Evidence map›Paper›PMID 42800714›Full record

ArticleBMJ paediatrics open2026

Using cognitive interviews with children to test the content validity of a paediatric patient reported experience measure.

Karlen R Barr, Erika Fortunati, Zachary Studniberg, Jessica Nikolovski, Leslie White, Sarah Elliott, Lynn McCartney, Dianna Smith-McCue, Mary Noah, Girish Swaminathan and 13 more

Abstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ paediatrics open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Karlen R BarrAcademic Unit of Infant Child and Adolescent Psychiatry South Western Sydney Local Health District, Sydney, New South Wales, Australia.
Erika FortunatiStarlight Children's Foundation, Naremburn, New South Wales, Australia.
Zachary StudnibergDiscipline of Psychiatry and Mental Health, University of New South Wales School of Clinical Medicine, Sydney, New South Wales, Australia.
Jessica NikolovskiNHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia.
Leslie WhiteUniversity of New South Wales Faculty of Medicine, Sydney, New South Wales, Australia.
Sarah ElliottWomen's Healthcare Australasia and Children's Healthcare Australasia, Mitchell, Australian Capital Territory, Australia.
Lynn McCartneySydney Children's Hospitals Network, Sydney, New South Wales, Australia.
Dianna Smith-McCueWomen's and Children's Health Network, Adelaide, South Australia, Australia.
Mary NoahRoyal Darwin Hospital, Casuarina, Northern Territory, Australia.
Girish SwaminathanAustralian Commission on Safety and Quality in Healthcare, Sydney, New South Wales, Australia.
James R JohnAcademic Unit of Infant Child and Adolescent Psychiatry South Western Sydney Local Health District, Sydney, New South Wales, Australia.
Claire TreadgoldStarlight Children's Foundation, Naremburn, New South Wales, Australia.
Aaron HallPatient Reported Measures Stream, NSW Agency for Clinical Innovation, St Leonards, New South Wales, Australia.
Ann DadichSchool of Business, Western Sydney University, Penrith, New South Wales, Australia.
Barb VernonWomen's Healthcare Australasia and Children's Healthcare Australasia, Mitchell, Australian Capital Territory, Australia.
Elesha ToscanoPatient Safety and Quality Service, Children's Health Queensland, South Brisbane, Queensland, Australia.
Harriet HiscockThe University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia.
Josephine ChowIngham Institute for Applied Medical Research, Liverpool, New South Wales, Australia.
Leanne JohnstonChildren's Health Queensland Hospital and Health Service, Herston, Queensland, Australia.
Lisa WhiteheadSchool of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia.
Mandie FosterSchool of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia.
Valerie SungRoyal Children's Hospital, Murdoch Children's Research Institute The Centre for Community Child Health, Parkville, Victoria, Australia.
Valsamma EapenAcademic Unit of Infant Child and Adolescent Psychiatry South Western Sydney Local Health District, Sydney, New South Wales, Australia v.eapen@unsw.edu.au.ORCID http://orcid.org/0000-0001-6296-8306

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPaediatric patient reported experience measures (pPREMs) can help children's voices be heard to evaluate and improve healthcare delivery. However, no standardised child-completed pPREM has been co-designed with children and validated in Australia. This research aimed to test the content validity of a co-created pPREM using an iterative, participatory approach with children.

methods21 children aged 6-11 years were recruited across four Australian hospitals. Children participated in online cognitive interviews to evaluate pPREM items and rating scales (using 'stars' or 'smiley faces') for their understandability, usability, relevance and importance related to their needs in hospital. Framework analysis was conducted iteratively, with items refined after the first round of interviews based on children's feedback.

resultsMost (n=20; 95%) children understood the instructions. After nine interviews, two items were revised: 'Someone I knew could stay with me' changed to 'Family and friends could be with me' and 'I was able to talk to other patients', to 'I was able to talk to other kids in hospital'. Following these revisions, all children understood most (13 of 18=72%) items. In the remaining five items, some phrases, such as 'Care and treatment', were not easily understood, and items were edited according to children's feedback. Most children (n=14; 67%) preferred the 'smiley faces' rating system, and 83% (n=15) reported the number of questions as the right amount. Children generally found all items important, although some items did not apply to all and a 'Does not apply to me' response option was added.

conclusionsChildren aged 6-11 years can meaningfully engage with a co-designed pPREM. Cognitive interviews and an iterative approach helped identify and rectify comprehension issues. It is feasible to involve children in the design of pPREMs and doing so strengthens pPREMs' usability and understandability.

Indexed as

Patient Reported Outcome MeasuresAustraliaChildFemaleHumansInterviews as TopicMaleReproducibility of ResultsChildChild HealthPatient RightsQualitative research

Identifiers

PMID42800714
PMCPMC13630164

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.