Results Summary

What was the research about?

Patients often take surveys about their health or quality of life. Results from these surveys can help doctors meet patients’ needs. Young children can’t fill out surveys by themselves. They may not be able to read or understand the questions. Most often, parents or hospital staff read the questions aloud, or parents answer the questions for their children. But this method may not give accurate results.

In this study, the research team tested three surveys for children ages 4 to 12 who are going to have or who recently had surgery. The first survey asks about general health. The second survey asks about feeling worried before surgery. The third survey asks about pain after surgery. A computer program reads the survey questions aloud. The surveys are animated and choices for the answers appear as cartoons.

The team wanted to learn if the surveys were

  • Accurate, or correctly capturing how the children were feeling
  • Reliable, or if children answered in a consistent way when asked similar questions

What were the results?

Overall, the three surveys were accurate and reliable. This result was true for children of different ages, genders, and races.

Who was in the study?

The study included 725 families with children getting care at Children’s Hospital of Orange County in California. All children were going to have surgery. Of the parents who took part in the study, 66 percent were Latino, 25 percent were white, and 9 percent were other races. The average parent age was 37, and 86 percent were women. Of the children, 71 percent were Latino, 21 percent were white, and 8 percent were other races. The average child age was 7, and 60 percent were boys.

What did the research team do?

The team asked children, paired with their parents, to complete the three surveys. Of the child–parent pairs, 420 pairs completed the surveys before surgery, and 242 pairs completed the surveys at two and seven days after surgery. Children answered animated questions by themselves. Their parents answered the same questions without the animations. Children and parents also completed other surveys on the same topic at the same time.

The team looked at survey responses of both children and parents to see if the responses were accurate and reliable.

Two groups of doctors, hospital administrators, and parents of children helped design the study and develop the survey.

What were the limits of the study?

The team designed the surveys for children ages 4 to 12. Younger children may not understand the survey questions. The study looked at recovery from surgery during a short time. The team did not test how well the surveys work if children take them at other times after surgery.

Future research could use other methods to test the surveys during a longer recovery time. Also, researchers could test if children younger than four years old are able to use animated surveys.

How can people use the results?

Doctors can use the animated computer surveys to understand their young patients’ health needs.

Final Research Report

View this project's final research report.

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Journal Citations

Peer-Review Summary

Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.

The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments. 

Peer reviewers found the study to be statistically sound and to address an important issue. The reviewers did note the complexity of the language describing the study’s psychometric methods. The researchers said it would be hard to satisfy both experts in the field and general scientists while staying within the page limit, but they provided an expanded glossary.

Conflict of Interest Disclosures

Project Information

Sherrie H. Kaplan, PhD
University of California, Irvine
$837,287 *
Computer-Administered Animation as a New Method for Measuring Young Children's Health Outcomes

Key Dates

December 2013
December 2018

Study Registration Information

Final Research Report

View this project's final research report.

Related PCORI Dissemination and Implementation Project

Using the Child Health Ratings Inventories (CHRIS) to Improve Diabetes Care for Children


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Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
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Last updated: October 18, 2023