Evidence map›Paper›PMID 32045446›Full record

ArticlePloS one2020

Guideline adherence in the management of head injury in Australian children: A population-based sample survey.

Janet C Long, Sarah Dalton, Gaston Arnolda, Hsuen P Ting, Charlotte J Molloy, Peter D Hibbert, Louise K Wiles, Simon Craig, Meagan Warwick, Kate Churruca and 3 more

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

Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.1field-weighted citation impact, top 22% 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

1 citing paper in PubMed, 6 citations in OpenAlex.

  1. Article
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

13 authors at 4 institutions in 1 country.

Janet C LongAustralian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.ORCID 0000-0002-0553-682X
Sarah DaltonEmergency Department, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
Gaston ArnoldaAustralian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.ORCID 0000-0003-4948-7633
Hsuen P TingAustralian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
Charlotte J MolloyAustralian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.ORCID 0000-0001-7451-9751
Peter D HibbertAustralian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
Louise K WilesAustralian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.ORCID 0000-0002-6557-6196
Simon CraigDepartment of Paediatrics, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.ORCID 0000-0003-2594-1643
Meagan WarwickAustralian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
Kate ChurrucaAustralian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
Louise A EllisAustralian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
Jeffrey BraithwaiteAustralian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.ORCID 0000-0003-0296-4957
CareTrack Kids investigative team
Macquarie University · AUUniversity of South Australia · AUChildren's Hospital at Westmead · AUMonash Health · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHead injuries in children are a common and potentially devastating presentation. The CareTrack Kids (CTK) study assessed care of Australian children aged 0-15 years, in 2012 and 2013, to evaluate the proportion in line with guideline-based indicators for 17 common conditions. Overall adherence to guideline-based recommended practice occurred 59.8% of care encounters (95% CI: 57.5-62.0), and 78.3% (95% CI: 75.1-81.2) for head injury. This paper presents results for head injury, at indicator level.

methodsA modified version of the RAND-UCLA method of indicator development was used. Indicators, measurable components of a standard or guideline, were developed from international and national guidelines relating to head injury in children and were ratified by clinical experts using a Delphi process. Paediatric nurses extracted data from medical records from general practitioners (GPs), emergency departments (EDs) and inpatient wards in Queensland, New South Wales and South Australia, for children under 15 years receiving care in 2012-13. Our purpose was to estimate the percentage adherent for each indicator.

resultsThe medical records of 629 children with head injury were examined. Fifty-one percent of children were under 5 years old, with more males (61%) than females. Thirty-eight indicators were assessed. Avoidance of nasotracheal airways (100%; 95% CI: 99.4-100) or nasogastric tubes (99.7%; 95% CI: 98.5-100) for children with a head injury had the highest adherence. Indicators relating to primary and secondary assessment of head injuries were mostly adhered to. However, adherence to other indicators was poor (e.g., documentation of the past history of children (e.g., presence or absence of seizures) before the injury; 29.9% (95% CI: 24.5-35.7)), and for others was difficult to estimate with confidence due to small sample sizes (e.g., Children with a head injury who were intubated had PaO2 above 80mm Hg; 56.0% (95% CI: 28.6-80.9)). Indicators guiding clinical decision making regarding the need for CT scan had insufficient data to justify reporting.

conclusionThis study highlights that management of head injury in children mostly follows guidelines, but also flags some specific areas of inconsistency. Individual sites are encouraged to use these results to guide investigation of local practices and inform quality improvement endeavours.

Indexed as

AdolescentAustraliaChildChild, PreschoolCraniocerebral TraumaDatabases, FactualFemaleGuideline AdherenceHumansInfantInfant, NewbornMaleQuality Indicators, Health CareRetrospective Studies

Identifiers

PMID32045446
PMCPMC7012413
OpenAlexW3005706392

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.