JACC Adv. 2026 Jun 4;5(7):102858. doi: 10.1016/j.jacadv.2026.102858. Online ahead of print.
ABSTRACT
BACKGROUND: Anxiety disorders are common in pediatric heart disease (PHD), including congenital, arrhythmic, and acquired heart disease. The standard screening tool, Screen for Child Anxiety Related Emotional Disorders (SCARED), is too lengthy to complete in a busy pediatric cardiology clinic.
OBJECTIVES: This study assessed the concurrent validity of a briefer tool, Pediatric-Reported Outcomes Measurement Information System Pediatric Anxiety (PROMIS-Anx), relative to SCARED in children with PHD.
METHODS: Children, aged 7.5 to <18 years, with PHD and their caregivers both completed PROMIS-Anx and SCARED between January 2020 and August 2022 during cardiology clinic visits. Association of PROMIS-Anx and SCARED scores were analyzed using Spearman correlation coefficient (rs), and a cut point was developed for PROMIS-Anx in children and their caregivers using Youden index.
RESULTS: Among 144 child/caregiver pairs, anxiety was present in 36.0% of children by SCARED. Scores on SCARED and PROMIS-Anx were higher in females, adolescents, and those with known behavioral health disorders, but were not associated with cardiac disease severity, race, or ethnicity. SCARED and PROMIS-Anx scores were highly correlated in children (rs = 0.76, P < 0.001), and slightly less so in caregivers (rs = 0.58, P < 0.001), both reaching statistical significance. A PROMIS-Anx score of >30 was identified as a threshold for significant anxiety symptoms based on SCARED.
CONCLUSIONS: PROMIS-Anx scores correlate with SCARED across the range of scores, particularly when completed by the child. Routine screening for anxiety in cardiology clinic, with a brief tool such as PROMIS-Anx, can promote earlier identification and treatment of anxiety in children with PHD.
PMID:42241734 | DOI:10.1016/j.jacadv.2026.102858
