Methodologic issues in pediatric outcomes research

Clinicians, health services researchers, and third-party payers, among othe rs, are justifiably interested in the outcomes of pediatric medical care an d are, therefore, supportive of research in this area. Pediatric population s pose some unique methodologic challenges for health services researchers. To date, however, many of the approaches, models, and techniques used in p ediatric outcomes research have been imported uncritically from experience with adult populations. As a result, some of the most interesting and salie nt aspects of pediatric outcomes research have yet to be fully developed. T hese include the following: 1) the problems posed by the dynamics of childh ood development, 2) an emphasis on health supervision, 3) the need to see c hildren within the context of a family system and to appreciate the inter-r elatedness of child health domains, 4) the measurement of the effects of in terventions that span sectors, and 5) the paucity of available data sources . This article reviews these problematic areas and argues for a broad conce ptual definition of pediatric health, a systems approach to assessing outco mes, and increased interdisciplinary collaboration.