Evaluation of measurement properties of pediatric acute diarrheal severity scoring systems

Methods Medline, EMbase and the Cochrane library were searched using a highly sensitive search filter developed by Terwee et al. to identify studies that evaluated measurement properties. This search filter was combined with the names of ten pre-identified scales of pediatric diarrhea severity. Reference lists from included articles and the original publications for the ten diarrhea scales were also reviewed. Eligibility criteria were: 1) ability to develop or evaluate the measurement properties – i.e. content validity, construct validity, reliability or responsiveness – of a measurement instrument; 2) ability to measure severity of diarrhea/gastroenteritis; and 3) ability of the scale to be developed or adapted for the pediatric population (0-18 y/o). The methodological quality of the included studies and the results of measurement properties were appraised using checklists from the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) group. Results The search yielded 98 potentially relevant articles, of which only 2 articles met inclusion criteria. Studies that did not evaluate measurement properties of the identified scales or did not measure pediatric diarrhea were excluded. Both included studies evaluated the measurement properties of the “Modified Vesikari score” (MVS). Assessment of methodological quality determined that both studies were of ‘poor’ quality in most properties except for hypothesis testing, which was rated as ‘good’. MVS was rated as positive for face and construct validity and indeterminate for internal consistency and interpretability.