Skip to main content

Advertisement

SpringerLink
Log in

Implementation of the Kids-CAT in clinical settings: a newly developed computer-adaptive test to facilitate the assessment of patient-reported outcomes of children and adolescents in clinical practice in Germany

  • Special Section: PROs in Non-Standard Settings (by invitation only)
  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

To describe the implementation process of a computer-adaptive test (CAT) for measuring health-related quality of life (HRQoL) of children and adolescents in two pediatric clinics in Germany. The study focuses on the feasibility and user experience with the Kids-CAT, particularly the patients’ experience with the tool and the pediatricians’ experience with the Kids-CAT Report.

Methods

The Kids-CAT was completed by 312 children and adolescents with asthma, diabetes or rheumatoid arthritis. The test was applied during four clinical visits over a 1-year period. A feedback report with the test results was made available to the pediatricians. To assess both feasibility and acceptability, a multimethod research design was used. To assess the patients’ experience with the tool, the children and adolescents completed a questionnaire. To assess the clinicians’ experience, two focus groups were conducted with eight pediatricians.

Results

The children and adolescents indicated that the Kids-CAT was easy to complete. All pediatricians reported that the Kids-CAT was straightforward and easy to understand and integrate into clinical practice; they also expressed that routine implementation of the tool would be desirable and that the report was a valuable source of information, facilitating the assessment of self-reported HRQoL of their patients.

Conclusions

The Kids-CAT was considered an efficient and valuable tool for assessing HRQoL in children and adolescents. The Kids-CAT Report promises to be a useful adjunct to standard clinical care with the potential to improve patient–physician communication, enabling pediatricians to evaluate and monitor their young patients’ self-reported HRQoL.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bullinger, M., & Hasford, J. (1991). Evaluating quality-of-life measures for clinical trials in Germany. Controlled Clinical Trials, 12(4 Suppl), 91s–105s.

    Article  CAS  PubMed  Google Scholar 

  2. Saxena, S., Orley, J., on behalf of the WHOQOL Group. (1997). Quality of life assessment: The World Health Organization perspective. Eur Psychiatry, 12(3 Suppl), 263s–266s.

    Article  PubMed  Google Scholar 

  3. Ravens-Sieberer, U. (2000). Verfahren zur Erfassung der gesundheitsbezogenen Lebensqualität bei Kindern und Jugendlichen Ein Überblick. Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz, 43(3), 198–209. doi:10.1007/s001030050035.

    Article  Google Scholar 

  4. Osoba, D. (2007). Translating the science of patient-reported outcomes assessment into clinical practice. JNCI Monographs, 2007(37), 5–11.

    Article  Google Scholar 

  5. Snyder, C. F., Aaronson, N. K., Choucair, A. K., Elliott, T. E., Greenhalgh, J., Halyard, M. Y., et al. (2012). Implementing patient-reported outcomes assessment in clinical practice: A review of the options and considerations. Quality of Life Research, 21(8), 1305–1314. doi:10.1007/s11136-011-0054-x.

    Article  PubMed  Google Scholar 

  6. Haverman, L., Engelen, V., van Rossum, M. A., Heymans, H. S., & Grootenhuis, M. A. (2011). Monitoring health-related quality of life in paediatric practice: Development of an innovative web-based application. BMC Pediatrics, 11(1), 3.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Ravens-Sieberer, U., Gosch, A., Abel, T., Auquier, P., Bellach, B. M., Bruil, J., et al. (2001). Quality of life in children and adolescents: A European public health perspective. Sozial-und Präventivmedizin, 46(5), 294–302.

    Article  CAS  PubMed  Google Scholar 

  8. Detmar, S. B., Muller, M. J., Schornagel, J. H., Wever, L. D., & Aaronson, N. K. (2002). Health-related quality-of-life assessments and patient–physician communication: A randomized controlled trial. JAMA, 288(23), 3027–3034.

    Article  PubMed  Google Scholar 

  9. Engelen, V., Detmar, S., Koopman, H., Maurice-Stam, H., Caron, H., Hoogerbrugge, P., et al. (2012). Reporting health-related quality of life scores to physicians during routine follow-up visits of pediatric oncology patients: Is it effective? Pediatric Blood & Cancer, 58(5), 766–774.

    Article  Google Scholar 

  10. Gutteling, J. J., Busschbach, J. J., de Man, R. A., & Darlington, A. S. (2008). Logistic feasibility of health related quality of life measurement in clinical practice: Results of a prospective study in a large population of chronic liver patients. Health and Quality Life Outcomes, 6, 97. doi:10.1186/1477-7525-6-97.

    Article  Google Scholar 

  11. Clarke, S.-A., & Eiser, C. (2004). The measurement of health-related quality of life (QOL) in paediatric clinical trials: A systematic review. Health and Quality Life Outcomes, 2(1), 66.

    Article  Google Scholar 

  12. Solans, M., Pane, S., Estrada, M. D., Serra-Sutton, V., Berra, S., Herdman, M., et al. (2008). Health-related quality of life measurement in children and adolescents: A systematic review of generic and disease-specific instruments. Value Health, 11(4), 742–764. doi:10.1111/j.1524-4733.2007.00293.x.

    Article  PubMed  Google Scholar 

  13. Varni, J. W., Burwinkle, T. M., & Lane, M. M. (2005). Health-related quality of life measurement in pediatric clinical practice: An appraisal and precept for future research and application. Health and Quality Life Outcomes, 3, 34. doi:10.1186/1477-7525-3-34.

    Article  Google Scholar 

  14. Greenhalgh, J., & Meadows, K. (1999). The effectiveness of the use of patient-based measures of health in routine practice in improving the process and outcomes of patient care: A literature review. Journal of Evaluation in Clinical Practice, 5(4), 401–416.

    Article  CAS  PubMed  Google Scholar 

  15. Valderas, J. M., Kotzeva, A., Espallargues, M., Guyatt, G., Ferrans, C. E., Halyard, M. Y., et al. (2008). The impact of measuring patient-reported outcomes in clinical practice: A systematic review of the literature. Quality of Life Research, 17(2), 179–193. doi:10.1007/s11136-007-9295-0.

    Article  CAS  PubMed  Google Scholar 

  16. Basch, E., & Goldfarb, S. (2009). Electronic patient-reported outcomes for collecting sensitive information from patients. Journal of Supportive Oncology, 7(3), 98–99.

    PubMed  Google Scholar 

  17. Zbrozek, A., Hebert, J., Gogates, G., Thorell, R., Dell, C., Molsen, E., et al. (2013). Validation of electronic systems to collect patient-reported outcome (PRO) data-recommendations for clinical trial teams: Report of the ISPOR ePRO systems validation good research practices task force. Value Health, 16(4), 480–489. doi:10.1016/j.jval.2013.04.002.

    Article  PubMed  Google Scholar 

  18. Rose, M., & Bezjak, A. (2009). Logistics of collecting patient-reported outcomes (PROs) in clinical practice: An overview and practical examples. Quality of Life Research, 18(1), 125–136. doi:10.1007/s11136-008-9436-0.

    Article  PubMed  Google Scholar 

  19. Schick-Makaroff, K., & Molzahn, A. (2015). Strategies to use tablet computers for collection of electronic patient-reported outcomes. Health and Quality of Life Outcomes, 13(1), 2. doi:10.1186/s12955-014-0205-1.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Snyder, C. F., & Aaronson, N. K. (2009). Use of patient-reported outcomes in clinical practice. The Lancet, 374(9687), 369–370.

    Article  Google Scholar 

  21. Velikova, G., Booth, L., Smith, A. B., Brown, P. M., Lynch, P., Brown, J. M., et al. (2004). Measuring quality of life in routine oncology practice improves communication and patient well-being: A randomized controlled trial. Journal of Clinical Oncology, 22(4), 714–724. doi:10.1200/jco.2004.06.078.

    Article  PubMed  Google Scholar 

  22. Bennett, A. V., Jensen, R. E., & Basch, E. (2012). Electronic patient-reported outcome systems in oncology clinical practice. CA: A Cancer Journal for Clinicians, 62(5), 337–347. doi:10.3322/caac.21150.

    Google Scholar 

  23. Espallargues, M., Valderas, J. M., & Alonso, J. (2000). Provision of feedback on perceived health status to health care professionals: A systematic review of its impact. Medical Care, 38(2), 175–186.

    Article  CAS  PubMed  Google Scholar 

  24. Embretson, S. E. R., & Steven, P. (2000). Item response theory for psychologists. London: Lawrence Erlbaum Associates.

    Google Scholar 

  25. Cella, D., Gershon, R., Lai, J. S., & Choi, S. (2007). The future of outcomes measurement: Item banking, tailored short-forms, and computerized adaptive assessment. Quality of Life Research, 16(Suppl 1), 133–141. doi:10.1007/s11136-007-9204-6.

    Article  PubMed  Google Scholar 

  26. Gibbons, R. D., Weiss, D. J., Kupfer, D. J., Frank, E., Fagiolini, A., Grochocinski, V. J., et al. (2008). Using computerized adaptive testing to reduce the burden of mental health assessment. Psychiatric Services, 59(4), 361–368. doi:10.1176/appi.ps.59.4.361.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Ravens-Sieberer, U., Gosch, A., Rajmil, L., Erhart, M., Bruil, J., Duer, W., et al. (2005). KIDSCREEN-52 quality-of-life measure for children and adolescents. Expert Review of Pharmacoeconomics & Outcomes Research, 5(3), 353–364. doi:10.1586/14737167.5.3.353.

    Article  Google Scholar 

  28. Bullinger, M., Schmidt, S., Petersen, C., & Disabkids Group. (2002). Assessing quality of life of children with chronic health conditions and disabilities: A European approach. International Journal of Rehabilitation Research, 25(3), 197–206. doi:10.1097/00004356-200209000-00005.

    Article  PubMed  Google Scholar 

  29. Devine, J., Otto, C., Rose, M., Barthel, D., Fischer, F., Mulhan, H., et al. (2015). A new computerized adaptive test advancing the measurement of health-related quality of life (HRQoL) in children: The Kids-CAT. Quality of Life Research, 24(4), 871–884. doi:10.1007/s11136-014-0812-7.

    Article  CAS  PubMed  Google Scholar 

  30. Mayring, P. (2010). Qualitative Inhaltsanalyse: Grundlagen und Techniken (11th ed.). Weinheim: Beltz Verlag.

    Google Scholar 

  31. Geerdink, L. M., Prince, F. H., Looman, C. W., & van Suijlekom-Smit, L. W. (2009). Development of a digital Childhood Health Assessment Questionnaire for systematic monitoring of disease activity in daily practice. Rheumatology (Oxford), 48(8), 958–963. doi:10.1093/rheumatology/kep135.

    Article  Google Scholar 

  32. van Bragt, S., van den Bemt, L., Thoonen, B., Jacobs, J., Merkus, P., & Schermer, T. (2014). Validity, reliability and discriminative capacity of an electronic quality of life instrument (Pelican) for childhood asthma in The Netherlands. Quality of Life Research, 23(3), 927–938. doi:10.1007/s11136-013-0533-3.

    Article  PubMed  Google Scholar 

  33. Street, R. L, Jr, Makoul, G., Arora, N. K., & Epstein, R. M. (2009). How does communication heal? Pathways linking clinician-patient communication to health outcomes. Patient Education and Counseling, 74(3), 295–301. doi:10.1016/j.pec.2008.11.015.

    Article  PubMed  Google Scholar 

  34. Higginson, I. J., & Carr, A. J. (2001). Measuring quality of life: Using quality of life measures in the clinical setting. BMJ, 322(7297), 1297–1300.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  35. Sneeuw, K. C., Sprangers, M. A., & Aaronson, N. K. (2002). The role of health care providers and significant others in evaluating the quality of life of patients with chronic disease. Journal of Clinical Epidemiology, 55(11), 1130–1143.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank all children, adolescents and pediatricians who participated in the Kids-CAT study or attended the focus groups. Furthermore, we thank Birgit Möller for her contribution to the Kids-CAT project. We thank the Federal Ministry of Education and Research for funding this research project.

The Kids-CAT Study Group comprises: A. Bünte (Department of General Pediatrics, University Medical Center Schleswig–Holstein, Arnold-Heller-Straße 3, House 9, 24105 Kiel, Germany), J. Devine (Research Unit Child Public Health, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany), F. Fischer (Department of Psychosomatic Medicine, Center of Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany), K. Gulau (Research Unit Child Public Health, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany), A. Knaak (Hospital for Pediatrics and Adolescent Medicine, University Medical Center Schleswig–Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany), A. Mierke (Department of Psychosomatic Medicine, Center of Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany), S. Schmidt (Department Health & Prevention, Ernst-Moritz-Arndt University; Robert-Blum-Str. 13, 17487 Greifswald, Germany) and S. v. Sengbusch (Hospital for Pediatrics and Adolescent Medicine, University Medical Center Schleswig–Holstein, Ratzeburger Allee 160, 23538 Lübeck, Germany).

Funding

This study was funded by the German Federal Ministry of Education and Research (Grant Number 0010-01GY1111).

Author information

Authors and Affiliations

  1. Research Unit Child Public Health, Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany

    D. Barthel, C. Otto, A. -K. Meyrose, S. Reisinger, M. Dabs & U. Ravens-Sieberer

  2. Department of Psychosomatic Medicine, Center of Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany

    K. I. Fischer, S. Nolte, O. Walter & M. Rose

  3. Hospital for Pediatrics and Adolescent Medicine, University Medical Center Schleswig–Holstein, Ratzeburger Allee 160, 23538, Lübeck, Germany

    U. Thyen

  4. Department of General Pediatrics, University Medical Center Schleswig–Holstein, Arnold-Heller-Straße 3, House 9, 24105, Kiel, Germany

    M. Klein & T. Ankermann

  5. Department Health and Prevention, Ernst-Moritz-Arndt University, Robert-Blum-Str. 13, 17487, Greifswald, Germany

    H. Muehlan

  6. Public Health Innovation, Population Health Strategic Research Centre, School of Health and Social Development, Deakin University, Burwood, VIC, 3125, Australia

    S. Nolte

  7. Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA

    M. Rose

Authors
  1. D. Barthel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. I. Fischer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. Nolte
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Otto
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. -K. Meyrose
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. S. Reisinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M. Dabs
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. U. Thyen
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. M. Klein
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. H. Muehlan
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. T. Ankermann
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. O. Walter
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. M. Rose
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. U. Ravens-Sieberer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D. Barthel.

Ethics declarations

Conflict of interest

D Barthel, K. I. Fischer, S. Nolte, C. Otto, A.-K. Meyrose, S. Reisinger, M. Dabs, U. Thyen, M. Klein, H. Muehlan, T. Ankermann, O. Walter, M. Rose, A. Bünte, J. Devine, F. Fischer, K. Gulau, A. Knaak, A. Mierke, S. Schmidt, S. v. Sengbusch and U. Ravens-Sieberer declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

For the Kids-CAT Study Group

D. Barthel and K. Fischer have shared first authorship.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 46 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Barthel, D., Fischer, K.I., Nolte, S. et al. Implementation of the Kids-CAT in clinical settings: a newly developed computer-adaptive test to facilitate the assessment of patient-reported outcomes of children and adolescents in clinical practice in Germany. Qual Life Res 25, 585–594 (2016). https://doi.org/10.1007/s11136-015-1219-9

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-015-1219-9

Keywords

Search

Navigation