Can the GAD-7 be used to create valid, reliable, feasible and actionable outcome-focused paediatric anxiety quality measures for use across specialty and paediatric treatment settings?

Introduction Paediatric anxiety disorders are among the most common psychiatric disorders of childhood and adolescence, affecting between 15% and 30% of youth. Rates rose sharply during the COVID-19 pandemic, and untreated anxiety is associated with impaired functioning and increased risk of depression, suicidality and substance use in adulthood.

Evidence-based treatments such as cognitive-behavioural therapy and selective serotonin reuptake inhibitors are highly effective yet remain underused, while non-recommended treatments, including benzodiazepines, are often prescribed. Despite the public health burden, there are currently no endorsed outcome-focused quality measures for paediatric anxiety.

Developing such measures would allow health systems and providers to track outcomes, reduce disparities and drive quality improvement. Methods and analysis This study will develop and test two complementary outcome-focused paediatric anxiety quality measures based on the seven-item Generalised Anxiety Disorder scale: (1) remission (clinically significant reduction in anxiety symptoms to below threshold) and (2) response (clinically significant improvement, even if remission is not achieved).