Parent-Child Agreement on Fatigue in Pediatric Otolaryngology Patients

Objectives: To investigate parent-child agreement on fatigue reporting in pediatric otolaryngology patients and whether agreement might vary by diagnosis and other patient factors. Study Design: Cross-sectional survey. Methods: Patients ages 5-18 years old being evaluated for hearing loss (HL) or obstructive sleep apnea (OSA) were recruited from a pediatric otolaryngology clinic and sleep center. Children and parents completed the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL MFS). Results: Responses of 42 patients with HL, 49 with OSA, 10 with sleep-disordered breathing (SDB), and 34 controls were analyzed. Parent and child PedsQL MFS scores were strongly correlated (Pearson r > 0.7) across groups with few exceptions. Only the median child-parent score differences for general domain score in the SDB group (12.5; 95% CI 2.08 to 22.9), and total score (7.41; 95% CI -0.69 to 25.7) and general domain score (11.5; 95% CI 2.08 to 27.1) in the developmental delay group met clinical significance thresholds. Wide confidence intervals prevented definitive conclusions regarding clinical significance. A pattern of decreased parent-child score correlations was observed in children reported to have delays. Weak (+/- 0.1 to +/- 0.4) to moderate (+/- 0.4 to +/- 0.69) correlations were observed for total score, general domain score, and cognitive domain score for children with reported developmental/speech/language delay. Conclusion: Overall, the parent-proxy PedsQL MFS demonstrates strong agreement with self-reports for pediatric otolaryngology patients being evaluated for HL and OSA. However, parent-child score discrepancies within specific patient groups, especially children whose parents reported speech/developmental/language delays, emphasize the importance of administering self-reports when possible.