Evidence map›Paper›PMID 38154994›Full record

Trial reportJournal of pediatric surgery2024

Care of Injured Children Compared to Adults at District and Regional Hospitals in Ghana and the Impact of a Trauma Intake Form: A Stepped-Wedge Cluster Randomized Trial.

Adam Gyedu, Adamu Issaka, Anthony Baffour Appiah, Peter Donkor, Charles Mock

Open access · greenAbstract readRandomized Controlled TrialComparative StudyMulticenter Study
In one paragraph

Trial report in Journal of pediatric surgery, 2024. 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
0.7field-weighted citation impact, top 27% 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, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Assessment and reassessment of injured patients at non-tertiary hospitals in Ghana: A stepped-wedge cluster randomized trial.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2024
    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

5 authors at 4 institutions in 2 countries.

Adam GyeduDepartment of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana; University Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. Electronic address: drgyedu@gmail.com.
Adamu IssakaDepartment of Surgery, School of Medicine, University for Development Studies, Tamale, Ghana.
Anthony Baffour AppiahGhana Field Epidemiology and Laboratory Training Program, School of Public Health, University of Ghana, Legon, Accra, Ghana.
Peter DonkorDepartment of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Charles MockDepartment of Surgery, University of Washington, Seattle, WA, USA; Harborview Injury Prevention and Research Center, Seattle, WA, USA.
Kwame Nkrumah University of Science and Technology · GHUniversity for Development Studies · GHUniversity of Ghana · GHUniversity of Washington · US

Funding

Improving Initial Management of the Injured at Ghanaian District and Regional Hospitals with a Trauma Intake FormR21TW011685 · FIC · KWAME NKRUMAH UNIVERSITY/SCIENCE/TECH · PI GYEDU, ADAM · 2020 to 2021
$297k
FIC NIH HHS R21 TW011685
6 · The paper itself

Abstract

backgroundThis study aimed to determine the effectiveness of a standardized trauma intake form (TIF) to improve achievement of key performance indicators (KPIs) of initial trauma care among injured children, compared to adults, at non-tertiary hospitals in Ghana.

methodsA stepped-wedge cluster randomized trial was performed with research assistants directly observing the management of injured patients before and after introducing the TIF at emergency units of 8 non-tertiary hospitals for 17.5 months. Differences in outcomes between children and adults in periods before and after TIF introduction were determined with multivariable logistic regression. Differences in outcomes among children after TIF introduction were determined using generalized linear mixed regression.

resultsManagement of 3889 injured patients was observed; 757 (19%) were children <18 years. Trauma care KPIs at baseline were lower for children compared to adults. Improvements in primary survey KPIs were observed among children after TIF introduction. Examples include airway assessment [279 (71%) to 359 (98%); adjusted odds ratio (AOR): 74.42, p = 0.005)] and chest examination [225 (58%) to 349 (95%); AOR 53.80, p = 0.002)]. However, despite these improvements, achievement of KPIs was still lower compared to adults. Examples are pelvic fracture evaluation [children: 295 (80%) vs adults: 1416 (88%), AOR: 0.56, p = 0.001] and respiratory rate assessment (children: 310 (84%) vs adults: 1458 (91%), AOR: 058, p = 0.030).

conclusionsWhile the TIF was effective in improving most KPIs of pediatric trauma care, more targeted education is needed to bridge the gap in quality between pediatric and adult trauma care at non-tertiary hospitals in Ghana and other low- and middle-income countries. TYPE OF STUDY: Stepped-wedged cluster randomized controlled trial. LEVEL OF EVIDENCE: I.

Indexed as

Wounds and InjuriesAdolescentAdultChildChild, PreschoolEmergency Service, HospitalFemaleGhanaHospitals, DistrictHumansInfantMaleQuality ImprovementYoung AdultChecklistGhanaNon-tertiary hospitalPediatricTrauma careTrauma intake form

Identifiers

PMID38154994
PMCPMC11105994
OpenAlexW4389513546

What OpenQuestion holds

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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.