ArticleJournal of clinical nursing2026
Assessing Clinical Deterioration in Children With Dark-Coloured Skin: A Scoping Review.
Article in Journal of clinical nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSigns of clinical deterioration may appear differently in children with dark-coloured skin. How to assess children in this cohort is currently poorly defined.
aimTo explore available information on the assessment of clinical deterioration in children with dark-coloured skin and identify research deficits.
methodsA scoping review following Arksey and O'Malley and PRISMA-ScR frameworks. Five online databases, grey literature and reference lists of eligible documents were searched. Source titles, abstracts and full texts were screened. Included documents were assessed for level of evidence according to the Joanna Briggs Institute. Data were charted on a pre-defined data collection tool and analysed through descriptive and content analysis.
resultsOut of 2382 documents screened, 37 were included. Document types included 16 quantitative studies, 14 opinion papers, five reviews and two reports. Most sources (21) were low-level evidence. Sixty-six unique terms were used to describe dark-coloured skin. Eighteen documents reported use of a skin classification system, including race/ethnicity, established colour scales, cosmetic references and observer opinion. Twelve focused on newborn hyperbilirubinaemia. Considerations for assessing jaundice, pallor, cyanosis, pulse oximetry, petechiae and signs of shock were reported. Techniques to improve assessment included optimising the environment, identifying baseline skin colour, and involving families and patients in assessment. No documents reported on assessment of mottling or capillary refill time for children with dark-coloured skin. LINKING EVIDENCE TO ACTION: Assessment of clinical deterioration for children with dark-coloured skin is highly relevant to health professional practice. There is an overall deficit in high-quality research. Specific information gaps in assessment are considerations for mottling, capillary refill time, APGAR scoring, and clinical implications of device overestimation of bilirubin and oxygen saturations in children with dark-coloured skin. Health professionals are encouraged to use devices cautiously. Greater accuracy and objectivity are necessary to fill these gaps and support effective detection of signs of clinical deterioration.
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