ArticlePaediatrics & child health2021
Unnecessary ultrasounds in children with undescended testes: An interrogation of the impact of the Choosing Wisely campaigns and clinical practice guidelines.
Article in Paediatrics & child health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed, 4 citations in OpenAlex.
- Pre-referral ultrasound for cryptorchidism: Still common, still not necessary.Journal of paediatrics and child health · 2024Article
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesOver the past decade, clinical practice guidelines and educational campaigns have counselled against the use of routine ultrasound (US) in the diagnosis of undescended testes (UDT). We aimed to establish whether or not there has been change in the proportion of children with UDT undergoing pre-referral US prior to referral to our centre over this period. We also sought to determine whether type of referring specialist, UDT diagnosis, and patient distance from the hospital had impacted the rate of pre-referral US.
methodsA select sample of hospital charts of children undergoing orchidopexy at a single tertiary paediatric urological referral centre between 2010 and 2019 were reviewed. Data regarding age at surgery, cryptorchidism diagnosis, type of referring physician, patient distance from institution, and evidence of US as part of diagnostic work-up were extracted.
resultsFive hundred charts were examined. Referring provider specialty impacted the number of US ordered (P=0.01). On subset analysis, paediatricians ordered fewer US for children with palpable UDT in 2014 (P=0.03). In 2018, community urologists ordered no US (P=0.02). These findings had temporal relationships with guideline release. The proportion of children undergoing US each year remained consistently between 50% and 62%, except in 2014, when only 36% had US. Distance from hospital and UDT diagnosis were of no significance.
conclusionDespite clinical practice guidelines and Choosing Wisely campaign recommendations, significant numbers of children with UDT still undergo US. Transient changes in sub-specialty guideline adherence are observed. Strategies to improve sustained guideline awareness in referring clinicians need to be considered.
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