Evidence map›Paper›PMID 31931759›Full record

ArticleBMC pediatrics2020

Management of fever in Australian children: a population-based sample survey.

Joanna Holt, Leslie White, Gavin R Wheaton, Helena Williams, Shefali Jani, Gaston Arnolda, Hsuen P Ting, Peter D Hibbert, Jeffrey Braithwaite, CareTrack Kids investigative team

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pediatrics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.7field-weighted citation impact, top 15% 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

2 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Review
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

10 authors at 4 institutions in 1 country.

Joanna HoltAustralian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, North Ryde, NSW, 2109, Australia.
Leslie WhiteAustralian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, North Ryde, NSW, 2109, Australia.
Gavin R WheatonDivision of Paediatric Medicine, Women's and Children's Health Network, SA Health, Adelaide, Australia.
Helena WilliamsDivision of Paediatric Medicine, Women's and Children's Health Network, SA Health, Adelaide, Australia.
Shefali JaniSydney Children's Hospitals Network, Westmead, Australia.
Gaston ArnoldaAustralian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, North Ryde, NSW, 2109, Australia.
Hsuen P TingAustralian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, North Ryde, NSW, 2109, Australia.
Peter D HibbertAustralian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, North Ryde, NSW, 2109, Australia.
Jeffrey BraithwaiteAustralian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, North Ryde, NSW, 2109, Australia. Jeffrey.braithwaite@mq.edu.au.ORCID 0000-0003-0296-4957
CareTrack Kids investigative team
Macquarie University · AUWomen's and Children's Health Network · AUUniversity of South Australia · AUSydney Children’s Hospitals Network · AU

Funding

National Health and Medical Research Council APP1065898
6 · The paper itself

Abstract

backgroundFever in childhood is a common acute presentation requiring clinical triage to identify the few children who have serious underlying infection. Clinical practice guidelines (CPGs) have been developed to assist clinicians with this task. This study aimed to assess the proportion of care provided in accordance with CPG recommendations for the management of fever in Australian children.

methodsClinical recommendations were extracted from five CPGs and formulated into 47 clinical indicators for use in auditing adherence. Indicators were categorised by phase of care: assessment, diagnosis and treatment. Patient records from children aged 0 to 15 years were sampled from general practices (GP), emergency departments (ED) and hospital admissions in randomly-selected health districts in Queensland, New South Wales and South Australia during 2012 and 2013. Paediatric nurses, trained to assess eligibility for indicator assessment and adherence, reviewed eligible medical records. Adherence was estimated by individual indicator, phase of care, age-group and setting.

resultsThe field team conducted 14,879 eligible indicator assessments for 708 visits by 550 children with fever in 58 GP, 34 ED and 28 hospital inpatient settings. For the 33 indicators with sufficient data, adherence ranged from 14.7 to 98.1%. Estimated adherence with assessment-related indicators was 51.3% (95% CI: 48.1-54.6), 77.5% (95% CI: 65.3-87.1) for diagnostic-related indicators and 72.7% (95% CI: 65.3-79.3) for treatment-related indicators. Adherence for children < 3 months of age was 73.4% (95% CI: 58.0-85.8) and 64.7% (95% CI: 57.0-71.9) for children 3-11 months of age, both significantly higher than for children aged 4-15 years (53.5%; 95% CI: 50.0-56.9). The proportion of adherent care for children attending an ED was 77.5% (95% CI: 74.2-80.6) and 76.7% (95% CI: 71.7-81.3) for children admitted to hospital, both significantly higher than for children attending a GP (40.3%; 95% CI: 34.6-46.1).

conclusionsThis study reports a wide range of adherence by clinicians to 47 indicators of best practice for the management of febrile children, sampled from urban and rural regions containing 60% of the Australian paediatric population. Documented adherence was lowest for indicators related to patient assessment, for care provided in GP settings, and for children aged 4-15 years.

Indexed as

General PracticeGuideline AdherenceAdolescentAustraliaChildChild, PreschoolEmergency Service, HospitalHumansInfantInfant, NewbornNew South WalesQueenslandAdherenceChildrenFeverGuidelines

Identifiers

PMID31931759
PMCPMC6956501
OpenAlexW2998786565

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.