Expert consensus on the development of a health-related questionnaire for the pediatric field of Korean medicine: a Delphi study

Jihong Lee, Sun Haeng Lee, Gyu Tae Chang, Jihong Lee, Sun Haeng Lee, Gyu Tae Chang

Abstract

Background: Although a variety of patient-reported outcome measures (PROMs) for children have been developed, there is no pediatric PROM specific to Korean medicine (KM) that is validated by experts in the field. The aim of this study was to collate the opinions of specialists in KM pediatrics on the development of a generic PROM that can be used by Korean medical doctors to assess the health status of children.

Methods: A three-round Delphi survey was conducted to determine the level of consensus on the development of a new PROM. Delphi questionnaires were sent by e-mail to 91 KM pediatricians on January 24, 2018. The Delphi questionnaire was composed of four sections: conceptualization, construction, items, and sources of content for a PROM. A nine-point Likert scale was used, and if more than two-thirds of the panels agreed or disagreed with a given sentence, they were considered to have reached a consensus. A draft of a PROM for the pediatric field of KM was developed in accordance with the preliminary conceptual framework.

Results: Out of 91 experts, 18 finished three rounds of the Delphi survey. The experts reached a consensus on the necessity of a KM pediatric PROM for measuring various areas including child health, and using Likert scales with a recall period of 3 months. They also agreed on specific items and sources of content. A new draft of a health questionnaire for KM pediatrics was developed based on the Delphi consensus. It contains 44 items covering 7 domains: i) functions of the digestive system, ii) functions of the respiratory system, iii) mental functions, iv) skin functions, v) pain, vi) functions of the metabolic and endocrine systems, and vii) demographic details.

Conclusions: This research represents the first step in developing a health questionnaire for the pediatric field of KM. The questionnaire can be used in clinical and research settings after verifying several types of validity and reliability.

Keywords: Child health; Children; Consensus; Delphi study; Korean medicine; Patient health questionnaire; Patient-reported outcome measure; Pediatrics; Questionnaire development.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow of participation of the three-round Delphi procedure
Fig. 2
Fig. 2
Preliminary conceptual framework for the KM pediatric questionnaire

References

    1. Cha WS, Oh JH, Park HJ, Ahn SW, Hong SY, Kim NI. Historical difference between traditional Korean medicine and traditional Chinese medicine. Neurol Res. 2007;29(Suppl 1):S5–S9. doi: 10.1179/016164107X172293.
    1. Shin Y, Shin JS, Lee J, Lee YJ, Kim M, Ahn Y, Park KB, Shin BC, Lee MS, Kim JH, Cho JH, Ha IHA. Survey among Korea medicine doctors (KMDs) in Korea on patterns of integrative Korean medicine practice for lumbar intervertebral disc displacement: preliminary research for clinical practice guidelines. BMC Complement Altern Med. 2015;15:432. doi: 10.1186/s12906-015-0956-1.
    1. 2016 Yearbook of Traditional Korean Medicine. Korea institute of oriental medicine, 2018. . Accessed 6 Nov 2018.
    1. Park HL, Kee HS, Shin BC, Liu JP, Shang Q, Yamashita H, Lim B. Traditional medicine in China, Korea, and Japan: a brief introduction and comparison. Evid Based Complement Alternat Med. 2012;2012:429103. doi: 10.1155/2012/429103.
    1. Kim KB, Kim DG, Kim YH, Kim JH, Min SY, Park EJ, Baek JH, Sung HK, Yu SA, Lee SY, Lee JY, Lee HJ, Chang GT, Jeong MJ, Chai JW, Cheon JH, Han YJ, Han JK. Korean pediatrics & adolescent medicine. Ui Sung Dang: Seoul; 2015.
    1. Choi SH. Korean medicine. Kyobo Book Center, 2016; . Accessed 6 Nov 2018.
    1. Hwang YJ, Kim KB, Min SY, Kim JH. Clinical investigation of survey and test in Korean oriental pediatrics. J Korean Orient Pediatr. 2008;22(1):25–34.
    1. Paeck EK, Park JH, Park JH, Yoon YJ, Jeong SK, Lee HJ, Lim JS, Bahn GH, Moon JS. Influence of taking medicine for a period of time on the liver function and improvement of the development disordered children. Korean J Orient Physiol Pathol. 2006;20(2):494–497.
    1. Bahn GH, Kim CJ, Chung JH, Kim YH, Paik EK, Park JH. A pilot study for developing an assessment scale for the effect of herbal medicine in healthy children: open-label study with Gami-Jiwhangtang. Korean J Orient Med. 2004;25(4):139–146.
    1. Clinical Evaluation Unit, Pediatric Branch of China Association for Traditional Chinese Medicine Guideline on evaluation of new drug of Chinese materia medica for treatment of recurrent respiratory tract infections in children. Drug Eval Res. 2015;38(3):238–243.
    1. Clinical Evaluation Unit, Pediatric Branch of China Association for Traditional Chinese Medicine Guideline on evaluation of Chinese medical research for treatment of anorexia in children. Drug Eval Res. 2015;38(3):244–250.
    1. Clinical Evaluation Unit, Pediatric Branch of China Association for Traditional Chinese Medicine Guideline on evaluation of Chinese medical research for treatment of eczema in children. Drug Eval Res. 2015;38(6):596–602.
    1. US department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research Center, Center for Devices and Radiological Health. Guidance for industry: Patient-reported outcome measures: use in medical product development to support labeling claims, 2009.
    1. Matza LS, Patrick DL, Riley AW, Alexander JJ, Rajmil L, Pleil AM, Bullinger M. Pediatric patient-reported outcome instruments for research to support medical product labeling: report of the ISPOR PRO good research practices for the assessment of children and adolescents task force. Value Health. 2013;16(4):461–479. doi: 10.1016/j.jval.2013.04.004.
    1. Chang PC, Yeh CH. Agreement between child self-report and parent proxy-report to evaluate quality of life in children with cancer. Psycho-oncology. 2005;14(2):125–134. doi: 10.1002/pon.828.
    1. Varni JW, Limbers CA, Burwinkle TM. Parent proxy-report of their children's health-related quality of life: an analysis of 13,878 parents' reliability and validity across age subgroups using the PedsQL™ 4.0 Generic Core Scales. Health Qual Life Outcomes. 2007;5:2. doi: 10.1186/1477-7525-5-2.
    1. Janssens A, Thompson Coon J, Rogers M, Allen K, Green C, Jenkinson C, Tennant A, Logan S, Morris C. A systematic review of generic multidimensional patient-reported outcome measures for children, part I: descriptive characteristics. Value Health. 2015;18(2):315–333. doi: 10.1016/j.jval.2014.12.006.
    1. Klassen AF, Landgraf JM, Lee SK, Barer M, Raina P, Chan HW, Matthew D, Brabyn D. Health related quality of life in 3 and 4 year old children and their parents: preliminary findings about a new questionnaire. Health Qual Life Outcomes. 2003;1:81. doi: 10.1186/1477-7525-1-81.
    1. Varni JW, Limbers CA, Neighbors K, Schulz K, Lieu JE, Heffer RW, Tuzinkiewicz K, Mangione-Smith R, Zimmerman JJ, Alonso EM. The PedsQL™ infant scales: feasibility, internal consistency reliability, and validity in healthy and ill infants. Qual Life Res. 2011;20(1):45–55. doi: 10.1007/s11136-010-9730-5.
    1. Landgraf JM, Vogel I, Oostenbrink R, van Baar ME, Raat H. Parent-reported health outcomes in infants/toddlers: measurement properties and clinical validity of the ITQOL-SF47. Qual Life Res. 2013;22(3):635–646. doi: 10.1007/s11136-012-0177-8.
    1. Spencer NJ, Coe C. Validation of the Warwick child health and morbidity profile in routine child health surveillance. Child Care Health Dev. 2000;26(4):323–336. doi: 10.1046/j.1365-2214.2000.00148.x.
    1. Landgraf JM, Maunsell E, Speechley KN, Bullinger M, Campbell S, Abetz L, Ware JE. Canadian-French, German and UK versions of the child health questionnaire: methodology and preliminary item scaling results. Qual Life Res. 1998;7:433–445. doi: 10.1023/A:1008810004694.
    1. Bunge EM, Essink-Bot ML, Kobussen MP, Suijlekom-Smit LW, Moll HA, Raat H. Reliability and validity of health status measurement by the TAPQOL. Arch Dis Child. 2005;90(4):351–358. doi: 10.1136/adc.2003.048645.
    1. Saigal S, Rosenbaum P, Stoskopf B, Hoult L, Furlong W, Feendy D, Hagan R. Development, reliability and validity of a new measure of overall health for pre-school children. Qual Life Res. 2005;14:243–257. doi: 10.1007/s11136-004-4228-7.
    1. Lee S, Kim A, Jang H, Jeong M. Study on weak children information collection using personal health record (PHR) J Pediatr Korean Med. 2017;31(3):46–63.
    1. Gok SY, Lyu SA, Lee SY. The correlation study between interference test with the weak children symptoms. J Korean Orient Pediatr. 2009;23(3):71–88.
    1. Kim MJ, Lee SH, Lee JY. A study on sleep habits of weak children groups. J Korean Orient Pediatr. 2015;29(4):01–11. doi: 10.7778/jpkm.2015.29.4.001.
    1. Jung SK, Yu SA, Lee SY. The correlation study between developmental disability and weak symptoms. J Korean Orient Pediatr. 2012;26(2):25–34. doi: 10.7778/jpkm.2012.26.2.025.
    1. Lee HL, Han JK, Kim YH. The characters of autonomic nervous system in heart weak children through analysis of heart rate variability. J Pediatr Korean Med. 2013;27(3):01–11. doi: 10.7778/jpkm.2013.27.3.001.
    1. Son MJ, Han JK, Kim YH. Oriental medical research about school life maladjustment by study of the weak children symptoms. J Korean Orient Pediatr. 2009;23(3):55–69.
    1. Hasson Felicity, Keeney Sinead, McKenna Hugh. Research guidelines for the Delphi survey technique. Journal of Advanced Nursing. 2000;32(4):1008–1015.
    1. Jones J, Hunter D. Consensus methods for medical and health services research. BMJ. 1995;311:376–380. doi: 10.1136/bmj.311.7001.376.
    1. Veziari Y, Kumar S, Leach M. The development of a survey instrument to measure the barriers to the conduct and application of research in complementary and alternative medicine: a Delphi study. BMC Complement Altern Med. 2018;18(1):335. doi: 10.1186/s12906-018-2352-0.
    1. Keeney S, Hasson F, Mckenna H. Consulting the oracle: ten lessons from using the Delphi technique in nursing research. J Adv Nurs. 2006;53(2):205–212. doi: 10.1111/j.1365-2648.2006.03716.x.
    1. J. Skulmoski Gregory, T. Hartman Francis, Krahn Jennifer. The Delphi Method for Graduate Research. Journal of Information Technology Education: Research. 2007;6:001–021. doi: 10.28945/199.
    1. Giannarou L, Zervas E. Using Delphi technique to build consensus in practice. Int J Bus Sci Appl Manag. 2014;9:65–82.
    1. Herdman M, Rajmil L, Ravens-Sieberer U, Bullinger M, Power M, Alonso J, the European Kidscreen and Disabkids groups Expert consensus in the development of a European health-related quality of life measure for children and adolescents: A Delphi study. Acta paediatr. 2002;91:1385–1390. doi: 10.1111/j.1651-2227.2002.tb02838.x.
    1. Toupin April K, Stinson J, Boon H, Duffy CM, Huber AM, Gibbon M, Descarreaux M, Spiegel L, Vohra S, Tugwell P. 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. PLoS One. 2016;11(3):e0149809. doi: 10.1371/journal.pone.0149809.
    1. World Health Organization. International classification of functioning, disability and health : children & youth version : ICF-CY. 2007; . Accessed 10 Nov 2018.
    1. Hsu C, Sandford BA. The Delphi technique: making sense of consensus. Pract Assess. 2007;12(Suppl 10):1–8.
    1. Powell Catherine. The Delphi technique: myths and realities. Journal of Advanced Nursing. 2003;41(4):376–382. doi: 10.1046/j.1365-2648.2003.02537.x.
    1. Ludwig B. Predicting the future: have you considered using the Delphi methodology? J Ext. 1997;35:1–4.
    1. Boulkedid Rym, Abdoul Hendy, Loustau Marine, Sibony Olivier, Alberti Corinne. Using and Reporting the Delphi Method for Selecting Healthcare Quality Indicators: A Systematic Review. PLoS ONE. 2011;6(6):e20476. doi: 10.1371/journal.pone.0020476.
    1. Fitch K, Bernstein S, Aguilar M, Burnand B, LaCalle J, et al. The RAND/UCLA Appropriateness Method User’s Manual. . Accessed 6 Nov 2018.
    1. Kim SY, Choi MY, Shin SS, Ji SM, Park JJ, Yoo JH, Lyu DH, Park SH. Handbook for Clinical Practice Guideline Developer. National Evidence-based Healthcare Collaborating Agency. 2015. = Accessed 6 Nov 2018.
    1. Fekkes M, Theunissen NCM, Brugman E. Development and psychometric evaluation of the TAPQOL: a health-related quality of life instrument for 1-5-year-old children. Qual Life Res. 2000;9:961–972. doi: 10.1023/A:1008981603178.
    1. Ahn HS, Shin HY. Hong chang yee Pediatrics 11th ed. Mirae N;Seoul:2016.
    1. Lee EJ, Lee BR, Lee JH, Chang GT. A study on the recent trend of chief complaint of Korean pediatric and adolescent outpatients. J Pediatr Korean Med. 2016;30(1):45–58. doi: 10.7778/jpkm.2016.30.1.045.
    1. Choi MH, Kin DG, Lee JY. A study on the chief complaint of pediatric outpatients in the Kyung Hee oriental medicine hospital. J Pediatr Korean Med. 2010;24(3):121–137.
    1. Choi EY, Chang GT, Kim JH. A study of the chief complaint of pediatric outpatients in the oriental hospital. J Korean Orient Pediatr. 2005;19(2):197–213.
    1. You TS, Kim YS, Bae JH, Kim DG. Literature review of the weak children. J Korean Orient Pediatr. 1990;4(1):67–78.
    1. Pediatrics of Kampo medicine. Pediatrics of Kampo medicine. Pediatr Intern Med. 1984;1984:1.
    1. Irwin DE, Varni JW, Yeatts K, DeWalt DA. Cognitive interviewing methodology in the development of a pediatric item bank: a patient reported outcomes measurement information system (PROMIS) study. Health Qual Life Outcomes. 2009;7:3. doi: 10.1186/1477-7525-7-3.

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