Observational studyPediatric rheumatology online journal2025
Referral letters to pediatric rheumatology: referral content and impact on triage - an observational study.
Observational study in Pediatric rheumatology online journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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Who cites it
1 citing paper in PubMed.
- A retrospective study of pediatric rheumatology referrals reveals large discrepancies in referring providers' musculoskeletal exams.Pediatric rheumatology online journal · 2026Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDelays in access to care in rheumatology are well documented. Many factors contribute to these delays and studies in adult populations indicate that incomplete referral letters may play a role. This study aims to describe the content of referral letters to pediatric rheumatology and to investigate the impact of incomplete letters on time to triage and accessing care.
findings
methodsWe evaluated referrals to a tertiary care pediatric rheumatology centre for eight components of comprehensive referral letters. In addition, we compared time-to-triage and percentage of patients receiving rheumatic diagnoses between letters with sufficient content for immediate triage versus incomplete letters requiring further information. Logistic regression models identified factors associated with delayed triage.
resultsFurther information was requested for 67/447 (15%) referrals, resulting in median delay in time-to-triage of seven days. Delayed triage was associated with four factors: lack of musculoskeletal physical examination, referral from family physicians versus other specialty, missing information regarding management, and lack of rheumatic diagnosis of concern. Rheumatic diagnoses resulted from 42% of all referrals overall, specifically from 170/384 (44%) of immediately triaged referrals and 19/63 (30%) of referrals requiring further information. Rheumatic diagnoses resulted less commonly from family physician referrals.
conclusionsMissing important details in referrals to pediatric rheumatology contribute to delayed assessment. These findings can inform initiatives to educate physicians around relevant content of referral letters to facilitate timely access to care.
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