Consensus-Based Evaluation of Outcome Measures in Pediatric Stroke Care: A Toolkit

Samantha J. Feldman, Lauren A. Beslow, Ryan J. Felling, Laura A. Malone, Michaela Waak, Stuart Fraser, Nihal Bakeer, Jo Ellen M. Lee, Victoria Sherman, Melissa M. Howard, Beth Anne Cavanaugh, Robyn Westmacott, Lori C. Jordan

Research output: Contribution to journalReview articlepeer-review


Following a pediatric stroke, outcome measures selected for monitoring functional recovery and development vary widely. We sought to develop a toolkit of outcome measures that are currently available to clinicians, possess strong psychometric properties, and are feasible for use within clinical settings. A multidisciplinary group of clinicians and scientists from the International Pediatric Stroke Organization comprehensively reviewed the quality of measures in multiple domains described in pediatric stroke populations including global performance, motor and cognitive function, language, quality of life, and behavior and adaptive functioning. The quality of each measure was evaluated using guidelines focused on responsiveness and sensitivity, reliability, validity, feasibility, and predictive utility. A total of 48 outcome measures were included and were rated by experts based on the available evidence within the literature supporting the strengths of their psychometric properties and practical use. Only three measures were found to be validated for use in pediatric stroke: the Pediatric Stroke Outcome Measure, the Pediatric Stroke Recurrence and Recovery Questionnaire, and the Pediatric Stroke Quality of Life Measure. However, multiple additional measures were deemed to have good psychometric properties and acceptable utility for assessing pediatric stroke outcomes. Strengths and weaknesses of commonly used measures including feasibility are highlighted to guide evidence-based and practicable outcome measure selection. Improving the coherence of outcome assessment will facilitate comparison of studies and enhance research and clinical care in children with stroke. Further work is urgently needed to close the gap and validate measures across all clinically significant domains in the pediatric stroke population.

Original languageEnglish (US)
Pages (from-to)118-132
Number of pages15
JournalPediatric Neurology
StatePublished - Apr 2023


  • Assessment
  • Measurement
  • Outcomes
  • Pediatric stroke

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Neurology
  • Developmental Neuroscience
  • Clinical Neurology


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