205 Systematic review PREMs MeSH (Medical Subject Headings) terms, keywords and their variations were used to develop a search strategy, which was initially applied to MEDLINE database to randomly screen 100 abstracts to refine this strategy. The final search strateg was applied to MEDLINE, EMBASE, PsycINFO, Cochrane Library, and CINAHL databases. Gray literature was searched through the websites of health institutes, pediatric hospitals, conferences, professional agencies, and search engines manually, which provided an overview of real-world implementation of PREMs. Box 1. Inclusion and Exclusion Criteria Inclusion Criteria 1. Population: Studies that focused only on pediatric populations (≤ 18 years) 2. Measure: Studies that implemented previously validated pediatric PREMs with explicit information regarding how the PREM was validated by mentioning either the validation process or referencing a previous article that described the validation and development process. 3. Geography: Included studies also needed to have been conducted in high-income countries, loosely defined by World Bank [7]. 4. Articles published from January 2000 to April 2021. Exclusion Criteria: 1. Population: Studies that focused on adult or general populations alongside pediatric populations 2. Measure: Studies that utilized a non-validated PREM or a satisfaction survey. Editing a validated PREM threatens its validity, therefore we excluded studies where PREMs were either edited or researcher created their own questionnaires without conducting any validity testing. 3. PREM validation studies 4. Study design: opinion pieces and reviews 5. Language: Studies in languages other than English, French, Spanish, or Dutch Covidence was used for article screening and selection against pre-defined inclusion and exclusion criteria (Box 1) [8]. In the first step, two independent reviewers screened titles and abstracts. Then, two reviewers independently screened selected articles by going through their full text. In both the steps, conflicts were resolved by discussion and consensus or by involving a third reviewer. Following screening, two reviewers independently extracted the data. Due to heterogeneity among the studies in both statistical and methodological domains, conducting a meta-analysis was neither warranted nor plausible. We instead synthesized the results inductively by tabulating identified PREMs in various geographic locations, their type, use and characteristics. Similarly, findings from gray literature are synthesized and reported separately. 8
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