Can the GAD-7 be used to create valid, reliable, feasible and actionable outcome-focused paediatric anxiety quality measures for use across specialty and paediatric treatment settings?
Year: 2026
Type: article
Study design: Study Protocol
Abstract: INTRODUCTION: Paediatric anxiety disorders are among the most common psychiatric disorders of childhood and adolescence, affecting between 15% and 30% of youth. Rates rose sharply during the COVID-19 pandemic, and untreated anxiety is associated with impaired functioning and increased risk of depression, suicidality and substance use in adulthood. Evidence-based treatments such as cognitive-behavioural therapy and selective serotonin reuptake inhibitors are highly effective yet remain underused, while non-recommended treatments, including benzodiazepines, are often prescribed. Despite the public health burden, there are currently no endorsed outcome-focused quality measures for paediatric anxiety. Developing such measures would allow health systems and providers to track outcomes, reduce disparities and drive quality improvement. METHODS AND ANALYSIS: This study will develop and test two complementary outcome-focused paediatric anxiety quality measures based on the seven-item Generalised Anxiety Disorder scale: (1) remission (clinically significant reduction in anxiety symptoms to below threshold) and (2) response (clinically significant improvement, even if remission is not achieved). Using electronic health record and claims data from Kaiser Permanente Northwest and Kaiser Permanente Southern California from 2017 to 2024, we will establish measure inclusion and exclusion criteria, evaluate the application of symptom weighting, test measure reliability and validity and implement casemix adjustment models. Analyses will examine disparities by race, ethnicity and social risk factors through linkage indices capturing local social determinants of health. Qualitative interviews with providers and electronic medical record vendors will be conducted to assess feasibility and usability. Measures will be prepared and submitted for endorsement by a national quality measurement body. ETHICS AND DISSEMINATION: This study has been reviewed and approved by the institutional review boards at RTI International and Kaiser Permanente. Findings will be disseminated through peer-reviewed publications, scientific conferences, stakeholder workshops and submissions to a national quality endorsement body.
Source: BMJ Open
Language: English
Subfield: Experimental and Cognitive Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $1,839
Funders: Consejería de Universidad, Investigación e Innovación, Junta de Andalucía, National Park Foundation, Amgen, Primate Conservation, Eli Lilly and Company, Leakey Foundation, Evelyn F. McKnight Brain Research Foundation, University of Texas at Austin, Wilhelm Sander-Stiftung, Japan Agency for Medical Research and Development, Queensland Health, Parks Victoria, Wellcome Trust, University of Manitoba, Kletjian Foundation, UK Research and Innovation, Amarin Corporation, Alkoholitutkimussäätiö, Tromsø Forskningsstiftelse, Cycle for Survival, Dutch Cardiovascular Alliance, Geoffrey Beene Foundation, Michael Smith Health Research BC, Cancer Research UK, European Commission, National Research Foundation, Deutsche Forschungsgemeinschaft, Agence Nationale de la Recherche, Ministry of Education, Culture, Sports, Science and Technology, Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung, National Natural Science Foundation of China, ZonMw, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Catholic University of Daegu, Seoul National University, Fundación Científica Asociación Española Contra el Cáncer, Else Kröner-Fresenius-Stiftung, Nederlandse Organisatie voor Wetenschappelijk Onderzoek, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Korea Health Industry Development Institute, National Research Foundation of Korea, Hjärt-Lungfonden, Natural Science Foundation of Hubei Province, KU Leuven, Vetenskapsrådet, Natural Science Foundation of Guangxi Province, Ministerio de Ciencia e Innovación, Innovative Team of Jiangsu Province, Norges Forskningsråd, Natural Science Foundation of Shandong Province, Qingdao University of Science and Technology, Paavo Nurmen Säätiö, Interdisziplinäres Zentrum für Klinische Forschung, Universitätsklinikum Würzburg, Novo Nordisk Fonden, Maccabi Institute for Health Services Research, Business Finland, Liaoning Revitalization Talents Program, LUPUS UK, Mason Medical Research Trust, Jazz Pharmaceuticals Canada, CRIS Cancer Foundation, National Institutes of Health, U.S. Food and Drug Administration, Johnson and Johnson, National Park Service, Direktion für Entwicklung und Zusammenarbeit, Center for Innovations in Quality, Effectiveness and Safety, Canadian Institutes of Health Research, Central Council for Research in Homeopathy, Ministry of AYUSH, Government of India, Economic and Social Research Council, Health Technology Assessment Programme, Australian Research Council, National Health and Medical Research Council, Japan Society for the Promotion of Science, Fundação para a Ciência e a Tecnologia, Public Health Research Programme, Beijing Nova Program, Yonsei University College of Medicine, Zhejiang Traditional Chinese Medicine Administration, Guangxi Key Research and Development Program, NIHR Nottingham Biomedical Research Centre, Norwegian Institute of Public Health, National Institute on Aging, National Institute of Mental Health, National Institute of Allergy and Infectious Diseases, Fogarty International Center, National Institute of Neurological Disorders and Stroke, National Institute of Biomedical Imaging and Bioengineering, Office of Behavioral and Social Sciences Research, National Center for Advancing Translational Sciences, Medical Science and Technology Project of Zhejiang Province, Los Alamos National Laboratory, NHLBI Division of Intramural Research, HORIZON EUROPE European Research Council, World Scleroderma Foundation, Universität Bayreuth, UK Prevention Research Partnership
OpenAlex ID: W7160159583