Department of Pediatric Gastroenterology, Hepatology and Nutrition, Emma's Children Hospital, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Reproduction & Development Research Institute, Amsterdam University Medical Centers, Location Academic Medical Center/Emma Children's Hospital, Amsterdam, The Netherlands; Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam, The Netherlands.
Department of Pediatric Gastroenterology, Hepatology and Nutrition, Emma's Children Hospital, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Reproduction & Development Research Institute, Amsterdam University Medical Centers, Location Academic Medical Center/Emma Children's Hospital, Amsterdam, The Netherlands; Department of Gastroenterology and Hepatology, Amsterdam UMC, University of Amsterdam, Gastroenterology and Hepatology, Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam, The Netherlands; Department of Pediatrics, St Antonius Ziekenhuis, Nieuwegein, The Netherlands.
J Pediatr. 2023 Dec;263:113647. doi: 10.1016/j.jpeds.2023.113647. Epub 2023 Jul 29.
To evaluate whether the use of pictograms improves symptom evaluation for children with functional abdominal pain disorders (FAPDs).
This survey study was conducted in 2 academic centers and included patients aged 8-18 years visiting the outpatient clinic for FAPD symptom evaluation. Patients were randomized to fill out the questionnaire without or with accompanying pictograms to assess gastrointestinal symptoms. Afterwards, patients underwent clinical health assessment by the healthcare professional (HCP). Subsequently, the HCP filled out the same questionnaire without pictograms, while blinded to the questionnaire completed by the patient. Primary outcome was the level of agreement between identified symptoms as assessed by patients and HCP.
We included 144 children (questionnaire without accompanying pictograms [n = 82] and with accompanying pictograms [n = 62]). Overall agreements rates were not significantly different (without pictograms median, 70% vs with pictograms median, 70%). Accompanying pictograms did not significantly improve the assessment of abdominal pain symptoms. Accompanying pictograms were beneficial for concordance rates for nausea and vomiting symptoms (without pictograms median, 67% vs with pictograms median, 100%; P = .047). Subgroup analyses for children aged 8-12 years of age revealed similar results (concordance on the presence of nausea and vomiting without pictograms median, 67% vs with pictograms median, 100%; P = .015). Subgroup analyses for children ages 12-18 years showed no significant differences in concordance rates.
Pictograms do not seem to improve the assessment of FAPDs. However, the use of pictograms improves the evaluation of nausea and vomiting, especially for children aged 8-12 years. Therefore, HCPs could consider using pictograms in that setting during consultations.
评估象形图是否能改善功能性腹痛障碍（FAPD）患儿的症状评估。
这是一项在 2 个学术中心进行的调查研究，纳入了 8-18 岁因 FAPD 症状评估而就诊门诊的患者。患者被随机分为填写不伴有或伴有象形图的问卷，以评估胃肠道症状。之后，由医疗保健专业人员（HCP）对患者进行临床健康评估。随后，HCP 在不看患者填写的问卷的情况下填写相同的问卷。主要结局是患者和 HCP 评估的症状是否一致。
我们纳入了 144 名儿童（不伴有伴随象形图的问卷[n=82]和伴有伴随象形图的问卷[n=62]）。总一致率无显著差异（无象形图中位数为 70%，有象形图中位数为 70%）。伴随象形图并不能显著改善腹痛症状的评估。伴随象形图对恶心和呕吐症状的一致性率有有益影响（无象形图中位数为 67%，有象形图中位数为 100%；P=0.047）。8-12 岁儿童的亚组分析结果相似（无象形图存在恶心和呕吐的一致性率为 67%，有象形图中位数为 100%；P=0.015）。12-18 岁儿童的亚组分析显示，一致性率无显著差异。
象形图似乎不能改善 FAPD 的评估。然而，象形图的使用改善了恶心和呕吐的评估，尤其是对于 8-12 岁的儿童。因此，HCP 在咨询时可以考虑在这种情况下使用象形图。
