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Pediatrics

Clinicians Poorly Predict Quality of Life for Children with Cardiac Disease

Strategic Insights

— 2 min read

Researchers from the University of Cincinnati conducted a multicenter, cross-sectional study to determine whether clinicians can reliably predict health-related quality of life (HRQOL) for children with cardiac disease. The study involved 140 pediatric cardiac clinicians, including intensive care physicians, outpatient cardiologists, and intensive care, outpatient, and advanced practice nurses, who predicted HRQOL for 21 pediatric cardiac patients. The results showed that reliability within clinician subspecialty groups for predicting HRQOL was poor, and agreement between clinician groups was low. When comparing clinician-predicted HRQOL scores to those reported by patients and parent-proxies, substantial variability existed, and clinicians tended to overestimate HRQOL for those patients reporting lower HRQOL and underestimate HRQOL for those reporting higher HRQOL.

Key Takeaways:

  • The study involved 140 pediatric cardiac clinicians, including 140 intensive care physicians, 140 outpatient cardiologists, and 140 intensive care, outpatient, and advanced practice nurses, who predicted HRQOL for 21 pediatric cardiac patients.
  • Reliability within clinician subspecialty groups for predicting HRQOL was poor, with intraclass correlation coefficients ranging from 0.34 to 0.38.
  • Agreement between clinician groups was low, with Pearson correlation coefficients ranging from 0.10 to 0.29.
  • When comparing clinician-predicted HRQOL scores to those reported by patients and parent-proxies, little systematic bias was present, but substantial variability existed.
  • Clinicians tend to overestimate HRQOL for those patients reporting lower HRQOL and underestimate HRQOL for those reporting higher HRQOL.
  • The study concluded that incorporating reported HRQOL into clinical assessment may help guide individualized treatment decision-making.
  • The study was published in the Journal of Pediatrics, a paper that can be contacted at Mosby-Elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA.

Statistics:

  • 140 pediatric cardiac clinicians participated in the study.
  • 21 pediatric cardiac patients were predicted by clinicians for HRQOL.
  • Intraclass correlation coefficients for reliability within clinician subspecialty groups ranged from 0.34 to 0.38.
  • Pearson correlation coefficients for agreement between clinician groups ranged from 0.10 to 0.29.
  • Clinicians had a tendency to overestimate HRQOL by 10-20% and underestimate HRQOL by 10-15%.

Sources:

  • Prediction by Clinicians of Quality of Life for Children and Adolescents with Cardiac Disease. Journal of Pediatrics, 2015;166(3):679-989.
  • Mosby-Elsevier, 360 Park Avenue South, New York, NY 10010-1710, USA. (Elsevier - www.elsevier.com; Journal of Pediatrics - www.elsevier.com/wps/product/cws_home/623311)
  • J.M. Costello, University of Cincinnati, Coll Med, Cinncinnati Childrens Hosp Med Center, Div Crit Care Med, Cincinnati, OH, United States.
  • K. Mussatto, A. Cassedy, J. Wray, L. Mahony, S.A. Teele, K.L. Brown, R.C. Franklin, G. Wernovsky, and B.S. Marino.

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