COSMIN database

Self-report of symptoms in children with cancer younger than 8 years of age: a systematic review

Tomlinson, D., Tigelaar, L., Hyslop, S., Lazor, T., Dupuis, L. L., Griener, K., Oliveria, J., and Sung, L.
OBJECTIVE: The study's objective was to summarize the psychometric evaluation of self-report symptom instruments used in children with cancer younger than 8 years of age.

METHODS: We conducted electronic searches of Ovid Medline, EMBASE, PsycInfo, Science Citation, Social Science Citation (Web of Science), and CINAHL. We included studies of children with cancer in which their self-report symptoms had been quantified and in which results were described for those younger than 8 years of age. The search was restricted to publications in English. Two reviewers screened studies and abstracted all data in duplicate. Descriptive analysis of reliability and validity was performed.

RESULTS: Thirteen studies were included. Only one study recruited children <8 years alone. Most studies described reliability and validity in a wider age range cohort in which most children were older than 8 years of age. Of the eight studies that evaluated reliability within the younger age group, six raised concerns about poor internal consistency with Cronbach's alpha <0.7 in at least one dimension. Concerns about test re-test reliability and inter-rater reliability were also observed. None of the studies evaluated validity.

CONCLUSIONS: We failed to demonstrate that currently available instruments to measure self-report symptoms are reliable or valid specifically for children with cancer younger than 8 years of age. Development of psychometrically robust instruments for younger children should be a priority.
Support Care Cancer
Publication year:
Symptom status:
Cognitive/mental state
Emotional state
Physical state
Functional status:
Cognitive/mental functioning
Physical functioning
Social functioning
Children (0-18)
Neoplasms and related symptoms
PRO / non-PRO:
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
2 - Interviews