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Physician consultation in young children with recurrent pain-a population-based study.

Hirschfeld G, Wager J, Zernikow B - PeerJ (2015)

Bottom Line: An analysis of the variability of these results indicated that several hundred participants are needed until the results stabilize.Conclusions.On a methodological level, our results show that large-scale studies are need to reliably identify predictors of health care utilization.

View Article: PubMed Central - HTML - PubMed

Affiliation: Faculty of Business Management and Social Sciences, University of Applied Sciences Osnabrück , Osnabrück , Germany ; German Paediatric Pain Centre, Children's Hospital Datteln , Germany.

ABSTRACT
Background. Recurrent pain is a common experience in childhood, but only few children with recurrent pain attend a physician. Previous studies yielded conflicting findings with regard to predictors of health care utilization in children with recurrent pain. Methods. The present study analyzes data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study comprising n = 2,149 children (3-10 years old) with recurrent pain to find robust predictors. We used multiple logistic regressions to investigate age, gender, socio-economic status (SES), migration background, pain intensity, pain frequency, pain-related disability, mental health problems, and health-related quality of life (HRQL) as predictors for visiting a doctor due to pain. Results. Overall, young girls with high pain-related disability, intensity, frequency, and migration background were more likely to attend a physician. Pain-related disability had the largest impact. Socioeconomic status, health-related quality of life and mental health problems were not systematically related to health care utilization. An analysis of the variability of these results indicated that several hundred participants are needed until the results stabilize. Conclusions. Our findings highlight the importance of pain-related disability and frequency in assessing the severity of recurrent pain. Generic predictors and demographic variables are of lesser relevance to children with recurrent pain. On a methodological level, our results show that large-scale studies are need to reliably identify predictors of health care utilization.

No MeSH data available.


Related in: MedlinePlus

Point of stability for the parameter estimates.The figure shows the cumulative frequency distribution of the POS for effect across 1,000 different random sequences. That is it shows how many of the 1,000 different orders have a POS that is smaller than the specific sample size. The higher the percentage of orders that have already stabilised the more confident can a researcher be that her results at this sample size are accurate and will not change with more participants. Note: Stars denote predictors that were significant in the full sample. Pain-Dis., Pain-related disability; Pain-Int., Pain intensity; Pain-Freq., Pain frequency; HRQL-Psy., Health related quality of life psychological; HRQL-Phys., Health related quality of life physiological; SES, Socioeconomic status; SDQ, Strengths and difficulties questionnaire.
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fig-3: Point of stability for the parameter estimates.The figure shows the cumulative frequency distribution of the POS for effect across 1,000 different random sequences. That is it shows how many of the 1,000 different orders have a POS that is smaller than the specific sample size. The higher the percentage of orders that have already stabilised the more confident can a researcher be that her results at this sample size are accurate and will not change with more participants. Note: Stars denote predictors that were significant in the full sample. Pain-Dis., Pain-related disability; Pain-Int., Pain intensity; Pain-Freq., Pain frequency; HRQL-Psy., Health related quality of life psychological; HRQL-Phys., Health related quality of life physiological; SES, Socioeconomic status; SDQ, Strengths and difficulties questionnaire.

Mentions: Figure 3 shows a trajectory of the estimates for one specific sampling order, i.e., the ORs from the logistic regression based on different subsamples of patients. In this sampling order the estimates of the effects change depending on how many participants are added to the analysis. The ORs for most effects converge to 1, i.e., a -effect, in the first 250 participants. Critically the ORs may even reverse, e.g., the effect of migration background is smaller than 1 up until about 450 included participants, from which point on the effect becomes larger than 1.


Physician consultation in young children with recurrent pain-a population-based study.

Hirschfeld G, Wager J, Zernikow B - PeerJ (2015)

Point of stability for the parameter estimates.The figure shows the cumulative frequency distribution of the POS for effect across 1,000 different random sequences. That is it shows how many of the 1,000 different orders have a POS that is smaller than the specific sample size. The higher the percentage of orders that have already stabilised the more confident can a researcher be that her results at this sample size are accurate and will not change with more participants. Note: Stars denote predictors that were significant in the full sample. Pain-Dis., Pain-related disability; Pain-Int., Pain intensity; Pain-Freq., Pain frequency; HRQL-Psy., Health related quality of life psychological; HRQL-Phys., Health related quality of life physiological; SES, Socioeconomic status; SDQ, Strengths and difficulties questionnaire.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4419529&req=5

fig-3: Point of stability for the parameter estimates.The figure shows the cumulative frequency distribution of the POS for effect across 1,000 different random sequences. That is it shows how many of the 1,000 different orders have a POS that is smaller than the specific sample size. The higher the percentage of orders that have already stabilised the more confident can a researcher be that her results at this sample size are accurate and will not change with more participants. Note: Stars denote predictors that were significant in the full sample. Pain-Dis., Pain-related disability; Pain-Int., Pain intensity; Pain-Freq., Pain frequency; HRQL-Psy., Health related quality of life psychological; HRQL-Phys., Health related quality of life physiological; SES, Socioeconomic status; SDQ, Strengths and difficulties questionnaire.
Mentions: Figure 3 shows a trajectory of the estimates for one specific sampling order, i.e., the ORs from the logistic regression based on different subsamples of patients. In this sampling order the estimates of the effects change depending on how many participants are added to the analysis. The ORs for most effects converge to 1, i.e., a -effect, in the first 250 participants. Critically the ORs may even reverse, e.g., the effect of migration background is smaller than 1 up until about 450 included participants, from which point on the effect becomes larger than 1.

Bottom Line: An analysis of the variability of these results indicated that several hundred participants are needed until the results stabilize.Conclusions.On a methodological level, our results show that large-scale studies are need to reliably identify predictors of health care utilization.

View Article: PubMed Central - HTML - PubMed

Affiliation: Faculty of Business Management and Social Sciences, University of Applied Sciences Osnabrück , Osnabrück , Germany ; German Paediatric Pain Centre, Children's Hospital Datteln , Germany.

ABSTRACT
Background. Recurrent pain is a common experience in childhood, but only few children with recurrent pain attend a physician. Previous studies yielded conflicting findings with regard to predictors of health care utilization in children with recurrent pain. Methods. The present study analyzes data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) study comprising n = 2,149 children (3-10 years old) with recurrent pain to find robust predictors. We used multiple logistic regressions to investigate age, gender, socio-economic status (SES), migration background, pain intensity, pain frequency, pain-related disability, mental health problems, and health-related quality of life (HRQL) as predictors for visiting a doctor due to pain. Results. Overall, young girls with high pain-related disability, intensity, frequency, and migration background were more likely to attend a physician. Pain-related disability had the largest impact. Socioeconomic status, health-related quality of life and mental health problems were not systematically related to health care utilization. An analysis of the variability of these results indicated that several hundred participants are needed until the results stabilize. Conclusions. Our findings highlight the importance of pain-related disability and frequency in assessing the severity of recurrent pain. Generic predictors and demographic variables are of lesser relevance to children with recurrent pain. On a methodological level, our results show that large-scale studies are need to reliably identify predictors of health care utilization.

No MeSH data available.


Related in: MedlinePlus