Evidence map›Paper›PMID 39916738›Full record

ArticleJournal of clinical orthopaedics and trauma2025

Are Virtual Fracture Clinics really "safe"? - An evaluation of the capability of a District General Hospital Virtual Fracture Clinic pathway to detect safeguarding issues.

Matthew Smitheman, Joseph Heylen, Kathryn Duke, Katy Western, Andrew Keightley, Alexander Dinneen

Abstract read
In one paragraph

Article in Journal of clinical orthopaedics and trauma, 2025. 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
  2. Review
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

6 authors.

Matthew SmithemanRoyal Surrey NHS Foundation Trust., Trauma & Orthopaedics Department, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, GU2 7XX, United Kingdom.
Joseph HeylenRoyal Surrey NHS Foundation Trust., Trauma & Orthopaedics Department, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, GU2 7XX, United Kingdom.
Kathryn DukeRoyal Surrey NHS Foundation Trust., Trauma & Orthopaedics Department, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, GU2 7XX, United Kingdom.
Katy WesternRoyal Surrey NHS Foundation Trust., Trauma & Orthopaedics Department, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, GU2 7XX, United Kingdom.
Andrew KeightleyRoyal Surrey NHS Foundation Trust., Trauma & Orthopaedics Department, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, GU2 7XX, United Kingdom.
Alexander DinneenRoyal Surrey NHS Foundation Trust., Trauma & Orthopaedics Department, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, GU2 7XX, United Kingdom.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Virtual Fracture Clinics (VFCs) have been widely reported as "safe" in the literature. This is due to exceptionally low rates of missed or incorrect diagnoses and safe management of conditions. However, there has been minimal discussion about the ability of VFCs to identify safeguarding issues. Methods: All referrals to the Unit's VFC in December 2022 were reviewed. n = 397. Each referral was reviewed to identify diagnosis, outcome, suspicion of safeguarding, type of healthcare professional referring and whether the specific safeguarding "check box" had been completed.Allied healthcare professionals (AHPs) involved in the VFC were invited to complete a questionnaire to determine their level of training and confidence in managing safeguarding issues. Results: Review of the VFC referrals showed most were from advanced nurse practitioners. 55 % of referrers did not engage with the specific safeguarding section on the referral. Of these 13 cases were suspicious for a safeguarding issue, of which 3 were subsequently not seen in a fracture clinic: 2 triaged to physiotherapy, 1 discharged. These could represent missed safeguarding opportunities.Review of questionnaire response showed that 86 % of respondents were up to date with mandatory safeguarding training. On average respondents felt "confident" managing safeguarding. However, the majority felt they wanted more teaching on safeguarding. Conclusion: Whilst VFCs have been deemed "safe" with regards to fracture management, they may not be "safe" with regards to identification of safeguarding issues. This project demonstrates the main issues are poor quality referrals and the missed opportunity for a healthcare professional, appropriately trained in safeguarding, to assess the patient face to face.

Indexed as

Non-accidental injurySafeguardingVFCVirtual fracture clinic

Identifiers

PMID39916738
PMCPMC11795132

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.