Pictorial adaptation of the quality of recovery 15 scale and psychometric validation into a pediatric surgical population.

Patient reported outcomes measures (PROMS) are important endpoints to measure patient health status in the perioperative setting. However, there are no good tools to measure PROMS in the pediatric surgical population. Patients 7 to 17 years old undergoing surgery were included and followed up for 1 day after surgery (POD1). At POD1 the patients were asked to rate their overall postoperative recovery using a 100-mm visual analog scale (VAS). The primary outcome was the pediatric QoR-15 score on postoperative day 1 (POD1). 150 patients completed the study. The mean (SD) pediatric QoR-15F scores were 132.1 (14.1) and 111.0 (27.0), preoperatively and on POD1, respectively. Convergent validity confirmed with Pearson (r) correlation between the postoperative pediatric QoR-15F and the patient-rated global recovery assessment was 0.72 (95% confidence interval [0.63-0.79]; p < 10-16). Concerning reliability, internal consistency of the pediatric QoR-15 assessed by Cronbach's alpha was 0.90. The test-retest concordance correlation coefficient was 0.92; 95% CI [0.83-0.96]. Split-half alpha was 0.74. The pictorial pediatric version of the QoR-15F showed good validity, reliability, responsiveness, acceptability and feasibility. This PROMS should be considered for clinical care and research in the perioperative pediatric patient setting.Trial Registration: NCT04453410 on clinicaltrials.gov.

Clinical management of the congenitally missing maxillary lateral incisor and mandibular second premolar: a clinical perspective.

The decision to close maintain, or open space at the agenesis sites of the maxillary lateral incisor and mandibular second premolar is generally based on several factors, including the class of malocclusion, skeletal pattern (divergence), esthetics, function, and periodontics. Replacement of congenitally missing maxillary lateral incisors, the second most commonly missing teeth, can involve (1) canine replacement, (2) tooth-supported restoration, and (3) implants. This paper contrary to the opinion of other authors, favors replacement of the congenitally missing lateral incisors in one of several ways, versus orthodontic space closure.