Development of a Core Patient-Reported Outcome (Measures) Set for Pediatric Physical Therapy.
Selina Limmen, Dorinde L Korteling, Manon A T Bloemen and 6 others
A core set of 9 outcome measures (plus 5 optional) was developed for pediatric PT, designed to take about 10 minutes.
The most important outcome — participation — has no suitable measure yet, a gap clinicians should know about.
Key findings
1The core set covers 9 PROs (participation, peer relations, physical functioning, fatigue intensity and interference, pain intensity and interference, quality of life, perceived health) measured by 6 PROMs, plus 5 optional PROs (anxiety, depression, anger, sleep, cognitive functioning) measured by 4 PROMs, for a total of 12–48 items.
2Participation was ranked the most important PRO by the 95 pediatric PTs surveyed, yet no suitable pediatric or proxy PROM was found for it; the only candidate was designed for adults, and 6 other candidates showed insufficient usability.
3The set is designed to take no more than about 10 minutes to complete, uses primarily PROMIS instruments available in multiple languages, and recommends the computerized adaptive testing (CAT) version for higher reliability, with free short forms as an alternative.
Still to come
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Adolescents and parents contributed to identifying what matters but were not involved in prioritizing the PROs or selecting the PROMs; their input stopped at the focus-group stage. All qualitative data came from the Dutch healthcare system; the authors note the scoping review and PROMIS instruments are international, but the context is still Dutch. PROM selection was anchored to the Dutch GPROM set, which may not map perfectly onto other countries' measurement traditions. The set does not distinguish subdomains within participation (e.g., attendance vs. involvement), which the authors acknowledge could be a limitation. Psychometric evidence for the recommended PROMIS instruments in children who use mobility aids is limited; validity and reliability in that group have not been established. The most important outcome (participation) has no suitable measure, so the core set is incomplete for the domain pediatric PTs consider central to their work.
Declared interests
Funded by ZonMW (grant 10270032130005) and Zorginstituut Nederland (grant 2022025449, 2022). The funders had no role in conceptualization, design, decision to publish, or preparation of the manuscript.
The easy way to misread this
Do not read the core set as a validated, evidence-based standard that has been tested in practice. It is a consensus recommendation built from one country's focus groups and a survey of 95 therapists, and the outcome the therapists ranked most important (participation) has no measure in the set. Also, the psychometric properties of the recommended PROMIS instruments have not been confirmed in children who use mobility aids, so scores in that group should be interpreted with care.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →