635 Identifying universally relevant, generic child health outcomes spanning diagnostic, discipline and sector boundaries

• Published in: Archives of disease in childhood Vol. 108; no. Suppl 2; p. A119
• Main Authors: Harbottle, Victoria, Arnott, Bronia, Gale, Chris, Rowen, Elizabeth, Kolehmainen, Niina
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01-07-2023
• Subjects: Activities of daily living; Boundaries; Child Health; Children; Children & youth; Childrens health; Dentistry; Health care; Interpersonal Relationship; Medical diagnosis; Metabolic disorders; Mobility; Ordination; Outcome Measures; Pain; Pediatrics; Quality of life; Rheumatology; School Involvement; Social behavior
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2023-rcpch.197

ObjectiveTo identify shared, generic domains of child health and wellbeing that are important and common across children, and that could be used as generic health indicators and healthcare outcomes across conditions and services. We did this by reviewing existing paediatric, diagnosis-specific, health core outcome sets, and identifying areas of commonality and divergence, as well as gaps.MethodsThe Core Outcome Measures in Effectiveness Trial register was searched for all child health core specific outcome sets published between 2008 and 2022. Outcomes from identified sets were extracted, and the WHO International Classification of Functioning, Disability and Health (WHO ICF) was used to as a framework to categorise the extracted outcomes, and to identify clusters. The involvement of children and their families in developing the core outcome sets was also assessed.ResultsA total of 206 sets were identified, of which 36 were included. These 36 sets related to: gastrointestinal conditions (n=8); neurological conditions (n=7); ear, nose and throat (n=5); orthopaedics (n=4); general paediatrics (n=3); neonatology (n=2); respiratory (n=2); metabolic disease (n=2); and rheumatology, oncology and dentistry specialities (n=1 each). The data extracted from these sets covered 441 unique outcomes, which mapped on to 22 separate outcome clusters. The most common cluster related to medical diagnoses (in 76% of sets) with the next most common being pain, followed by communication and social interaction, mobility, self-care and school. Additionally, three clusters outside the WHO ICF were identified: mortality, dental/oral health, and quality of life. Only 36% of reviewed studies included children and young people’s views in the development of the core outcome sets.ConclusionsThere is considerable overlap in terms of health indicators included in existing child health core outcome sets. Specifically, pain, social communication, mobility, self-care and school participation seem to be universally agreed important outcomes, generic to all children across diagnostic specialities. This suggests that there is potential for a universally relevant, generic set of child health outcomes or indicators spanning traditional diagnostic, discipline and sector boundaries – that is, a minimum set of success criteria that are important for all children, regardless where they are in the healthcare system, what interventions they are receiving, and what conditions they have. Developing and adopting such a generic approach has the potential to facilitate more integrated practice, health care, and research for children and families; as well as to improve co-ordination and resource-use across services.