Evidence map›Paper›PMID 35418420›Full record

ArticleBMJ open2022

Clinical perspectives on the identification of neurodevelopmental conditions in children and changes in referral pathways: qualitative interviews.

Barry Coughlan, Matt Woolgar, Alissa Mann, Robbie Duschinsky

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2022. 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
0.5field-weighted citation impact, top 42% 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, 5 citations in OpenAlex.

  1. Article
  2. 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

4 authors at 3 institutions in 1 country.

Barry CoughlanDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, UK bc471@medschl.cam.ac.uk.ORCID 0000-0002-1484-6491
Matt WoolgarInstitute of Psychiatry Psychology and Neuroscience, King's College London, London, UK.
Alissa MannDepartment of Psychology, University of Bath, Bath, UK.ORCID 0000-0002-3618-0395
Robbie DuschinskyDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, UK.ORCID 0000-0003-2023-5328
University of Cambridge · GBKing's College London · GBUniversity of Bath · GB

Funding

Department of HealthWellcome Trust
6 · The paper itself

Abstract

objectivePrevious work has raised questions about the role of general practitioners (GPs) in the identification of neurodevelopmental conditions such as autism spectrum disorders (autism) and attention deficit hyperactivity disorders (ADHD). This study aimed to explore how GPs identify these conditions in practice and their perspectives on recent changes to local referral pathways that mean referrals to the neurodevelopmental team come through educational professionals and health visitors, rather than GPs. This study also aimed to explore Child and Adolescent Mental Health Services (CAMHS) specialist's perspectives on the role of GPs.

settingGP practices, local neurodevelopmental services and specialist CAMHS services in the UK.

participantssemistructured interviews were conducted with GPs (n=8), specialists in local CAMHS (n=7), and professionals at national CAMHS services around the country (n=10). Interviews were conducted between January and May 2019. A framework approach informed by thematic analysis was used to analyse the data.

resultsGPs drew on various forms of tacit and explicit information including behavioural markers, parental report, prior knowledge of the family, expert and lay resources. Opinions varied between GPs regarding changes to the referral pathway, with some accepting the changes and others describing it as a 'disaster'. CAMHS specialists tended to feel that GPs required more neurodevelopmental training and time to conduct consultations.

conclusionThis study adds to the literature showing that GPs use an array of information sources when making referral decisions for autism and ADHD. Further work is urgently required to evaluate the impact of reconfiguring neurodevelopmental referral pathways such that GPs have a diminished role in identification.

Indexed as

Attention Deficit Disorder with HyperactivityAutism Spectrum DisorderGeneral PractitionersAdolescentChildHumansQualitative ResearchReferral and ConsultationSpecializationChild & adolescent psychiatryCommunity child healthDevelopmental neurology & neurodisabilityPRIMARY CAREQUALITATIVE RESEARCH

Identifiers

PMID35418420
PMCPMC9014038
OpenAlexW4224045664

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.