Availability of Common Pediatric Radiology Studies: Are Rural Patients at a Disadvantage?

Whitley, Jorge A.; Gnaneswaran, Shruthie; Thach, Molly; Taylor, Amy C.; Merguerian, Paul A.; Kieran, Kathleen

doi:10.1016/j.jss.2018.08.047

Cited by 6 publications

(6 citation statements)

References 33 publications

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“…Rural-urban disparities in access to subspecialty and intensive care as well as disease prevalence in pediatric medicine are well recognized [ 24 – 27 ]. A recent study demonstrated that access to routine pediatric urology imaging studies such as VCUG and diuretic renal scans were seldom offered at rural hospitals within Washington state [ 28 ]. The same access difficulties are present within the IH system, with much of specialized uroradiographic testing occurring at the only freestanding tertiary care pediatric hospital in the Intermountain West.…”

Section: Discussionmentioning

confidence: 99%

Utilization of Radiographic Imaging for Infant Hydronephrosis over the First 12 Months of Life

Schaeffer

Cartwright

Lau

et al. 2020

Advances in Urology

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Purpose. The workup and surveillance strategies for infant hydronephrosis (HN) vary, although this could be due to grade-dependent differences in imaging intensity. We aimed to describe the frequency of imaging studies for HN within the first year of life, stratified by initial HN grade, within a large regional healthcare system. Study Design and Data Source. Retrospective cohort using Intermountain Healthcare Data Warehouse. Inclusion criteria: (1) birth between 1/1/2005 and 12/31/2013, (2) CPT code for HN, and (3) ultrasound (U/S) confirmed HN within four months of birth. Data Collection. Grade of HN on initial postnatal U/S; number of HN-associated radiologic studies (renal U/Ss, voiding cystourethrograms (VCUGs), and diuretic renal scans); demographic and medical variables. Primary Outcome. Sum of radiologic studies within the first year of life or prior to pyeloplasty. Statistical Analysis. Multivariate poisson regression to analyze association between the primary outcome and the initial HN grade. Results. Of 1,380 subjects (993 males and 387 females), 990 (72%), 230 (17%), and 160 (12%) had mild, moderate, and severe HN, respectively. Compared with those with mild HN, patients with moderate (RR: 1.57; 95% CI: 1.42–1.73) and severe (RR: 2.09; 95% CI: 1.88–2.32) HN had a significantly higher rate of imaging use over 12 months (or prior to surgery) after controlling for potential confounders. Conclusions. In a large regional healthcare system, imaging use for HN is proportional to its initial grade. This suggests that within our system, clinicians treating this condition are using a risk-stratified approach to imaging.

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Section: Discussionmentioning

confidence: 99%

Utilization of Radiographic Imaging for Infant Hydronephrosis over the First 12 Months of Life

Schaeffer

Cartwright

Lau

et al. 2020

Advances in Urology

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“…The inclusion of CLS in the research protocols authored by physicians, nurses, and other clinicians was considered a facilitator of CLS' utilization. CLS were described as playing multiple roles in research (Figures 6), with 35% (n = 37) of manuscripts 5,7,12,16,17,20,25,[33][34][35][36]38,42,44,47,48,50,58,[62][63][64][65]69,80,84,87,98,100,103,104,106,107,111,116,118,120,121 identifying CLS as part of the research team and 52% (n = 55) of research protocols involving CLS in the implementation of the study protocol. 12-14,16,17,20,22,24,25,34,39,42-44,47,48,51,55,59,60, 64, 65, 68-70, 73,75, 76, 78,80,82,84, 88,89, 93,94,96, 98-102,104, 105,107-109, 111,113-116,118,119,122 The lack of CLS as part of the research team could be a barrier to CLS utilization.…”

Section: The Role Of Child Life Specialists In Multidisciplinary Rese...mentioning

confidence: 99%

“…CLS were researchers/authors, defined as named authorship, in 35% (n = 37) of the research reviewed. 5,7,12,16,17,20,25,[33][34][35][36]38,42,44,47,48,50,58,[62][63][64][65]69,80,84,87,98,100,104,106,107,111,116,118,[120][121][122]…”

Section: The Role Of Child Life Specialists In Multidisciplinary Rese...mentioning

confidence: 99%

Child life specialist services, practice, and utilization across health care: a scoping review

Rosenblatt,

Pederson,

Davis-Sandfoss

et al. 2024

JBI Evidence Synthesis

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Objective: The objective of this review was to map the available evidence regarding the scope of child life specialist services, practice, and utilization. Introduction: Child life specialists are members of multidisciplinary health care system teams who prioritize the developmental needs of pediatric patients to support and improve patient and family health care experiences. Evidence of the effectiveness of child life specialist services and the utilization of those services is often incorporated in multidisciplinary research reports and thus overlooked. Inclusion Criteria: All quantitative, qualitative, and mixed methods research study reports and systematic reviews investigating child life specialist services, practice, and utilization in health care systems were included. Methods: This review was guided by the JBI methodology for scoping reviews and a published a priori protocol. CINAHL (EBSCOhost), MEDLINE (PubMed), Scopus, and PsycINFO (APA) were searched for evidence published from January 1980 to August 2022. Results: Research publications about child life specialist services, practice, and utilization have increased dramatically over the past decade with more than 50% of studies published in the last 5 years. Although the first authors of the majority of the research publications were physicians, these multidisciplinary author teams depicted child life specialist services in a variety of roles, including co-investigators, interventionists, and research subjects. The 105 full-text publications reviewed were from 10 countries and occurred across a wide scope of health care settings and medical subspecialties, but primarily in hospitals and health centers, and to a lesser extent, in ambulatory clinics and communities. A wide variety of child life specialist services were described across these settings. Conclusion: The concept of child life services began in 1922 and emerged as the child life specialist services specialty in the United States in the 1970s and 1980s. Mapping the research can help delineate the barriers and facilitators to these services in health care systems. This scoping review provides evidence of the global diffusion of child life specialist services across health care system settings with recent increases in research publications involving child life specialist services.

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“…Another barrier to pediatric patients receiving appropriate imaging is where they live, specifically if they live in rural areas. Studies have shown a lack of pediatric radiologists in rural areas limiting the availability of specialized pediatric imaging studies [80]. The literature does suggest one way to possibly eliminate disparities in ED imaging in pediatric patients would be strict adherence to standardized clinical algorithms, as evident in a study finding no racial differences in the radiological studies in pediatric head injury patients when clinical algorithms were routinely followed [81].…”

Section: Ed Imagingmentioning

confidence: 99%

Health Care Disparities in Radiology—A Review of the Current Literature

DeBenedectis¹,

Spalluto²,

Americo³

et al. 2022

Journal of the American College of Radiology

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Introduction: Health care disparities exist in all medical specialties, including radiology. Raising awareness of established health care disparities is a critical component of radiology's efforts to mitigate disparities. Our primary objective is to perform a comprehensive review of the last 10 years of literature pertaining to disparities in radiology care. Our secondary objective is to raise awareness of disparities in radiology.Methods: We reviewed English-language medicine and health services literature from the past 10 years (2010-2020) for research that described disparities in any aspect of radiologic imaging using radiology search terms and key words for disparities in OVID. Relevant studies were identified with adherence to the guidelines set forth by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results:The search yielded a total 1,890 articles. We reviewed the citations and abstracts with the initial search yielding 1,890 articles (without duplicates). Of these, 1,776 were excluded based on the criteria set forth in the methods. The remaining unique 114 articles were included for qualitative synthesis.Discussion: We hope this article increases awareness and inspires action to address disparities and encourages research that further investigates previously identified disparities and explores not-yet-identified disparities.

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Availability of Common Pediatric Radiology Studies: Are Rural Patients at a Disadvantage?

Cited by 6 publications

References 33 publications

Utilization of Radiographic Imaging for Infant Hydronephrosis over the First 12 Months of Life

Utilization of Radiographic Imaging for Infant Hydronephrosis over the First 12 Months of Life

Child life specialist services, practice, and utilization across health care: a scoping review

Health Care Disparities in Radiology—A Review of the Current Literature

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