Table 3.

Frequency of Symptoms Reported by the Child/Caregiver at the Time of Consultation Not Previously Diagnosed by the Referring Medical Service

Symptom	Reported by child/caregiver but not diagnosedaby referring medical service		pb	Kappa coefficientc
	n	%
Lack of appetite	74	61.2	<0.001	0.02
Sleep disturbance	68	55.7	<0.001	−0.06
Lack of energy	60	49.2	<0.001	0.09
Irritability	56	45.9	<0.001	0.04
Sadness	47	38.5	<0.001	0.01
Nervousness	43	35.3	<0.001	0.26
Dyspnea	26	21.3	0.30	0.06
Nausea	25	20.5	0.89	0.20
Constipation	17	13.9	0.13	0.24
Diarrhea	10	8.2	1.00	0.38
Pain	2	1.9	0.16	0.94

^a“Diagnosis” is defined as (1) described in a clinical note and treated, (2) described in a clinical note but not treated, or (3) not described in a clinical note but treated as evidenced by the presence of a medication prescribed to treat the specific symptom or referral to another service for management of the specific symptom.

^bp < 0.05 indicates significant difference in symptom reporting between child/caregiver and referring medical team (by McNemar's test).

^cThe Kappa coefficient measures the agreement between the child/caregiver symptom report and the referring medical service documentation of symptoms in the three antecedent notes.