title: Pediatric post-thrombotic syndrome in children: Toward the development of a new diagnostic and evaluative measurement tool.
abstract: OBJECTIVE
  Our goal was to conduct the item generation and piloting phases of a new discriminative and evaluative tool for pediatric post-thrombotic syndrome.
  
  
  METHODS
  We followed a formative model for the development of the tool, focusing on the signs/symptoms (items) that define post-thrombotic syndrome. For item generation, pediatric thrombosis experts and subjects diagnosed with extremity post-thrombotic syndrome during childhood nominated items. In the piloting phase, items were cross-sectionally measured in children with limb deep vein thrombosis to examine item performance.
  
  
  RESULTS
  Twenty-three experts and 16 subjects listed 34 items, which were then measured in 140 subjects with previous diagnosis of limb deep vein thrombosis (70 upper extremity and 70 lower extremity). The items with strongest correlation with post-thrombotic syndrome severity and largest area under the curve were pain (in older children), paresthesia, and swollen limb for the upper extremity group, and pain (in older children), tired limb, heaviness, tightness and paresthesia for the lower extremity group.
  
  
  CONCLUSIONS
  The diagnostic properties of the items and their correlations with post-thrombotic syndrome severity varied according to the assessed venous territory. The information gathered in this study will help experts decide which item should be considered for inclusion in the new tool.
authors.affiliation: Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: M L
authors.initials: ML
authors.lastname: Avila
authors.affiliation: Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada. Electronic address: leonardo.brandao@sickkids.ca.
authors.forename: L R
authors.initials: LR
authors.lastname: Brandão
authors.affiliation: Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Williams
authors.affiliation: School of Chemistry and Molecular Biosciences, The University of Queensland, St. Lucia, Brisbane, Australia.
authors.forename: L C
authors.initials: LC
authors.lastname: Ward
authors.affiliation: Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: M I
authors.initials: MI
authors.lastname: Montoya
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Stinson
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Department of Research Design and Biostatistics, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Kiss
authors.affiliation: Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: I
authors.initials: I
authors.lastname: Lara-Corrales
authors.affiliation: Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Child Health Evaluative Sciences, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: B M
authors.initials: BM
authors.lastname: Feldman
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply* / Q000473:pathology; D008297:Male; D054070:Postthrombotic Syndrome / Q000175:diagnosis* / Q000209:etiology; D034941:Upper Extremity / Q000098:blood supply* / Q000473:pathology; D020246:Venous Thrombosis / Q000150:complications
keywords: Child; Deep vein thrombosis; Lower extremity; Sign; Symptom; Upper extremity