Evidence map›Paper›PMID 35787254›Full record

ArticleBMC pediatrics2022

Heterogeneity in the evaluation of suspected MIS-C: a cross-sectional vignette-based survey.

Claudia A Rosu, Anna M Martens, Jeffrey Sumner, Eva J Farkas, Puneeta Arya, Alexy Boudreau Arauz, Vandana L Madhavan, Hector Chavez, Shawn D Larson, Oluwakemi Badaki-Makun and 2 more

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

Article in BMC pediatrics, 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
0.7field-weighted citation impact, top 32% 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, 3 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

12 authors at 6 institutions in 1 country.

Claudia A Rosu *Massachusetts General Hospital, Institute of Health Professionals, Boston, MA, USA.
Anna M Martens *Harvard Medical School, Boston, MA, USA.
Jeffrey SumnerHarvard Medical School, Boston, MA, USA.
Eva J FarkasMassachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Puneeta AryaHarvard Medical School, Boston, MA, USA.
Alexy Boudreau ArauzHarvard Medical School, Boston, MA, USA.
Vandana L MadhavanHarvard Medical School, Boston, MA, USA.
Hector ChavezDepartment of Pediatric Emergency Medicine, Holtz's Children's Hospital, Miami, FL, USA.
Shawn D LarsonDepartment of Surgery, University of Florida, Gainesville, FL, USA.
Oluwakemi Badaki-MakunDepartment of Pediatrics, Johns Hopkins Hospital, Baltimore, MD, USA.
Daniel IrimiaHarvard Medical School, Boston, MA, USA.
Lael M YonkerHarvard Medical School, Boston, MA, USA. lyonker@mgh.harvard.edu.
Massachusetts General Hospital · USHarvard University · USBurn Institute · USJohns Hopkins Hospital · USMGH Institute of Health Professions · USUniversity of Florida · US

Funding

Renewal: Dysfunctional Myelopoiesis and Myeloid-Derived Suppressor Cells in Sepsis PathobiologyRM1GM139690 · NIGMS · UNIVERSITY OF FLORIDA · PI Philip A Efron, Michael Paul Kladde · 2021 to 2026
$10.3M
Neutrophil Decision Making in Confined Environments in Health and DiseaseR01GM092804 · NIGMS · MASSACHUSETTS GENERAL HOSPITAL · PI IRIMIA, DANIEL · 2010 to 2022
$4.3M
Microfluidic Assessment of Clinical Outcomes in Preterm NewbornsR01HD089939 · NICHD · UNIVERSITY OF FLORIDA · PI IRIMIA, DANIEL, MOLDAWER, LYLE L · 2017 to 2021
$3.3M
Mechanistically Disentangling the Infected, Inflamed LungK08HL143183 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI YONKER, LAEL · 2018 to 2022
$869k
NHLBI NIH HHS K08 HL143183NICHD NIH HHS R01 HD089939NIGMS NIH HHS R01 GM092804NIGMS NIH HHS RM1 GM139690
6 · The paper itself

Abstract

BACKGROUND AND

objectivesMultisystem Inflammatory Syndrome in Children (MIS-C) is an emerging complication of COVID-19 which lacks a definitive diagnostic test and evidence-based guidelines for workup. We sought to assess practitioners' preferences when initiating a workup for pediatric patients presenting with symptoms concerning for MIS-C.

methodsIn a cross-sectional vignette-based survey, providers were presented with clinical vignettes of a patient presenting with 24 h of fever from a community with high rates of COVID-19. Respondents were asked about their general practices in pursuing a workup for potential MIS-C including testing obtained, criteria for diagnosis, and timing to confirm or rule out the diagnosis.

resultsMost of the 174 respondents were physicians from the United States at academic medical centers. The majority of providers would not initiate MIS-C workup for fever and non-specific symptoms unless the fever lasted more than 72 h. Skin rash, abdominal pain, and shortness of breath were symptoms that raised greatest concern for MIS-C. Most providers would obtain COVID-19 PCR or antigen testing, plus blood work, in the initial workup. The list of laboratory studies providers would obtain is extensive. Providers primarily rely on cardiac involvement to confirm a MIS-C diagnosis, and establishing a diagnosis takes 24-48 h.

conclusionsSignificant heterogeneity exists amongst providers as to when to initiate the MIS-C workup, the order and content of the workup, and how to definitively diagnose MIS-C. A diagnostic test with high sensitivity and specificity for MIS-C and refined evidence-based guidelines are needed to expedite diagnosis and treatment.

Indexed as

COVID-19ChildCross-Sectional StudiesHumansSystemic Inflammatory Response SyndromeUnited StatesMultisystem inflammatory syndrome in childrenPediatric COVID-19

Identifiers

PMID35787254
PMCPMC9254446
OpenAlexW4283794545

What OpenQuestion holds

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Registered trials

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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.