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Evaluation of the electronic self-report Symptom Screening in Pediatrics Tool (SSPedi)
  1. Cathy O'Sullivan1,
  2. L Lee Dupuis2,3,
  3. Paul Gibson4,
  4. Donna L Johnston5,
  5. Christina Baggott6,
  6. Carol Portwine7,
  7. Brenda Spiegler8,
  8. Susan Kuczynski9,
  9. Deborah Tomlinson1,
  10. George A Tomlinson10 and
  11. Lillian Sung1,11
  1. 1 Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
  2. 2 Department of Pharmacy, The Hospital for Sick Children, Toronto, Ontario, Canada
  3. 3 Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
  4. 4 Departments of Haematology/Oncology and Pediatrics, London Health Sciences Centre, London, Ontario, Canada
  5. 5 Division of Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
  6. 6 Cancer Clinical Trials Office, Stanford University, Palo Alto, California, USA
  7. 7 Division of Haematology/Oncology, McMaster Children's Hospital, Health Sciences Centre, Hamilton, Ontario, Canada
  8. 8 Department of Psychology, The Hospital for Sick Children, Toronto, Ontario, Canada
  9. 9 Ontario Parents Advocating for Children with Cancer (OPACC), Toronto, Ontario, Canada
  10. 10 Department of Medicine, Toronto General Hospital, Toronto, Ontario, Canada
  11. 11 Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
  1. Correspondence to Dr Lillian Sung, Division of Haematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8; lillian.sung{at}


Objective We previously developed the paper-based Symptom Screening in Pediatrics Tool (SSPedi) designed for paediatric cancer symptom screening. Objectives were to evaluate and refine the electronic mobile application (app) of SSPedi using the opinions of children with cancer.

Methods Participants were children 8–18 years of age with cancer. Participants completed electronic SSPedi on their own and then responded to semistructured questions to determine whether they found electronic SSPedi easy or difficult to complete and understand, understood and liked the app features (audio and animation), and understood previously difficult to understand concepts with the introduction of a help menu. After each group of 10 children, responses were reviewed to determine whether modifications were required.

Results 20 children evaluated electronic SSPedi. None found electronic SSPedi difficult to complete or understand. All children understood the app features and each of the 4 more difficult to understand concepts after using the help menu. 19 of 20 children thought the app was a good way to communicate with doctors and nurses.

Conclusions We finalised an electronic version of SSPedi that is easy to use and understand with features specifically designed to facilitate child self-report. Future work will evaluate the psychometric properties of electronic SSPedi.

  • symptom screening
  • paedriatric oncology
  • electronic
  • patient-reported outcome
  • Cancer
  • tool development

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  • Contributors LS conceived of the study, participated in its design and coordination, and helped draft the manuscript. LLD participated in the study design. CO drafted the manuscript and carried out the recruitment and interviews, with DT providing assistance. CO, LLD, PG, DLJ, CB, CP, BS, SK, DT, GAT and LS contributed to the analysis and interpretation of data. All authors read and approved the final manuscript.

  • Funding This research is funded by the Pedal for Hope Impact Grant of the Canadian Cancer Society (grant number 702295).

  • Competing interests None declared.

  • Ethics approval The Hospital for Sick Children.

  • Provenance and peer review Not commissioned; externally peer reviewed.