Evidence map›Paper›PMID 27898253›Full record

ArticleSurgical infections

Establishing Equipoise: National Survey of the Treatment of Pediatric Para-Pneumonic Effusion and Empyema.

Morgan K Richards, Jarod P Mcateer, Todd C Edwards, Lucas R Hoffman, Matthew P Kronman, Dennis W Shaw, Adam B Goldin

Open access · greenAbstract read
In one paragraph

Article in Surgical infections. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
1.0field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.

  1. Pooled it
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  3. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Morgan K Richards1 Department of Surgery, University of Washington , Seattle, Washington.
Jarod P Mcateer1 Department of Surgery, University of Washington , Seattle, Washington.
Todd C Edwards2 Department of Health Services, University of Washington , Seattle, Washington.
Lucas R Hoffman3 Department of Pediatrics, Division of Pulmonary and Sleep Medicine, Seattle Children's Hospital , Seattle.
Matthew P Kronman4 Department of Pediatrics, Division of Infectious Disease, Seattle Children's Hospital , Seattle.
Dennis W Shaw5 Department of Radiology, Seattle Children's Hospital .
Adam B Goldin6 Department of Thoracic and General Surgery, Seattle Children's Hospital .
University of Washington · USSeattle Children's Hospital · US

Funding

Pseudomonas Aeruginosa Early CF Adaptive Changes: A Translational StudyK02HL105543 · NHLBI · UNIVERSITY OF WASHINGTON · PI HOFFMAN, LUCAS R · 2011 to 2014
$400k
NHLBI NIH HHS K02 HL105543
6 · The paper itself

Abstract

backgroundDespite six randomized trials of various treatments for pediatric para-pneumonic effusion (PPE), management approaches differ. The purpose of this study was to gain insight into opinions on PPE treatment with the goal of designing a definitive trial to generate consensus intervention guidelines.

methodsTo evaluate physician opinions regarding PPE management, we developed a survey based on input from a nationwide, multi-disciplinary advisory group that established content validity. The survey was disseminated broadly to six pediatric medicine and interventional radiology groups. Descriptive and χ

resultsThere were 741 respondents (response rate 13.1%), of whom 52.2% were surgeons, 15.2% hospitalists, 14.2% pulmonologists, 12.4% intensivists, and 6.0% interventional radiologists. Nearly all respondents (97.3%) reported caring primarily for pediatric patients. Eighty percent reported no written institutional treatment guidelines. Nearly all (90.3%) agreed that patients require antibiotics, but there was disagreement regarding their duration. Respondents also were split as to how often PPE required drainage. There were multiple absolute indications for drainage, including mediastinal shift on chest radiograph (67.2%) and loculations on imaging (47.7%). There were substantial differences in the preferred first-line methods of drainage based on the treating physician's specialty, with surgeons preferring tube thoracostomy and a fibrinolytic agent (42.0%) or video-assisted thoracoscopic surgery (41.6%), whereas interventional radiologists preferred either a tube thoracostomy (46.4%) or a tube thoracostomy with a fibrinolytic agent (39.3%) (p < 0.001). A large majority (75.3%) believed that the published evidence does not identify the optimal intervention.

conclusionsThere is a lack of consensus regarding the optimal treatment of PPE. Respondents believed the published evidence is inconclusive and were willing to participate in a prospective trial. These findings will help inform the design of a randomized, pragmatic clinical trial to optimize PPE management.

Indexed as

Thoracic Surgical ProceduresAttitude of Health PersonnelCross-Sectional StudiesEmpyema, PleuralHumansPhysiciansPneumoniaPractice Guidelines as TopicPractice Patterns, Physicians'Surveys and Questionnaireschest surgeryempyemapneumonia

Identifiers

PMID27898253
PMCPMC5335786
OpenAlexW2560557486

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.