Paediatric gastrointestinal and hepatobiliary radiology: why do we need subspecialists, and what is new?

Watson, Tom; Barber, Joy L.; Woodley, Helen

doi:10.1007/s00247-020-04778-y

Pediatr Radiol

2021

DOI: 10.1007/s00247-020-04778-y

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Paediatric gastrointestinal and hepatobiliary radiology: why do we need subspecialists, and what is new?

Tom Watson

Joy L. Barber

Helen Woodley

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Cited by 3 publications

(2 citation statements)

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“…Quality, not quantity, is key. While all of this is essential when working with children, there are clearly transferable lessonsa more holistic approach benefits all patients whatever their age [1,2].…”

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confidence: 99%

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Considering paediatric radiology

Halliday

2021

Pediatr Radiol

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confidence: 99%

“…This is particularly important when serial imaging is required for long-term or developmental conditions such as cystic fibrosis. The information obtained from high-quality serial studies is vital to understanding disease progression, enabling identification of patients who will benefit from early intervention [2,3].…”

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Considering paediatric radiology

Halliday

2021

Pediatr Radiol

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Hofstra

Horst³

et al. 2023

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Estimation of age of transition from children's to adult healthcare for young people with long term conditions using linked routinely collected healthcare data

Jarvis

Richardson

Flemming

et al. 2021

IJPDS

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IntroductionHealthcare transitions, including from paediatric to adult services, can be disruptive and cause a lack of continuity in care. Existing research on the paediatric-adult healthcare transition often uses a simple age cut-off to assign transition status. This risks misclassification bias, reducing observed changes at transition (adults are included in the paediatric group and vice versa) possibly to differing extents between groups that transition at different ages. ObjectiveTo develop and assess methods for estimating the transition point from paediatric to adult healthcare from routine healthcare records. MethodsA retrospective cohort of young people (12 to 23 years) with long term conditions was constructed from linked primary and secondary care data in England. Inpatient and outpatient records were classified as paediatric or adult based on treatment and clinician specialities. Transition point was estimated using three methods based on record classification (First Adult: the date of first adult record; Last Paediatric: date of last paediatric record; Fitted: a date determined by statistical fitting). Estimated transition age was compared between methods. A simulation explored impacts of estimation approaches compared to a simple age cut-off when assessing associations between transition status and healthcare events. ResultsSimulations showed using an age-based cut-off at 16 or 18 years as transition point, common in research on transition, may underestimate transition-associated changes. Many health records for those aged 14 years were classified as adult, limiting utility of the First Adult approach. The Last Paediatric approach is least sensitive to this possible misclassification and may best reflect experience of the transition. ConclusionsEstimating transition point from routine healthcare data is possible and offers advantages over a simple age cut-off. These methods, adapted as necessary for data from other countries, should be used to reduce risk of misclassification bias in studies of transition in nationally representative data.

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Paediatric gastrointestinal and hepatobiliary radiology: why do we need subspecialists, and what is new?

Cited by 3 publications

References 88 publications

Considering paediatric radiology

Considering paediatric radiology

Transdisciplinary entrustable professional activities

Estimation of age of transition from children's to adult healthcare for young people with long term conditions using linked routinely collected healthcare data

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