title: Minimally Important Differences in Patient or Proxy-Reported Outcome Studies Relevant to Children: A Systematic Review.
abstract: BACKGROUND
  No study has characterized and appraised all anchor-based minimally important differences (MIDs) associated with patient-reported outcome (PRO) instruments in pediatric studies.
  
  
  OBJECTIVE
  To complete a comprehensive systematic survey and appraisal of published anchor-based MIDs associated with PRO instruments used in children.
  
  
  METHODS
  Medline, Embase, and PsycINFO (1989 to February 11, 2015).
  
  
  METHODS
  Studies reporting empirical ascertainment of anchor-based MIDs among PROs used in pediatric care.
  
  
  METHODS
  All pertinent data items related to the characteristics of PRO instruments, anchors, and MIDs.
  
  
  RESULTS
  Of 4179 unique citations, 30 studies (including 32 cohorts) proved eligible and reported on 28 unique PROs (8 generic, 13 disease-specific, 5 symptoms-specific, 2 function-specific), with 9 (32%) classified as patient-reported, 11 (39%) proxy-reported, and 8 (29%) both patient- and proxy-reported. Of the 30 studies, we rated 14 (44%) as providing highly credible estimates of the MID. Most cohorts (n= 20, 62%) recorded patients' direct response to the target PRO and the use of an independent standard of comparison (n= 25, 78%). Most, however, failed to effectively report measurement properties of the anchor (n= 24, 75%).
  
  
  CONCLUSIONS
  We have not yet addressed the measurement properties of instrument to measure credibility; our search was restricted to 3 electronic sources, and we used a single data abstractor.
  
  
  CONCLUSIONS
  Our study found 28 PROs that have been developed for children, with fewer than half providing credible estimates. Clinicians, clinical trialists, systematic reviewers, and guideline developers seeking to effectively summarize and interpret results of studies addressing PROs in child health are likely to find our comprehensive compendium of MIDs of use, both in providing best estimates of MIDs and identifying credible estimates.
authors.affiliation: Systematic Overviews through advancing Research Technology (SORT), Child Health Evaluative Sciences, The Research Institute, and.|Departments of Clinical Epidemiology and Biostatistics and.|Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California.
authors.forename: Shanil
authors.initials: S
authors.lastname: Ebrahim
authors.affiliation: Department of Epidemiology, Harvard University, Cambridge, Massachusetts.
authors.forename: Kelsey
authors.initials: K
authors.lastname: Vercammen
authors.affiliation: Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Arunima
authors.initials: A
authors.lastname: Sivanand
authors.affiliation: Departments of Clinical Epidemiology and Biostatistics and.|Medicine, and Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Gordon H
authors.initials: GH
authors.lastname: Guyatt
authors.affiliation: Departments of Clinical Epidemiology and Biostatistics and.|Evidence-Based Dentistry Unit, Faculty of Dentistry, Universidad de Chile, Independencia, Santiago, Chile.
authors.forename: Alonso
authors.initials: A
authors.lastname: Carrasco-Labra
authors.affiliation: Department of Pediatrics, Santa Maria Hospital, Lisboa, Portugal.
authors.forename: Ricardo M
authors.initials: RM
authors.lastname: Fernandes
authors.affiliation: Department of Anaesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Crawford
authors.affiliation: Nephrology Program, Humber River Regional Hospital, Toronto, Ontario, Canada.|Division of Nephrology, University of Western Ontario, London, Ontario, Canada.|Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; and.
authors.forename: Gihad
authors.initials: G
authors.lastname: Nesrallah
authors.affiliation: Systematic Overviews through advancing Research Technology (SORT), Child Health Evaluative Sciences, The Research Institute, and bradley.johnston@sickkids.ca.|Departments of Clinical Epidemiology and Biostatistics and.|Department of Anaesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.|Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Bradley C
authors.initials: BC
authors.lastname: Johnston
mesh_terms: D035843:Biomedical Research; D006801:Humans; D000071066:Patient Reported Outcome Measures; D010372:Pediatrics; D011594:Psychometrics