213 Systematic review PREMs Among the studies, the most commonly used PREMs were the various Press Ganey surveys [50] (n = 18), the Measure of Processes of Care (MPOC)[28] (n = 15), Child HCAHPS [10] (n = 10) and HCAHPS surveys [51] (n = 5). Among all the included studies, there was a high amount of variation in the purpose of using PREMs. PREMs were most commonly used to evaluate factors that affected overall patient experience and to assess the experiences after an intervention, most often an improvement in quality of care. A complete overview of the characteristics of the included studies can be found in the Supplement 1. Figure 2. Geographic locations of pediatric PREMs identified through systematic review and grey literature PREMs This extensive review identified 39 previously validated pediatric PREMs (Table 1). These PREMs were developed in 7 countries. The greatest number of PREMs were developed in the United States of America (n = 21), followed by the United Kingdom (n = 9), Canada (n = 4), the Netherlands (n = 2), Finland (n = 1), Germany (n = 1), and Sweden (n = 1). Most of the included PREMs were generic (n = 34), aiming to measure general experiences of healthcare regardless of the disease or care sector. The included disease specific PREMs (n = 5) have been developed to capture the experience of healthcare from patients with inflammatory bowel disease, epilepsy, diabetes, cancer, and mental health conditions. 8
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