DESIGNING, DEVELOPING AND VALIDATING A SET OF STANDARDIZED PEDIATRIC PICTOGRAMS TO SUPPORT PEDIATRIC-REPORTED GASTRODUODENAL SYMPTOMS

ABSTRACT Objective To develop and validate a set of static and animated pediatric gastroduodenal symptom pictograms. Methods There were three study phases: 1: Co-creation used experience design methods resulting in ten pediatric gastroduodenal symptom pictograms (static and animation); 2: an online survey to assess acceptability, face and content validity; and 3: a preference study. Phases 2 and 3 compared the novel paediatric pictograms with existing pictograms used with adult patients. Results Eight children aged 6-15 years (5 Female) participated in Phase 1, 69 children in Phase 2 (median age 13 years: IQR 9-15), and an additional 49 participants were included in Phase 3 (median age 15: IQR 12-17). Face and content validity were higher for the pediatric and animated pictogram sets compared to pre-existing adult pictograms (78% vs. 78% vs. 61%). Participants with worse gastric symptoms (lower PedsQL-GIS score) had superior comprehension of the pediatric pictograms (χ 2 8 < .001). The pediatric pictogram set was preferred by all participants over animation and adult (χ 2 2 < .001). Conclusion The co-creation phase resulted in the symptom concept confirmation and design of ten acceptable static and animated gastroduodenal pictograms with high face and content validity when evaluated with children aged 6 to 18. Validity was superior when children reported more problematic symptoms. Therefore, these pictograms could be used in clinical and research practice to enable standardized symptom reporting for children with gastroduodenal disorders. Why is it important ▪ Diagnosis of gastroduodenal disorders of the gut-brain interaction (DGBI) in pediatrics is difficult as symptoms often overlap. ▪ Pediatric patients find identifying and distinguishing symptoms difficult. ▪ Validated gastroduodenal symptom pictograms have been found to help adults accurately report their symptoms and have been used effectively to standardize symptom monitoring, including continuous symptom reporting during investigations. ▪ There are no validated pediatric gastroduodenal symptom pictograms. What we did ▪ Co-created a set of ten pediatric gastroduodenal symptom pictograms. ▪ Undertook a face and content validity study to assess the novel pictograms with 118 pediatric participants with a median PedsQL-GIS score of 86.1 (IQR 68.1-90.0). The Outcome ▪ Design: ed a novel set of pictograms with face and content validity that were preferred over other sets, enabling acceptable, simple and validated pediatric patient reporting of their gastroduodenal symptoms.