Evidence map›Paper›PMID 34671841›Full record

ArticleWorld journal of surgery2022

Long-Term Impact of a Low-Cost Paediatric Intussusception Air Enema Reduction Simulation-Based Education Programme in a Low-Middle Income Country.

R M Nataraja, Yin Mar Oo, D Ljuhar, M Pacilli, Nyo Nyo Win, S Stevens, Aye Aye, D Nestel

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Article in World journal of surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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, 1 synthesis or guideline pooled it.

  1. Pooled it
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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

8 authors.

R M NatarajaDepartment of Paediatric Surgery, Urology and Surgical Simulation, Monash Children's Hospital, 246 Clayton Road, Clayton, Melbourne, VIC, 3168, Australia. ram.nataraja@monashhealth.org.ORCID 0000-0003-4438-0263
Yin Mar OoDepartment of Paediatric Surgery, Yangon Children's Hospital, Yangon, Myanmar.
D LjuharDepartment of Paediatric Surgery, Urology and Surgical Simulation, Monash Children's Hospital, 246 Clayton Road, Clayton, Melbourne, VIC, 3168, Australia.
M PacilliDepartment of Paediatric Surgery, Urology and Surgical Simulation, Monash Children's Hospital, 246 Clayton Road, Clayton, Melbourne, VIC, 3168, Australia.
Nyo Nyo WinDepartment of Paediatric Surgery, Yangon Children's Hospital, Yangon, Myanmar.
S StevensAustin Clinical School, University of Melbourne, Melbourne, VIC, Australia.
Aye AyeDepartment of Paediatric Surgery, Yangon Children's Hospital, Yangon, Myanmar.
D NestelAustin Precinct, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionIntussusception is one of the commonest causes of bowel obstruction in infants. Most infants in Low- and Middle-Income Countries (LMICs) undergo an invasive operative intervention. Supported by simulation-based education (SBE), the Air Enema (AE) non-operative technique was introduced in 2016 in Myanmar. This study assesses the long-term outcomes.

methodsMixed methods study design over 4 years including clinical outcomes and surgeon's attitudes towards the AE technique and SBE. Prospectively collected clinical outcomes and semi-structured interview with reflexive thematic analysis (RTA). Primary outcome measure was a long-term shift to non-operative intervention. SECONDARY OUTCOMES: Length of Stay (LoS), recurrence rates, intestinal resection rates, compared to the operative group. The data was analysed according to intention to treat. Quantitative data analysis with Mann-Whitney U test, Fisher's exact test, Student's T-Test or Wilcoxon Signed-Rank Test utilised. A p-value of <.05 was considered significant.

resultsA total of 311 infants with intussusception were included. A sustained shift to AE was revealed with high success rates (86.1-91.2%). AE had a reduced LoS (4 vs. 7 days p ≤ 0.0001), Duration of Symptoms (DoS) was lower with AE (1.9/7 vs. 2.5/7, p = 0.002). Low recurrence rates (0-5.8%) and intestinal resection rates stabilised at 30.5-31.8% vs.15.3% pre-intervention. Four RTA themes were identified: Expanding conceptions of healthcare professional education and training; realising far reaching advantages; promoting critical analysis and reflective practice of clinicians; and adapting clinical practice to local context. RTA revealed an overall positive paradigm shift in attitudes and application of SBE.

conclusionsA sustained change in clinical outcomes and appreciation of the value of SBE was demonstrated following the intervention.

Indexed as

EnemaIntussusceptionHumansInfantLength of StayPovertyRetrospective StudiesTreatment Outcome

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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.