Evidence map›Paper›PMID 42070582›Full record

ArticleJournal of hospital medicine2026

Renal ultrasound after first febrile urinary tract infection in hospitalized children: The ROUTINE prospective observational study protocol.

Sanjay Mahant, Keenjal Mistry, Ann Bayliss, Nicholas Barrowman, Karen Born, Cornelia Borkhoff, Raman Chawla, David D'Arienzo, Aurelie D'Hondt, Kim De Castris-Garcia and 31 more

Abstract read
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In one paragraph

Article in Journal of hospital medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

41 authors.

Sanjay MahantThe Hospital for Sick Children, Toronto, Ontario, Canada.
Keenjal MistryChild Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada.
Ann BaylissChildren's Health Division, Trillium Health Partners, Mississauga, Ontario, Canada.
Nicholas BarrowmanClinical Research Unit, Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, Canada.
Karen BornInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Cornelia BorkhoffThe Hospital for Sick Children, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0003-3420-1866
Raman ChawlaSection of Hospital Medicine, Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada.
David D'ArienzoDepartment of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada.ORCID https://orcid.org/0000-0002-9601-8533
Aurelie D'HondtDepartment of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada.
Kim De Castris-GarciaChild Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada.
Joana Dos SantosDivision of Urology, Department of Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.
Olivier DrouinDivision of General Pediatrics, Department of Pediatrics, Université de Montreal, CHU Sainte-Justine, Montreal, Quebec, Canada.
Ricardo FaingoldDepartment of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada.
Vince Albert FloresChild Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada.
Jessica FouldsDepartment of Pediatrics, Stollery Children's Hospital, Edmonton, Alberta, Canada.ORCID https://orcid.org/0000-0002-2471-0432
Jeremy FriedmanThe Hospital for Sick Children, Toronto, Ontario, Canada.
Lucy GigliaDepartment of Pediatrics, McMaster University and McMaster Children's Hospital, Hamilton, Ontario, Canada.
Joanna HollandDepartment of Pediatrics, Dalhousie University, IWK Health Centre, Halifax, Nova Scotia, Canada.
Radha JettyDepartment of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
Kristopher KangDivision of Pediatric Medicine, Department of Paediatrics, University of British Columbia, BC Children's Hospital, Vancouver, British Columbia, Canada.
Patricia LiDepartment of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada.
Grace LeoChild Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada.
Armando LorenzoDepartment of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada.
Elise LuDepartment of Pediatrics, Western University, Children's Hospital at London Health Sciences Centre (LHSC), London, Ontario, Canada.ORCID https://orcid.org/0009-0000-8998-9895
Colin MacarthurThe Hospital for Sick Children, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0002-5029-0996
Kyle MillarDepartment of Pediatrics and Child Health, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Myla E MorettiThe Hospital for Sick Children, Toronto, Ontario, Canada.
Nassr NamaDivision of Hospital Medicine, Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, Washington.ORCID https://orcid.org/0000-0002-0199-3599
Olivia OstrowThe Hospital for Sick Children, Toronto, Ontario, Canada.
Rachel PearlDepartment of Pediatrics, William Osler Health System, Brampton, Ontario, Canada.
Patricia ParkinThe Hospital for Sick Children, Toronto, Ontario, Canada.
Mandy RickardDivision of Urology, Department of Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.ORCID https://orcid.org/0000-0003-0598-1824
Mahmoud SakranDepartment of Pediatrics, Queens University, Lakeridge Health, Oshawa, Ontario, Canada.
Anupam SehgalDepartment of Pediatrics, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada.
Nader ShaikhDepartment of Pediatrics, University of Pittsburgh, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
Sepideh TaheriDepartment of Pediatrics, Western University, Children's Hospital at London Health Sciences Centre (LHSC), London, Ontario, Canada.ORCID https://orcid.org/0000-0003-3412-2164
Otto G VanderkooiPediatric Infectious Diseases, Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada.
Gemma VomieroSection of Hospital Medicine, Department of Pediatrics, University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada.
Kim ZhouDepartment of Pediatrics, North York General Hospital, Toronto, Ontario, Canada.
Peter J GillThe Hospital for Sick Children, Toronto, Ontario, Canada.
Canadian Paediatric Inpatient Research Network (PIRN)

Funding

CIHR 183860Physicians' Services Incorporated Foundation 22-03
6 · The paper itself

Abstract

backgroundUrinary tract infection (UTI) is a common reason for hospitalization in young children. American and Canadian guidelines recommend universal renal ultrasound after a first febrile UTI to identify genitourinary abnormalities that require further management, despite limited supporting evidence. The Renal ultrasOund after first febrile Urinary Tract INfEction (ROUTINE) study aims to (a) determine the incidence of clinically important and insignificant genitourinary abnormalities on renal ultrasound, (b) describe the cascade of healthcare interventions following the detection of abnormalities, (c) explore parents' experiences, and (d) identify clinical factors associated with clinically important abnormalities.

methodThis multicentre, prospective, observational study with an embedded qualitative component will enroll children <24 months of age hospitalized at 17 children's and community hospitals in Canada and the United States after a first febrile UTI, with 1-year follow-up. The primary outcome is detection of genitourinary abnormalities on renal ultrasound, classified by clinical importance using a standardized system. Secondary outcomes include clinical (recurrent febrile UTI), radiologic (vesicoureteral reflux), healthcare interventions (surgery, antibiotic prophylaxis, imaging, specialist follow-up), and parent-reported outcomes (anxiety, involvement in decision making). Parent experiences will be explored through semistructured interviews. Primary analysis will estimate the incidence of clinically important abnormalities and potential overdiagnosis with 95% confidence intervals (CIs). Secondary analysis will summarize radiologic, clinical, healthcare intervention, and parent-reported outcomes and assess predictors of clinically important abnormalities using multivariable logistic regression. DISCUSSION: This multicentre prospective study with longitudinal follow-up will generate evidence on the utility of universal renal ultrasound after the first febrile UTI. Findings will inform evidence-based management, shared decision-making, and clinical practice guidelines.

Indexed as

FeverKidneyUrinary Tract InfectionsCanadaChild, PreschoolFemaleHospitalizationHumansInfantMaleMulticenter Studies as TopicObservational Studies as TopicProspective StudiesUltrasonographyUnited States

Identifiers

PMID42070582
PMCPMC13327701

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

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.