CT angiography is feasible in children and can be used to delineate abnormal great vessel anatomy.
Background/ObjectivesMeasures of pruritus severity and quality of life (QoL) are necessary for the development of therapeutics for children with chronic pruritus. In children, questionnaires need to be developed for specific age groups given the differences in cognitive levels. In this study, we aimed to develop tools to assess QoL and pruritus severity in children 6 to 7‐years‐old with chronic pruritus.MethodsBased on open interviews with children, we developed a cartoon‐annotated QoL instrument, KidsItchyQoL, and validated an existing pruritus severity instrument, ItchyQuant, that measures pruritus impact and severity for the preceding week. Both instruments were administered to 100 children aged 6‐7 years with chronic pruritus. The data were analyzed for reliability, reproducibility, construct validity, and responsiveness.ResultsWe found the 14‐item KidsItchyQoL to be reliable (Cronbach's α = 0.846) and reproducible (intraclass correlation coefficient (ICC) = 0.66) as was the ItchyQuant (ICC = 0.47). With respect to construct validity, examination of eigenvalues of the inter‐item polychoric correlation matrix suggested three dominant factors. A subsequent confirmatory factor analysis suggested that a 3‐dimensional simple structure model with correlated factors provided a reasonable data representation. The responsiveness of KidsItchyQoL and ItchyQuant (P = .005, GLM procedure) were demonstrated with scores changing as expected with the self‐reported change of itch severity.ConclusionsThese results demonstrate promise for a new set of reliable research tools to assess QoL and pruritus severity in children 6 to 7 years of age.
Background/Objectives Validated pruritus‐specific quality of life and self‐reported severity instruments exist primarily for adults. Clinical trials to develop therapeutics for children with chronic pruritus are hampered by the paucity of appropriate outcome measures. To address this gap, we aimed to develop validated instruments to measure itch‐specific quality of life and self‐reported severity in children. Methods We conducted in‐depth, open‐ended interviews of itchy children and generated concepts to develop TweenItchyQoL. We administered TweenItchyQoL, ItchyQuant, a cartoon‐annotated self‐reported pruritus severity numeric rating scale (NRS), and a non‐cartoon NRS to 175 itchy children aged 8‐17 years. We analyzed the data for feasibility, preference, reliability, construct validity, and responsiveness. Results Average completion time was 4.8 minutes for TweenItchyQoL and 33 seconds for ItchyQuant. The majority of patients either preferred ItchyQuant or found no difference between ItchyQuant and the NRS. Cronbach's alpha for TweenItchyQoL total and subscales ranged from 0.84 to 0.95. Test‐retest reliability coefficients were ≥0.7 for TweenItchyQoL and 0.4 for ItchyQuant. A 3‐dimensional bifactor model was most appropriate (RMSEA = 0.048) on the confirmatory factor analyses. As a function of those reporting worsening, improvement, or no change at their final visit, TweenItchyQoL and ItchyQuant scores in those cohorts changed as expected. Conclusions This new set of validated and feasible instruments shows promise to quantify itch severity and QoL impact in older children.
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