“Reading level is just one component”: best practices for cognitive debriefing patient-reported outcome instruments with pediatric populations

PURPOSE: The purpose of this study was to develop best practices for conducting cognitive debriefing interviews with pediatric populations by drawing on the currently available literature and insights from experts in the health-related quality of life research community. METHODS: A scoping review of the literature was conducted to identify existing recommendations, considerations, and methods for conducting cognitive debriefing interviews with pediatric populations. Findings from the review informed the development of a draft set of best practices, which were subsequently reviewed and refined through a two‑round modified Delphi process. The Delphi panel was composed of experts (i.e., researchers) in patient-reported outcome instrument development and evaluation with experience conducting interviews with pediatric populations. RESULTS: Thirty-five articles or guidance documents were included in the final scoping review, contributing insights that were used to develop a draft set of 17 best practices. Following the two rounds of review by the Delphi panel, the final set of 17 best practices, which reflects panel consensus, addresses: developing the interview guide, evaluating the characteristics of the instrument to be debriefed, and interview conduct. CONCLUSION: The best practices described in this article provide evidence‑based guidance that can help to standardize and strengthen the rigor of cognitive debriefing interviews with pediatric populations while potentially also improving the experience for participants. Broader implementation across drug development programs may enhance the reliability of measurement, improve the quality of pediatric participant input, and promote more patient‑centered decision‑making.