Loading…
Development of hospital-based guidelines for skeletal survey in young children with bruises
To develop guidelines for performing an initial skeletal survey (SS) for children
Saved in:
| Published in: | Pediatrics (Evanston) 2015-02, Vol.135 (2), p.e312-e320 |
|---|---|
| Main Authors: | , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c456t-42e68e7d95314050d78ce7c89cf16dafc56c11fb808341060996b75a1459e6583 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c456t-42e68e7d95314050d78ce7c89cf16dafc56c11fb808341060996b75a1459e6583 |
| container_end_page | e320 |
| container_issue | 2 |
| container_start_page | e312 |
| container_title | Pediatrics (Evanston) |
| container_volume | 135 |
| creator | Wood, Joanne N Fakeye, Oludolapo Mondestin, Valerie Rubin, David M Localio, Russell Feudtner, Chris |
| description | To develop guidelines for performing an initial skeletal survey (SS) for children |
| doi_str_mv | 10.1542/peds.2014-2169 |
| format | article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4306798</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A402618527</galeid><sourcerecordid>A402618527</sourcerecordid><originalsourceid>FETCH-LOGICAL-c456t-42e68e7d95314050d78ce7c89cf16dafc56c11fb808341060996b75a1459e6583</originalsourceid><addsrcrecordid>eNpdkT2P1DAQhi0E4paDlhJZoqHJMnZsJ2mQTnt8SSddAxWF5TiTrA-vHexkYf89ifY4AdUU88yrefUQ8pLBlknB347Y5S0HJgrOVPOIbBg0dSF4JR-TDUDJCgEgL8iznO8AQMiKPyUXXCpgTc035Ns1HtHH8YBhorGn-5hHNxlftCZjR4fZdehdwEz7mGj-jh6XLc1zOuKJukBPcQ4DtXvnu4SB_nTTnrZpdhnzc_KkNz7ji_t5Sb5-eP9l96m4uf34eXd1U1gh1bQ8i6rGqmtkyQRI6KraYmXrxvZMdaa3UlnG-raGuhQMFDSNaitpmJANKlmXl-TdOXec2wN2dqmSjNdjcgeTTjoap__dBLfXQzxqUYKqmjXgzX1Aij9mzJM-uGzRexMwzlkzJbmQoqrZgr7-D72LcwpLvZWSpVQCxEIVZ2owHrULNoYJf002eo8D6qX97lZfCeCK1ZJXC7898zbFnBP2D88z0KtnvXrWq2e9el4OXv1d-QH_I7b8DVbQo_Y</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1655356404</pqid></control><display><type>article</type><title>Development of hospital-based guidelines for skeletal survey in young children with bruises</title><source>EZB-FREE-00999 freely available EZB journals</source><creator>Wood, Joanne N ; Fakeye, Oludolapo ; Mondestin, Valerie ; Rubin, David M ; Localio, Russell ; Feudtner, Chris</creator><creatorcontrib>Wood, Joanne N ; Fakeye, Oludolapo ; Mondestin, Valerie ; Rubin, David M ; Localio, Russell ; Feudtner, Chris</creatorcontrib><description>To develop guidelines for performing an initial skeletal survey (SS) for children <24 months of age presenting with bruising in the hospital setting, combining available evidence with expert opinion.
Applying the Rand/UCLA Appropriateness Method, a multispecialty panel of 10 experts relied on evidence from the literature and their own clinical expertise in rating the appropriateness of performing SS for 198 clinical scenarios characterizing children <24 months old with bruising. After a moderated discussion of initial ratings, the scenarios were revised. Panelists re-rated SS appropriateness for 219 revised scenarios. For the 136 clinical scenarios in which SS was deemed appropriate, the panel finally assessed the necessity of SS.
Panelists agreed that SS is "appropriate" for 62% (136/219) of scenarios, and "inappropriate" for children ≥ 12 months old with nonpatterned bruising on bony prominences. Panelists agreed that SS is "necessary" for 95% (129/136) of the appropriate scenarios. SS was deemed necessary for infants <6 months old regardless of bruise location, with rare exceptions, but the necessity of SS in older children depends on bruise location. According to the panelists, bruising on the cheek, eye area, ear, neck, upper arm, upper leg, hand, foot, torso, buttock, or genital area necessitates SS in children <12 months.
The appropriateness and necessity of SS in children presenting for care to the hospital setting with bruising, as determined by a diverse panel of experts, depends on age of the child and location of bruising.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.2014-2169</identifier><identifier>PMID: 25601982</identifier><identifier>CODEN: PEDIAU</identifier><language>eng</language><publisher>United States: American Academy of Pediatrics</publisher><subject>Analysis ; Bone surveys ; Brain Injuries - diagnosis ; Brain Injuries - etiology ; California ; Child ; Child abuse ; Child abuse & neglect ; Child Abuse - diagnosis ; Children ; Children & youth ; Company business management ; Contusions ; Contusions - diagnosis ; Contusions - etiology ; Cooperative Behavior ; Delphi Technique ; Diagnosis, Differential ; Emergency Service, Hospital ; Female ; Fractures, Bone - diagnosis ; Fractures, Bone - etiology ; Health aspects ; Hospital Departments ; Hospitals ; Hospitals, University ; Humans ; Infant ; Infant, Newborn ; Injuries ; Interdisciplinary Communication ; Male ; Management ; Pediatrics ; Physical Examination - methods ; Program Evaluation ; Risk factors ; Wounds and Injuries - diagnosis ; Wounds and Injuries - etiology</subject><ispartof>Pediatrics (Evanston), 2015-02, Vol.135 (2), p.e312-e320</ispartof><rights>Copyright © 2015 by the American Academy of Pediatrics.</rights><rights>Copyright American Academy of Pediatrics Feb 2015</rights><rights>Copyright © 2015 by the American Academy of Pediatrics 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c456t-42e68e7d95314050d78ce7c89cf16dafc56c11fb808341060996b75a1459e6583</citedby><cites>FETCH-LOGICAL-c456t-42e68e7d95314050d78ce7c89cf16dafc56c11fb808341060996b75a1459e6583</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,309,310,314,778,782,787,788,883,23913,23914,25123,27907,27908</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25601982$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wood, Joanne N</creatorcontrib><creatorcontrib>Fakeye, Oludolapo</creatorcontrib><creatorcontrib>Mondestin, Valerie</creatorcontrib><creatorcontrib>Rubin, David M</creatorcontrib><creatorcontrib>Localio, Russell</creatorcontrib><creatorcontrib>Feudtner, Chris</creatorcontrib><title>Development of hospital-based guidelines for skeletal survey in young children with bruises</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>To develop guidelines for performing an initial skeletal survey (SS) for children <24 months of age presenting with bruising in the hospital setting, combining available evidence with expert opinion.
Applying the Rand/UCLA Appropriateness Method, a multispecialty panel of 10 experts relied on evidence from the literature and their own clinical expertise in rating the appropriateness of performing SS for 198 clinical scenarios characterizing children <24 months old with bruising. After a moderated discussion of initial ratings, the scenarios were revised. Panelists re-rated SS appropriateness for 219 revised scenarios. For the 136 clinical scenarios in which SS was deemed appropriate, the panel finally assessed the necessity of SS.
Panelists agreed that SS is "appropriate" for 62% (136/219) of scenarios, and "inappropriate" for children ≥ 12 months old with nonpatterned bruising on bony prominences. Panelists agreed that SS is "necessary" for 95% (129/136) of the appropriate scenarios. SS was deemed necessary for infants <6 months old regardless of bruise location, with rare exceptions, but the necessity of SS in older children depends on bruise location. According to the panelists, bruising on the cheek, eye area, ear, neck, upper arm, upper leg, hand, foot, torso, buttock, or genital area necessitates SS in children <12 months.
The appropriateness and necessity of SS in children presenting for care to the hospital setting with bruising, as determined by a diverse panel of experts, depends on age of the child and location of bruising.</description><subject>Analysis</subject><subject>Bone surveys</subject><subject>Brain Injuries - diagnosis</subject><subject>Brain Injuries - etiology</subject><subject>California</subject><subject>Child</subject><subject>Child abuse</subject><subject>Child abuse & neglect</subject><subject>Child Abuse - diagnosis</subject><subject>Children</subject><subject>Children & youth</subject><subject>Company business management</subject><subject>Contusions</subject><subject>Contusions - diagnosis</subject><subject>Contusions - etiology</subject><subject>Cooperative Behavior</subject><subject>Delphi Technique</subject><subject>Diagnosis, Differential</subject><subject>Emergency Service, Hospital</subject><subject>Female</subject><subject>Fractures, Bone - diagnosis</subject><subject>Fractures, Bone - etiology</subject><subject>Health aspects</subject><subject>Hospital Departments</subject><subject>Hospitals</subject><subject>Hospitals, University</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Injuries</subject><subject>Interdisciplinary Communication</subject><subject>Male</subject><subject>Management</subject><subject>Pediatrics</subject><subject>Physical Examination - methods</subject><subject>Program Evaluation</subject><subject>Risk factors</subject><subject>Wounds and Injuries - diagnosis</subject><subject>Wounds and Injuries - etiology</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNpdkT2P1DAQhi0E4paDlhJZoqHJMnZsJ2mQTnt8SSddAxWF5TiTrA-vHexkYf89ifY4AdUU88yrefUQ8pLBlknB347Y5S0HJgrOVPOIbBg0dSF4JR-TDUDJCgEgL8iznO8AQMiKPyUXXCpgTc035Ns1HtHH8YBhorGn-5hHNxlftCZjR4fZdehdwEz7mGj-jh6XLc1zOuKJukBPcQ4DtXvnu4SB_nTTnrZpdhnzc_KkNz7ji_t5Sb5-eP9l96m4uf34eXd1U1gh1bQ8i6rGqmtkyQRI6KraYmXrxvZMdaa3UlnG-raGuhQMFDSNaitpmJANKlmXl-TdOXec2wN2dqmSjNdjcgeTTjoap__dBLfXQzxqUYKqmjXgzX1Aij9mzJM-uGzRexMwzlkzJbmQoqrZgr7-D72LcwpLvZWSpVQCxEIVZ2owHrULNoYJf002eo8D6qX97lZfCeCK1ZJXC7898zbFnBP2D88z0KtnvXrWq2e9el4OXv1d-QH_I7b8DVbQo_Y</recordid><startdate>201502</startdate><enddate>201502</enddate><creator>Wood, Joanne N</creator><creator>Fakeye, Oludolapo</creator><creator>Mondestin, Valerie</creator><creator>Rubin, David M</creator><creator>Localio, Russell</creator><creator>Feudtner, Chris</creator><general>American Academy of Pediatrics</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201502</creationdate><title>Development of hospital-based guidelines for skeletal survey in young children with bruises</title><author>Wood, Joanne N ; Fakeye, Oludolapo ; Mondestin, Valerie ; Rubin, David M ; Localio, Russell ; Feudtner, Chris</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c456t-42e68e7d95314050d78ce7c89cf16dafc56c11fb808341060996b75a1459e6583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Analysis</topic><topic>Bone surveys</topic><topic>Brain Injuries - diagnosis</topic><topic>Brain Injuries - etiology</topic><topic>California</topic><topic>Child</topic><topic>Child abuse</topic><topic>Child abuse & neglect</topic><topic>Child Abuse - diagnosis</topic><topic>Children</topic><topic>Children & youth</topic><topic>Company business management</topic><topic>Contusions</topic><topic>Contusions - diagnosis</topic><topic>Contusions - etiology</topic><topic>Cooperative Behavior</topic><topic>Delphi Technique</topic><topic>Diagnosis, Differential</topic><topic>Emergency Service, Hospital</topic><topic>Female</topic><topic>Fractures, Bone - diagnosis</topic><topic>Fractures, Bone - etiology</topic><topic>Health aspects</topic><topic>Hospital Departments</topic><topic>Hospitals</topic><topic>Hospitals, University</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Injuries</topic><topic>Interdisciplinary Communication</topic><topic>Male</topic><topic>Management</topic><topic>Pediatrics</topic><topic>Physical Examination - methods</topic><topic>Program Evaluation</topic><topic>Risk factors</topic><topic>Wounds and Injuries - diagnosis</topic><topic>Wounds and Injuries - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wood, Joanne N</creatorcontrib><creatorcontrib>Fakeye, Oludolapo</creatorcontrib><creatorcontrib>Mondestin, Valerie</creatorcontrib><creatorcontrib>Rubin, David M</creatorcontrib><creatorcontrib>Localio, Russell</creatorcontrib><creatorcontrib>Feudtner, Chris</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wood, Joanne N</au><au>Fakeye, Oludolapo</au><au>Mondestin, Valerie</au><au>Rubin, David M</au><au>Localio, Russell</au><au>Feudtner, Chris</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Development of hospital-based guidelines for skeletal survey in young children with bruises</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2015-02</date><risdate>2015</risdate><volume>135</volume><issue>2</issue><spage>e312</spage><epage>e320</epage><pages>e312-e320</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><coden>PEDIAU</coden><abstract>To develop guidelines for performing an initial skeletal survey (SS) for children <24 months of age presenting with bruising in the hospital setting, combining available evidence with expert opinion.
Applying the Rand/UCLA Appropriateness Method, a multispecialty panel of 10 experts relied on evidence from the literature and their own clinical expertise in rating the appropriateness of performing SS for 198 clinical scenarios characterizing children <24 months old with bruising. After a moderated discussion of initial ratings, the scenarios were revised. Panelists re-rated SS appropriateness for 219 revised scenarios. For the 136 clinical scenarios in which SS was deemed appropriate, the panel finally assessed the necessity of SS.
Panelists agreed that SS is "appropriate" for 62% (136/219) of scenarios, and "inappropriate" for children ≥ 12 months old with nonpatterned bruising on bony prominences. Panelists agreed that SS is "necessary" for 95% (129/136) of the appropriate scenarios. SS was deemed necessary for infants <6 months old regardless of bruise location, with rare exceptions, but the necessity of SS in older children depends on bruise location. According to the panelists, bruising on the cheek, eye area, ear, neck, upper arm, upper leg, hand, foot, torso, buttock, or genital area necessitates SS in children <12 months.
The appropriateness and necessity of SS in children presenting for care to the hospital setting with bruising, as determined by a diverse panel of experts, depends on age of the child and location of bruising.</abstract><cop>United States</cop><pub>American Academy of Pediatrics</pub><pmid>25601982</pmid><doi>10.1542/peds.2014-2169</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0031-4005 |
| ispartof | Pediatrics (Evanston), 2015-02, Vol.135 (2), p.e312-e320 |
| issn | 0031-4005 1098-4275 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4306798 |
| source | EZB-FREE-00999 freely available EZB journals |
| subjects | Analysis Bone surveys Brain Injuries - diagnosis Brain Injuries - etiology California Child Child abuse Child abuse & neglect Child Abuse - diagnosis Children Children & youth Company business management Contusions Contusions - diagnosis Contusions - etiology Cooperative Behavior Delphi Technique Diagnosis, Differential Emergency Service, Hospital Female Fractures, Bone - diagnosis Fractures, Bone - etiology Health aspects Hospital Departments Hospitals Hospitals, University Humans Infant Infant, Newborn Injuries Interdisciplinary Communication Male Management Pediatrics Physical Examination - methods Program Evaluation Risk factors Wounds and Injuries - diagnosis Wounds and Injuries - etiology |
| title | Development of hospital-based guidelines for skeletal survey in young children with bruises |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-16T23%3A08%3A34IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Development%20of%20hospital-based%20guidelines%20for%20skeletal%20survey%20in%20young%20children%20with%20bruises&rft.jtitle=Pediatrics%20(Evanston)&rft.au=Wood,%20Joanne%20N&rft.date=2015-02&rft.volume=135&rft.issue=2&rft.spage=e312&rft.epage=e320&rft.pages=e312-e320&rft.issn=0031-4005&rft.eissn=1098-4275&rft.coden=PEDIAU&rft_id=info:doi/10.1542/peds.2014-2169&rft_dat=%3Cgale_pubme%3EA402618527%3C/gale_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c456t-42e68e7d95314050d78ce7c89cf16dafc56c11fb808341060996b75a1459e6583%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1655356404&rft_id=info:pmid/25601982&rft_galeid=A402618527&rfr_iscdi=true |