Pediatric traumatic brain injury prehospital guidelines: a systematic review and appraisal

Wang, Zhe; Nguonly, Dellvin; Du, Rebecca Y.; García, Roxanna M.; Lam, Sandi

doi:10.1007/s00381-021-05364-9

Cited by 3 publications

(3 citation statements)

References 48 publications

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“…On the other hand, appraisal of paediatric prehospital head injury guidelines identifies areas of inconsistency in multiple treatment recommendations. 18 Low-quality or non-existent evidence for these treatment recommendations may be a substantial contributor.…”

Section: Discussionmentioning

confidence: 99%

“…High‐quality evidence underpins the majority of these treatment recommendations, with areas of guideline discordance reflecting evidence gaps. On the other hand, appraisal of paediatric prehospital head injury guidelines identifies areas of inconsistency in multiple treatment recommendations 18 . Low‐quality or non‐existent evidence for these treatment recommendations may be a substantial contributor.…”

Section: Discussionmentioning

confidence: 99%

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Appraisal of Australian and New Zealand paediatric sepsis guidelines

Sasse,

Borland,

George

et al. 2024

Emerg Medicine Australasia

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ObjectiveClinical practice guidelines (CPGs) are an important tool for the management of children with sepsis. The quality, consistency and concordance of Australian and New Zealand (ANZ) childhood sepsis CPGs with the Australian Commission on Safety and Quality in Healthcare (ACSQHC) sepsis clinical care standards and international sepsis guidelines is unclear.MethodsWe accessed childhood sepsis CPGs for all ANZ states and territories through Paediatric Research in Emergency Departments International Collaborative members. The guidelines were assessed for quality using the AGREE‐II instrument. Consistency between CPG treatment recommendations was assessed, as was concordance with the ACSQHC sepsis clinical care standards and international sepsis guidelines.ResultsOverall, eight CPGs were identified and assessed. CPGs used a narrative and pathway format, with those using both having the highest quality overall. CPG quality was highest for description of scope and clarity of presentation, and lowest for editorial independence. Consistency between guidelines for initial treatment recommendations was poor, with substantial variation in the choice and urgency of empiric antimicrobial administration; the choice, volume and urgency of fluid resuscitation; and the choice of first‐line vasoactive agent. Most CPGs were concordant with time‐critical components of the ACSQHC sepsis clinical care standard, although few addressed post‐acute care. Concordance with international sepsis guidelines was poor.ConclusionChildhood sepsis CPGs in current use in ANZ are of variable quality and lack consistency with key treatment recommendations. CPGs are concordant with the ACSQHC care standard, but not with international sepsis guidelines. A bi‐national sepsis CPG may reduce unnecessary variation in care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Appraisal of Australian and New Zealand paediatric sepsis guidelines

Sasse,

Borland,

George

et al. 2024

Emerg Medicine Australasia

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“…We used a global score and a global appreciation of quality that was not described in AGREE documentation but was described in the latest methodological recommendations for CPG systematic reviews 12 and has been used in other reviews. [46][47][48] In addition, the distinction between high-and low-quality CPGs (no CPGs were rated 'moderate' quality) was very clear; all lowquality CPGs had a score <40% and all high-quality CPGs had a score > 70%. Included guidelines used different methods to grade quality of evidence and strength of recommendations.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Clinical Practice Guideline Recommendations in Pediatric Orthopaedic Injury: A Systematic Review

Moore,

Drager,

Freire

et al. 2023

Journal of Pediatric Orthopaedics

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Background: Lack of adherence to recommendations on pediatric orthopaedic injury care may be driven by lack of knowledge of clinical practice guidelines (CPGs), heterogeneity in recommendations or concerns about their quality. We aimed to identify CPGs for pediatric orthopaedic injury care, appraise their quality, and synthesize the quality of evidence and the strength of associated recommendations. Methods: We searched Medline, Embase, Cochrane CENTRAL, Web of Science and websites of clinical organizations. CPGs including at least one recommendation targeting pediatric orthopaedic injury populations on any diagnostic or therapeutic intervention developed in the last 15 years were eligible. Pairs of reviewers independently extracted data and evaluated CPG quality using the Appraisal of Guidelines Research and Evaluation (AGREE) II tool. We synthesized recommendations from high-quality CPGs using a recommendations matrix based on the GRADE Evidence-to-Decision framework. Results: We included 13 eligible CPGs, of which 7 were rated high quality. Lack of stakeholder involvement and applicability (i.e., implementation strategies) were identified as weaknesses. We extracted 53 recommendations of which 19 were based on moderate or high-quality evidence. Conclusions: We provide a synthesis of recommendations from high-quality CPGs that can be used by clinicians to guide treatment decisions. Future CPGs should aim to use a partnership approach with all key stakeholders and provide strategies to facilitate implementation. This study also highlights the need for more rigorous research on pediatric orthopaedic trauma. Level of Evidence: Level II—therapeutic study.

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