Parent-Child Agreement on Postconcussion Symptoms in the Acute Postinjury Period
| Autor: | Christopher G. Vaughan, Elizabeth F. Teel, Gerard A. Gioia, Mary Aglipay, Maegan D. Sady, Isabelle Gagnon, Roger Zemek, Nick Barrowman |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Parents medicine.medical_specialty Time Factors Adolescent Intraclass correlation Poison control Clinical prediction rule Logistic regression Severity of Illness Index Diagnostic Self Evaluation 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Severity of illness Humans Medicine Child Retrospective Studies Receiver operating characteristic Post-Concussion Syndrome business.industry Area under the curve Confidence interval Child Preschool Pediatrics Perinatology and Child Health Physical therapy Female Symptom Assessment business |
| Zdroj: | Pediatrics. 146 |
| ISSN: | 1098-4275 0031-4005 |
| DOI: | 10.1542/peds.2019-2317 |
| Popis: | OBJECTIVES: To evaluate parent-child agreement on postconcussion symptom severity within 48 hours of injury and examine the comparative predictive power of a clinical prediction rule when using parent or child symptom reporting. METHODS: Both patients and parents quantified preinjury and current symptoms using the Postconcussion Symptom Inventory (PCSI) in the pediatric emergency department. Two-way mixed, absolute measure intraclass correlation coefficients were calculated to evaluate the agreement between patient and parent reports. A multiple logistic regression was run with 9 items to determine the predictive power of the Predicting and Preventing Postconcussive Problems in Pediatrics clinical prediction rule when using the child-reported PCSI. Delong’s receiver operating characteristic curve analysis was used to compare the area under the curve (AUC) for the child-report models versus previously published parent-report models. RESULTS: Overall parent-child agreement for the total PCSI score was fair (intraclass correlation coefficient = 0.66). Parent-child agreement was greater for (1) postinjury (versus preinjury) ratings, (2) physical (versus emotional) symptoms, and (3) older (versus younger) children. Applying the clinical prediction rule by using the child-reported PCSI maintained similar predictive power to parent-reported PCSI (child AUC = 0.70 [95% confidence interval: 0.67–0.72]; parent AUC = 0.71 [95% confidence interval: 0.68–0.74]; P = .23). CONCLUSIONS: Overall parent-child agreement on postconcussion symptoms is fair but varies according to several factors. The findings for physical symptoms and the clinical prediction rule have high agreement; information in these domains are likely to be similar regardless of whether they are provided by either the parent or child. Younger children and emotional symptoms show poorer agreement; interviewing both the child and the parent would provide more comprehensive information in these instances. |
| Databáze: | OpenAIRE |
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