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A Pilot Comparison of High- Versus Low-Tech Palatability Assessment Tools in Young Children

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Abstract

Background

Medication refusal in children is largely driven by aversive taste profiles, which in turn influence adherence and therapeutic outcomes. However, there are no standardized methods for evaluating taste in young children. This study compares facial recognition technology with three hedonic visual scales in this population.

Methods

Children, 3–7 years of age, were enrolled with informed parental permission into an institutional review board-approved, double-blind, randomized investigation. Each child received three test articles: prednisone (bitter), simple syrup (sweet), and filtered water (neutral), with an appropriate washout. Facial recognition software (Noldus FaceReader 7) recorded facial expression and intensity for 30–60 s after administration. Participants subsequently rated taste using three hedonic scales (5-point Sjövall and 5- and 3-point TASTY) and responded to simple questions on their perception of the test article. Repeated measures analysis of variance and multiple regression analysis were used to explore associations between palatability measures.

Results

Twelve children (seven males: ten white and two black) completed the study without adverse effects. There were no significant differences in participant characteristics by randomization sequence. The three hedonic scales tracked similarly for each test substance, with correlations between the 5-point scales (r = 0.899) comparable to those between the 3- and 5-point scales (r = 0.860–0.903). Hedonic scales appeared more reliable in assessing taste response than facial recognition, which did not effectively discriminate positive and negative responses.

Conclusions

Our experience suggests that the TASTY scales appear to offer the greatest promise for assessing palatability in future clinical use.

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Acknowledgements

The efforts of Sheila Stroupe, BSN, RN and Dr. Henry Farrar in the Pediatric Clinical Research Unit of the Arkansas Children’s Hospital are gratefully acknowledged.

Author information

Authors and Affiliations

  1. Division of Pediatric Pharmacology, Toxicology and Therapeutic Innovation, Children’s Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA

    Susan M. Abdel-Rahman

  2. University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA

    Susan M. Abdel-Rahman

  3. The Ohio State University, Columbus, OH, USA

    Shasha Bai

  4. Arkansas Children’s Research Institute, Little Rock, AR, USA

    Patricia A. Porter-Gill & Grace A. Goode

  5. University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Grace A. Goode

  6. Texas Christian University and UNTHSC School of Medicine, Fort Worth, TX, USA

    Gregory L. Kearns

Authors
  1. Susan M. Abdel-Rahman
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  2. Shasha Bai
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  3. Patricia A. Porter-Gill
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  4. Grace A. Goode
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  5. Gregory L. Kearns
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Corresponding author

Correspondence to Susan M. Abdel-Rahman.

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Funding

Funded, in part, by the Ross and Mary Whipple Family Distinguished Research Scientist endowed chair held by Dr. Kearns at the time the clinical portion of this study was completed and Grant 16-3800-7001 from the National Endowment for the Arts (Abdel-Rahman PI).

Conflicts of interest/Competing interests

Susan M. Abdel Rahman, Shasha Bai, Patricia A. Porter-Gill, Grace A. Goode, and Gregory L. Kearns declare that they have no conflict of interest.

Ethics approval

The authors affirm that all procedures contributing to this work comply with the ethical standards of the relevant national guidelines on human experimentation and have been approved by the institutional review board at Arkansas Children’s Hospital.

Consent to participate

All patients and parents/caregivers provided written informed permission and assent (as applicable) at the time of enrollment.

Consent for publication

Not applicable.

Availability of data and material

The copyright for the TASTY scale is held by Children’s Mercy Hospital, Kansas City. Contact Dr. Abdel-Rahman, corresponding author, for permission to use this figure.

Code availability

Not Applicable.

Authors' contributions

All authors contributed to the study conception and design. PAP-G, GAG, and GLK contributed to material preparation and data collection. SB and SMAR performed data analyses. The first draft of the manuscript was written by SMAR, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Abdel-Rahman, S.M., Bai, S., Porter-Gill, P.A. et al. A Pilot Comparison of High- Versus Low-Tech Palatability Assessment Tools in Young Children. Pediatr Drugs 23, 95–104 (2021). https://doi.org/10.1007/s40272-020-00430-2

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