Utility of the pediatric outcomes data collection instrument for assessing acute hand and wrist injuries in children

Samuel Kunkel, Emily Eismann, Roger Cornwall
Journal of Pediatric Orthopedics 2011, 31 (7): 767-72

BACKGROUND: Despite the frequency of hand and wrist injuries in children, patient-reported outcomes have not been systematically assessed. This study hypothesizes that the Pediatric Outcomes Data Collection Instrument (PODCI) can be reliable, responsive, and discriminatory in assessing the impact of acute pediatric hand and wrist injuries on function and quality of life.

METHODS: Consecutive patients presenting to a pediatric clinic with acute hand and wrist injuries over a 3-month period completed PODCI questionnaires at initial and follow-up visits. Reliability was assessed with Cronbach α and responsiveness with standardized response means and effect sizes. Scores for each PODCI scale were compared with established age-matched normative scores and among injury types, injury locations, sexes, age groups, and visits using t tests. Changes in clinic wait times, visit lengths, and patient satisfaction were assessed as measures of feasibility through t tests and Fisher exact tests. The influence of PODCI administration on patient wait times, total visit lengths, and satisfaction was measured through t tests and Fisher exact tests.

RESULTS: During this study, 125 patients with acute hand and wrist injuries completed PODCI questionnaires at initial presentation. Follow-up questionnaires were collected at a median of 3 weeks later from 22 patients. All PODCI scales demonstrated internal reliability and responsiveness to clinical change in this sample. At the initial visit, mean scores for all PODCI scales, except happiness, were significantly lower than established age-matched normative values. Adolescents had worse pain and global function than young children. Children significantly improved in mobility, comfort, and global function from initial visit to follow-up. At follow-up, young children were similar to norms on all scales except global function, whereas adolescents were only similar to norms on pain. PODCI administration did not influence patient wait times, total visit lengths, or satisfaction.

CONCLUSIONS: Patient-reported outcomes can be systematically assessed in children and adolescents with acute hand and wrist injuries. The PODCI is reliable, responsive to changes over time, and able to discriminate between populations. The PODCI has potential to be an effective clinical and research tool for assessing and improving patient outcomes.


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