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J Burn Care Res. 2018 Jan 1;39(1):30-39. doi: 10.1097/BCR.0000000000000566.

Building Bridges Using the Shriners Hospitals for Children/American Burn Association Burn Outcome Questionnaires to Follow Teenagers and Young Adults Across the Age Spans.

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Department of Medical Social Sciences, Northwestern University, Chicago, Illinois.
Department of Surgery, Massachusetts General Hospital, Boston.
Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts.
Department of Mathematical Sciences, Bentley University, Waltham, Massachusetts.
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
Shriners Hospitals for Children, Boston, Massachusetts.
Harvard Medical School, Boston, Massachusetts.
Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts.


The Shriners Hospitals for Children/American Burn Association Burn Outcomes Questionnaires (BOQ) are well-established, reliable, and valid outcome measures. The adolescent (BOQ11-18 years) and young adult version (YABOQ 18-30 years) have similar overlapping domains, but the scores are not comparable. This study objective was to build bridges across these forms. Datasets were from the Multi-Center Benchmarking Study Group. The comparable subscales from the BOQ11-18 and the YABOQ were bridged using item response theory cocalibration. The item response theory scale scores were then transformed into an expected raw score on the alternative form, from which normative scores are available. A sensitivity analysis using up to three time points, as opposed to one randomly selected occasion, was also conducted to ensure robust results. Data were available on 353 unique adolescents and 148 young adults. The comparable subscales were successfully bridged across forms (adolescent reliability from 0.67 to 0.85; young adult from 0.69 to 0.88). Compared with adolescents, young adults on average reported more pain and itch, less symptom and role satisfaction, and poorer work/school reintegration (Cohen's d = 0.39-0.77; P < .05). Physical functioning, appearance, and family/parental concern were comparable across ages (d = -0.01 to 0.09; P > .05). Family functioning was better for young adults than adolescents (d = -0.25; P = .006). BOQ11-18 scores can be mapped from adolescence into young adulthood. Physical and psychosocial outcomes change across the lifespan. Bridges provide a highly useful approach to track changes across this part of the lifespan.

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