Barriers to translating diagnostic research in febrilechildren to clinical practice: A systematic review

Background: Although the topic of identifying febrile children at risk of serious infections has been addressed by numerous research groups, identified predictors remain diverse and implementation of results in routine practice has been limited. The aim of this paper is to discuss the problems and c...

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Main Authors: Oostenbrink, R, Thompson, M, Steyerberg, E
Format: Journal article
Language:English
Published: 2012
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author Oostenbrink, R
Thompson, M
Steyerberg, E
author_facet Oostenbrink, R
Thompson, M
Steyerberg, E
author_sort Oostenbrink, R
collection OXFORD
description Background: Although the topic of identifying febrile children at risk of serious infections has been addressed by numerous research groups, identified predictors remain diverse and implementation of results in routine practice has been limited. The aim of this paper is to discuss the problems and challenges in advancing diagnostic research in febrile children. Methods: The characteristics and results of 35 studies identified from a systematic review on predictors for febrile children were evaluated. Results: Current diagnostic research is mainly performed in subpopulations, defined by age and temperature limits and in paediatric emergency settings, ignoring the role of primary care. It is characterised by a dichotomous approach of outcomes and a wide variability of potential predictors. Validation of results to other settings and impact studies of prediction rules on patient outcomes are scarce. In designing diagnostic studies on children suspected of serious infections focus is needed on all clinically relevant populations within the spectrum of primary care and emergency department settings. Consensus is also needed on the definition of fever, the concept of serious infection and the set of predictors to focus on. The heterogeneity of patients in different settings and countries stress the need for continuous updating of prediction rules in routine practice. Broad validation in different clinical settings and countries and impact analysis in routine care is essential. Conclusions: Scientists in the field of diagnosis of serious infection in children must agree on core design features to be incorporated in all studies in the area of diagnostic research in febrile children. This will improve evidence from future studies, and their generalisability and implementation in routine practice.
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spelling oxford-uuid:1af24cc9-e31a-48bc-9d17-8e4ba48465f82022-03-26T10:57:33ZBarriers to translating diagnostic research in febrilechildren to clinical practice: A systematic reviewJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1af24cc9-e31a-48bc-9d17-8e4ba48465f8EnglishSymplectic Elements at Oxford2012Oostenbrink, RThompson, MSteyerberg, EBackground: Although the topic of identifying febrile children at risk of serious infections has been addressed by numerous research groups, identified predictors remain diverse and implementation of results in routine practice has been limited. The aim of this paper is to discuss the problems and challenges in advancing diagnostic research in febrile children. Methods: The characteristics and results of 35 studies identified from a systematic review on predictors for febrile children were evaluated. Results: Current diagnostic research is mainly performed in subpopulations, defined by age and temperature limits and in paediatric emergency settings, ignoring the role of primary care. It is characterised by a dichotomous approach of outcomes and a wide variability of potential predictors. Validation of results to other settings and impact studies of prediction rules on patient outcomes are scarce. In designing diagnostic studies on children suspected of serious infections focus is needed on all clinically relevant populations within the spectrum of primary care and emergency department settings. Consensus is also needed on the definition of fever, the concept of serious infection and the set of predictors to focus on. The heterogeneity of patients in different settings and countries stress the need for continuous updating of prediction rules in routine practice. Broad validation in different clinical settings and countries and impact analysis in routine care is essential. Conclusions: Scientists in the field of diagnosis of serious infection in children must agree on core design features to be incorporated in all studies in the area of diagnostic research in febrile children. This will improve evidence from future studies, and their generalisability and implementation in routine practice.
spellingShingle Oostenbrink, R
Thompson, M
Steyerberg, E
Barriers to translating diagnostic research in febrilechildren to clinical practice: A systematic review
title Barriers to translating diagnostic research in febrilechildren to clinical practice: A systematic review
title_full Barriers to translating diagnostic research in febrilechildren to clinical practice: A systematic review
title_fullStr Barriers to translating diagnostic research in febrilechildren to clinical practice: A systematic review
title_full_unstemmed Barriers to translating diagnostic research in febrilechildren to clinical practice: A systematic review
title_short Barriers to translating diagnostic research in febrilechildren to clinical practice: A systematic review
title_sort barriers to translating diagnostic research in febrilechildren to clinical practice a systematic review
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AT steyerberge barrierstotranslatingdiagnosticresearchinfebrilechildrentoclinicalpracticeasystematicreview