's scores, using paired t-test and Pearson correlation. 335 children's [197 boys/138 girls; mean age (SD): 9.9yrs (4.4)] fractures of the pelvis/hip (4), femur (99), knee (24), tibia (141), ankle (40) and foot (27) were included. The PROOF-LE demonstrated moderate to excellent test-retest reliability for the Total and domain scores for children (ICC:0.75 - 0.89) and parents (ICC:0.69-0.88); high internal consistency for children (0.72 - 0.9) and parents (0.72 - 0.91). PROOF-LE domain scores correlated positively with like domains of the PODCI. As hypothesized, fractures with complications scored significantly worse than those without. The PROOF-LE was highly responsive with SRMs of 0.99 (parents) and 1.2 (children) for the total scores over three time-points. Parents’ scores correlated strongly with their children (r=0.89; p < 0 .001) with parents’ scores an average of 2.9 points lower than children's. The PROOF-LE is the only PROM designed specifically to measure outcomes of pediatric lower extremity fractures and their treatments. The child and parent versions of the PROOF-LE are reliable, internally consistent, valid and responsive for lower extremity fractures in children. The PROOF-LE reports scores across four different domains and in total, which allows it to better distinguish pros and cons of competing treatments, information about which will inform future decision-making about treatment choices. The PROOF-LE may be considered as the PROM of choice for pediatric lower extremity fractures and their treatments.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».