Validation of a simple tool for anxiety trait screening in children presenting for surgery

Abstract

Background. Screening for preoperative anxiety is an important challenge during the preoperative period. The aim of our study was to validate the faces scale used to detect anxiety trait in children. Methods. Children aged 8-18 yr were asked to quantify their anxiety trait using the readily available faces scale and to respond to the trait component of the State-Trait Anxiety Inventory (STAI) for children (C) or adults (A) before the anaesthesia consultation. Using receiver operating characteristics analysis, we determined the faces scale optimal value on a construct cohort. A validation cohort was recruited to assess the accuracy of the results. Results. The construction cohort comprised 207 patients and the validation cohort 91 patients. The receiver operating characteristics analysis found an area under the curve of 0.75 [95% confidence interval (CI) 0.67, 0.83]. The optimal value for faces scale score was 4, with a sensitivity of 0.61 [95% CI 0.59, 0.62] and a specificity of 0.82 [95% CI 0.81, 0.83]. When this threshold was applied to the construction and validation cohorts, 61.3 and 44.4% of positives were true positives in the construction and validation cohorts, respectively; and 82.1 and 81.3% of negatives were true negatives, respectively. Conclusions. Our study determined the performance of a simple faces scale to measure the preoperative anxiety trait in children aged 8-18 yr. This tool is potentially helpful for clinicians aiming to identify patients at risk of preoperative anxiety and to assign them to targeted management.