Evidence map›Paper›PMID 39214557›Full record

Observational studyBMJ paediatrics open2024

Implementation of the WHO standards to assess the quality of care for children with acute diarrhoea: findings of a multicentre study (CHOICE) in Italy.

Marzia Lazzerini, Idanna Sforzi, Ilaria Liguoro, Enrico Felici, Stefano Martelossi, Silvia Bressan, Gian Luca Trobia, Riccardo Lubrano, Silvia Fasoli, Angela Troisi and 11 more

Abstract readMulticenter StudyObservational Study
In one paragraph

Observational study in BMJ paediatrics open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Observational
  2. Observational
  3. 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

21 authors.

Marzia LazzeriniInstitute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.ORCID http://orcid.org/0000-0001-8608-2198
Idanna SforziDepartment of Pediatric Emergency Medicine and Trauma Center, IRCCS Meyer Children's University Hospital, Florence, Italy.ORCID http://orcid.org/0000-0002-3445-8963
Ilaria LiguoroSanta Maria della Misericordia University Hospital, Udine, Friuli-Venezia Giulia, Italy.
Enrico FeliciAzienda Ospedaliera Nazionale Santi Antonio e Biagio e Cesare Arrigo Alessandria, Alessandria, Piemonte, Italy.ORCID http://orcid.org/0000-0002-5997-7057
Stefano MartelossiDepartment of Pediatrics, Treviso Hospital, Treviso, Italy.
Silvia BressanDepartment of Women's and Children's Health, University of Padova, Padova, Italy.ORCID http://orcid.org/0000-0002-6736-5392
Gian Luca TrobiaAzienda Ospedaliera Cannizzaro, Catania, Italy.ORCID http://orcid.org/0000-0002-6943-4638
Riccardo LubranoDepartment of Pediatrics Sapienza University of Rome, Santa Maria Goretti Hospital, Latina, Italy.ORCID http://orcid.org/0000-0001-8237-955X
Silvia FasoliDepartment of Pediatrics, "Carlo Poma" Hospital, Mantova, Italy.
Angela TroisiDepartment of Pediatrics, Santa Maria delle Croci Hospital, Ravenna, Italy.ORCID http://orcid.org/0000-0001-9457-3974
Michela PandulloSanta Maria della Misericordia University Hospital, Udine, Friuli-Venezia Giulia, Italy.
Marta GagliardiAzienda Ospedaliera Nazionale Santi Antonio e Biagio e Cesare Arrigo Alessandria, Alessandria, Piemonte, Italy.
Paola MorasDepartment of Pediatrics, Treviso Hospital, Treviso, Italy.
Silvia GaliazzoDepartment of Women's and Children's Health, University of Padova, Padova, Italy.
Marta ArrabitoDepartment of Clinical and Experimental Medicine, University of Catania, Catania, Italy.ORCID http://orcid.org/0009-0000-3066-7672
Mariateresa SansevieroDepartment of Pediatrics Sapienza University of Rome, Santa Maria Goretti Hospital, Latina, Italy.ORCID http://orcid.org/0000-0001-7935-6648
Mariangela LabruzzoDepartment of Pediatrics, "Carlo Poma" Hospital, Mantova, Italy.
Sara Dal BoDepartment of Pediatrics, Santa Maria delle Croci Hospital, Ravenna, Italy.
Valentina BaltagDepartment of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland.
Paolo DalenaInstitute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy paolo.dalena@burlo.trieste.it.ORCID http://orcid.org/0000-0003-2920-9572
CHOICE study group

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundThere is no documented experience in the use of the WHO standards for improving the quality of care (QOC) for children at the facility level. We describe the use of 10 prioritised WHO-Standard-based Quality Measures to assess QOC for children with acute diarrhoea (AD) in Italy.

methodsIn a multicentre observational study in 11 paediatric emergency departments with different characteristics and geographical location, we collected data on 3061 children aged 6 months to 15 years with AD and no complications. Univariate and multivariate analyses were conducted.

resultsStudy findings highlighted both good practices and gaps in QoC, with major differences in QOC across facilities. Documentation of body weight and temperature varied from 7.7% to 98.5% and from 50% to 97.7%, respectively (p<0.001); antibiotic and probiotic prescription rates ranged from 0% to 10.1% and from 0% to 80.8%, respectively (p<0.001); hospitalisations rates ranged between 8.5% and 62.8% (p<0.001); written indications for reassessment were provided in 10.4%-90.2% of cases (p<0.001). When corrected for children's individual characteristics, the variable more consistently associated with each analysed outcome was the individual facility. Higher rates of antibiotics prescription (+7.6%, p=0.04) and hospitalisation (+52.9%, p<0.001) were observed for facilities in Southern Italy, compared with university centres (-36%, p<0.001), independently from children characteristics. Children's clinical characteristics in each centre were not associated with either hospitalisation or antibiotic prescription rates.

conclusionsThe 10 prioritised WHO-Standard-based Quality Measures allow a rapid assessment of QOC in children with AD. Action is needed to identify and implement sustainable and effective interventions to ensure high QOC for all children.

Indexed as

DiarrheaWorld Health OrganizationAcute DiseaseAdolescentAnti-Bacterial AgentsChildChild, PreschoolEmergency Service, HospitalFemaleHospitalizationHumansInfantItalyMaleProbioticsQuality of Health CareAnti-Bacterial AgentsQualitative research

Identifiers

PMID39214557
PMCPMC13059892

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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.