Measurement Properties of Questionnaires Assessing Complementary and Alternative Medicine Use in Pediatrics: A Systematic Review

Abstract

Objective Complementary and alternative medicine (CAM) is commonly used by children, but estimates of that use vary widely partly due to the range of questionnaires used to assess CAM use. However, no studies have attempted to appraise measurement properties of these questionnaires. The aim of this systematic review was to critically appraise and summarize measurement properties of questionnaires of CAM use in pediatrics. Study design A search strategy was implemented in major electronic databases in March 2011 and conference websites, scientific journals and experts were consulted. Studies were included if they mentioned a questionnaire assessing the prevalence of CAM use in pediatrics. Members of the team independently rated the methodological quality of the studies (using the COSMIN checklist) and measurement properties of the questionnaires (using the Terwee and Cohen criteria). Results A total of 96 CAM questionnaires were found in 104 publications. The COSMIN checklist showed that no studies reported adequate methodological quality. The Terwee criteria showed that all included CAM questionnaires had indeterminate measurement properties. According to the Cohen score, none were considered to be a well-established assessment, two approached the level of a well-established assessment, seven were promising assessments and the remainder (n = 87) did not reach the score’s minimum standards. Conclusion None of the identified CAM questionnaires have been thoroughly validated. This systematic review highlights the need for proper validation of CAM questionnaires in pediatrics, which may in turn lead to improved research and knowledge translation about CAM in clinical practice.

Improving our understanding of the use of traditional complementary/alternative medicine in children with cancer

“…To the authors' knowledge, we describe the development of the first international survey designed to be adaptable to multiple cultures and ethnicities, and possess measures of validity and reliability in the collection of the use of TCAM among children with cancer. Our focus in designing a survey to assess patients' use and perception of TCAM was motivated by the dearth of validated and standardized instruments for exploring TCAM within a comparative context and systematic reviews of the literature in pediatric oncology that highlighted the lack of valid and reliable instruments to assess patients' use and perception of TCAM …”

Use of alternative–complementary-medicine (CAM) in Calabrian children

“…This may be explained by the relative novelty of studies in this field. In fact is difficult to collect data in a standardized way since not only there is no agreement on the definition of CAM by researchers, but also for the fact that the parent’s perception of the product’s nature used may be confounding [36]. For these reasons, in order to reduce the bias toward the type of CAM, we decided to limit the number of CAM considered in the survey to the CAM reported by FNOMCEO [33].…”

Development and Preliminary Face and Content Validation of the “Which Health Approaches and Treatments Are You Using?” (WHAT) Questionnaires Assessing Complementary and Alternative Medicine Use in Pediatric Rheumatology

“…Contrary to most existing CAM questionnaires, both health care providers and patients were involved in developing and evaluating face and content validity of the present questionnaires [ 10 ]. Using a phased approach consisting of a Delphi survey and consensus conference with key stakeholders will ensure that our questionnaires target key aspects of CAM and are useful to clinicians, researchers and families.…”

“…The e-mail described the study purpose and procedures, and directed participants to a Survey Monkey link. Experts were asked about the importance of developing a CAM questionnaire for use in clinical practice and research, and to provide opinions on the appropriateness of domains that should be included in a pediatric CAM measure based on key domains identified in a systematic review of pediatric CAM questionnaires [ 10 ]. Experts were asked to rate domains using a scale from 1 to 5 where 1 = “not at all important” and 5 = “very important”.…”

“…g ., homeopathy and traditional healers) [ 1 ]. However, the lack of consensus on a definition [ 8 ; 9 ], as well as lack of standardized instruments to assess its use in clinical practice and research [ 10 ], have led to significant variations in its reported use among pediatric populations. In JIA for example, CAM use has been reported to range from 34% to 92% [ 2 – 7 ].…”