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However, outcome measurement in this context remains fragmented, with tools often lacking validation, paediatric specificity, or contextual relevance, especially in low- and middle-income countries (LMICs). This scoping review maps the outcome measurement tools used in paediatric oncology palliative care, examining their assessed domains, psychometric properties and cultural, linguistic and health-system contextual relevance, particularly in LMICs. We systematically searched six databases from 2006 to 2025 and identified 27 eligible studies reporting on 28 unique tools across six key domains: symptom burden, quality of life, psychological well-being, spiritual health, caregiver burden and end-of-life care. While tools like Paediatric Quality of Life Inventory (PedsQL) and Symptom Screening in Pediatrics Tool (SSPedi) showed strong psychometric performance, only a few had been adapted for LMIC contexts. The psychological and spiritual domains were underrepresented, and most tools relied on proxy reporting, which limited child-centred assessments. The findings suggest the need for validated, culturally sensitive and inclusive tools co-developed with children and caregivers. Establishing such outcome measures is essential to ensuring equitable, high-quality palliative care across diverse settings. This review lays the groundwork for developing tools and advancing policies that support comprehensive and compassionate care for children with cancer. Review registration: The review is registered on Open Science Framework (OSF)\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"10.17605\/OSF.IO\/G8BN3\" ext-link-type=\"doi\">https:\/\/doi.org\/10.17605\/OSF.IO\/G8BN3<\/jats:ext-link>\n                    .\n                  <\/jats:p>","DOI":"10.1038\/s44276-026-00219-9","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:45:54Z","timestamp":1781628354000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcome measurement tools in pediatric oncology palliative care: a scoping review of domains, validation and contextual relevance"],"prefix":"10.1038","volume":"4","author":[{"given":"Vani","family":"Verma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9975-2568","authenticated-orcid":false,"given":"Arun","family":"Ghoshal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mebin","family":"Mathew","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harshitha","family":"D","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aishwarya","family":"Sanian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krithika","family":"S. 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