Abstract:
BACKGROUND AND OBJECTIVES:A 4-variable abusive head trauma (AHT) clinical prediction rule (CPR) for use in the PICU was derived and validated for children <3 years of age by the Pediatric Brain Injury Research Network (PediBIRN). We aimed to externally validate PediBIRN as designed (PICU only) as well as using broader inclusion criteria (admitted children with head injuries). METHODS:This was a secondary analysis of a prospective multicenter study of pediatric head injuries at 5 Australian and New Zealand tertiary pediatric centers. Possible AHT was identified by clinician suspicion, epidemiology codes, or a high-risk group (<3 years of age, admitted, abnormal neuroimaging results). At 1 center, we additionally reviewed head injuries in the forensic database. We designated patients as positive for AHT, negative for AHT, or having indeterminate outcome after multidisciplinary review and applied the PediBIRN CPR, blinded to outcome, to PICU admissions only, and any head injury admissions. CPR accuracy was calculated by using 95% confidence intervals. RESULTS:One hundred and forty-one patients were admitted with abnormal neuroimaging results. Twenty-eight (20%) were positive for AHT, 94 (67%) were negative for AHT, and 19 (13%) had indeterminate outcome. Excluding indeterminate cases, in the PICU (n = 28), the CPR was 100% (75%-100%) sensitive and 11% (0%-48%) specific; in all admitted patients (n = 141), sensitivity was 96% (82%-100%) and specificity of 43% (32%-53%). CONCLUSIONS:This validation revealed high sensitivity and low specificity for PICU patients. Specificity was improved but moderate in a broader group of admitted head injury patients.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Pfeiffer H,Smith A,Kemp AM,Cowley LE,Cheek JA,Dalziel SR,Borland ML,O'Brien S,Bonisch M,Neutze J,Oakley E,Crowe L,Hearps SJC,Lyttle MD,Bressan S,Babl FE,Paediatric Research in Emergency Department International Collaboratdoi
10.1542/peds.2017-3674subject
Has Abstractpub_date
2018-05-01 00:00:00issue
5eissn
0031-4005issn
1098-4275pii
peds.2017-3674journal_volume
141pub_type
杂志文章,多中心研究相关文献
PEDIATRICS文献大全abstract::A prospective study was conducted to assess the applicability of the Denver Prescreening Developmental Questionnaire (DPDQ) in a predominantly black, low-income population in Mobile, Alabama. The effect of an educational intervention designed to increase the accuracy of parental responses to the DPDQ was also assessed...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1983-03-01 00:00:00
abstract:OBJECTIVE:The goal of this study was to determine whether multisystemic therapy (MST), an intensive, home-based psychotherapy, could decrease diabetes-related stress among adolescents with chronically poorly controlled type 1 diabetes. Stress was also evaluated as a mediator of the effect of MST on adherence and metabo...
journal_title:Pediatrics
pub_type: 杂志文章,随机对照试验
doi:10.1542/peds.2005-0638
更新日期:2005-12-01 00:00:00
abstract:OBJECTIVE:Drug trafficking among adolescents is a newly recognized high-risk behavior that seems to be involving large numbers of youths. Strategies to prevent and/or alter this behavior must be developed and evaluated. In view of the high exposure of adolescents to the mass media, interventionists seeking to reduce ad...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:
更新日期:1994-06-01 00:00:00
abstract:INTRODUCTION:Persistent patent ductus arteriosus (PDA) often produces hemodynamic and respiratory derangement necessitating use of inotropic drugs and escalating ventilatory support in premature infants. When medical therapy fails, surgical ligation is indicated. Because of the risks of transferring unstable neonates t...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.112.6.1298
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:To compare the use of once-a-day cefpodoxime proxetil to once-a-day cefixime in the treatment of acute suppurative otitis media. DESIGN:Randomized, multicenter, investigator-blinded. SETTING:Outpatient. PATIENTS:A total of 368 patients (age 2 months to 17 years) were randomized to receive either cefpodoxim...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:The possible link between immunization and atopic diseases has been under intense debate in the last decade. OBJECTIVE:The aim of this study was to systematically review the available evidence on the association of whole-cell pertussis and BCG vaccination with the risk of asthma in childhood and adolescence...
journal_title:Pediatrics
pub_type: 杂志文章,meta分析
doi:10.1542/peds.2006-3569
更新日期:2007-11-01 00:00:00
abstract::Fifteen asymptomatic children with benign rheumatoid nodules, followed up to 12 years, are described. Nodules are characterized by subcutaneous location with predilection for pretibial regions and scalp, occasional large size, spontaneous regression, and frequent recurrence. Granuloma annulare was present in two patie...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1975-07-01 00:00:00
abstract:OBJECTIVE:Most clinical descriptions of invasive staphylococcal disease (ISD) in neonates date from before the mid-1980s, when neonatal viability and intensive care differed substantially from current standards. We aimed to describe the contemporary incidence, clinical features, and outcome of infants with ISD in a neo...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2004-0043
更新日期:2004-10-01 00:00:00
abstract:OBJECTIVE:To determine the risk of mortality associated with cardiometabolic risk factors in a national sample of adolescents and young adults. METHODS:Prospective study of participants in the third NHANES (1988-1994), aged 12 to 39 years at the time of the survey (n = 9245). Risk factors included 3 measures of adipos...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2012-2583
更新日期:2013-03-01 00:00:00
abstract::A sample of 90 children with Down's syndrome were measured for recumbent length and weight from birth to age 36 months at the Children's Hospital Medical Center in Boston. At birth, means for both length and weight were reduced by about 0.5 SDs from the control group means. By 36 months, mean recumbent length was grea...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1978-04-01 00:00:00
abstract::We have examined the suppression of urinary pregnanetriol and 17-ketosteroids during treatment with cortisol, cortisone, prednisone, and dexamethasone in eight patients with congenital adrenal hyperplasia. A large individual variation in response to each agent was observed. In some individuals, cortisone is less effec...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1976-06-01 00:00:00
abstract:OBJECTIVES:The objective of this study was to examine the relationship between duration of poverty and the health of preschool children in the Quebec Longitudinal Study of Child Development birth cohort. METHODS:Data from the Quebec Longitudinal Study of Child Development for 1950 children who were followed annually u...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2006-1750
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVES:More than 500,000 adolescents with special health care needs age into adulthood each year in the United States, and there is growing recognition of the need for support of their transition to adult-oriented health care. Because of improved survival, cystic fibrosis has experienced this increasing transition ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2007-2217
更新日期:2008-05-01 00:00:00
abstract::Henoch-Schonlein purpura is a multisystem vasculitis that primarily affects children. Characteristic symptoms include purpura of the lower extremities and buttocks, abdominal pain, arthralgias, and hematuria. Gastrointestinal bleeding occurs in approximately 50% of children and, although often self-limiting, can be si...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2005-3111
更新日期:2006-09-01 00:00:00
abstract::The effect of taurine supplementation on the absorption of a fat meal was evaluated in patients with cystic fibrosis. In a cross-over design study, five patients with cystic fibrosis (12.1 +/- 2.6 years of age) and three control subjects received either placebo or taurine (30 mg/kg/d) for two 1-week periods, a month a...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1987-10-01 00:00:00
abstract::A ganglioneuroblastoma developed in a 35-month-old boy with both the fetal hydantoin and fetal alcohol syndromes. Our case, plus two recent reports in the literature, would very likely establish the relationship between fetal hydantoin syndrome and the development of neural crest tumors. Infants exposed in utero to hy...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1979-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Observation status, in contrast to inpatient status, is a billing designation for hospital payment. Observation-status stays are presumed to be shorter and less resource-intensive, but utilization for pediatric observation-status stays has not been studied. The goal of this study was to describ...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1542/peds.2012-2494
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:To determine how sociodemographic factors and type of insurance influence use of medical and health-related services by children with special health care needs (CSHCN), after controlling for need. METHODS:A cross-sectional analysis of 1994 National Health Interview Disability Survey was conducted. Children b...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1542/peds.112.3.593
更新日期:2003-09-01 00:00:00
abstract:OBJECTIVE:Increased physical activity and menstrual irregularity have been associated with increased risk for stress fracture among adult women active in athletics. The purposes of this study were to determine whether menstrual irregularity is also a risk factor for stress fracture in active female adolescents and to e...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2006-2145
更新日期:2007-08-01 00:00:00
abstract::This report describes an attempt to evaluate the effectiveness of "trained mother" interviews early in the medical school curriculum. As an adjunct to a first-year course that teaches interviewing techniques, half of the students were exposed to an interview with one of three trained mothers early in the course. This ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1977-08-01 00:00:00
abstract:OBJECTIVE:To determine whether it is necessary to delay discharge of newly circumcised male neonates to observe voiding. SUBJECTS AND METHODS:A prospective study was conducted in 1992 and 1993 of 51 healthy male, newly circumcised neonates between 0 and 10 days of age. The neonates were observed for the time of first ...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章
doi:
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:Bacteremia is now an uncommon presentation to the children's emergency department (ED) but is associated with significant morbidity and mortality. Its evolving etiology may affect the ability of clinicians to initiate timely, appropriate antimicrobial therapy. METHODS:A retrospective time series analysis of...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2014-2061
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVES:Clinicians caring for persons with phenylketonuria (PKU) have been perplexed by the occasional normal individual with the classical biochemical profile consistent with the diagnosis of PKU. Usually untreated subjects with the biochemical profile of blood phenylalanine (Phe) levels >1200 micromol/L are severe...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.106.5.1093
更新日期:2000-11-01 00:00:00
abstract::Delayed initiation of proper therapy for infants with primary infantile glaucoma results in an unnecessarily poor outcome. In an effort to understand why some infants and children had more advanced disease than others, researchers reviewed the records of 24 consecutive infants and children with this problem. The prese...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1986-03-01 00:00:00
abstract::Toilet-seat contact dermatitis is a common condition around the world and is reemerging in the United States. It can be easily recognized and treated. However, few practitioners consider this diagnosis, which results in a delay in treatment and often exacerbation of the skin eruption. In the past, exposure to wooden t...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2009-2430
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:We present a long-term safety, immunogenicity, and effectiveness study of a quadrivalent human papillomavirus (HPV4) vaccine. METHODS:Sexually naive boys and girls aged 9 to 15 years (N = 1781) were assigned (2:1) to receive HPV4 vaccine or saline placebo at day 1 and months 2 and 6. At month 30, the placeb...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1542/peds.2013-4144
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:Circumstances surrounding parental availability and decision-making were examined in the setting of a research protocol involving newborn screening (NBS) for fragile X syndrome, in which the institutional review board (IRB) had determined that consent (permission) was required from both parents. METHODS:A su...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2012-1278
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:Health care-associated infections persist as a major problem in most neonatal intensive care units. Hand hygiene has been singled out as the most important measure in preventing hospital-acquired infection. However, hand hygiene compliance among health care workers (HCWs) remains low. The objective of this st...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2004-1107
更新日期:2004-11-01 00:00:00
abstract::Tobacco use is the leading preventable cause of morbidity and death in the United States. Because 80% to 90% of adult smokers began during adolescence, and two thirds became regular, daily smokers before they reached 19 years of age, tobacco use may be viewed as a pediatric disease. Every year in the United States, ap...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2009-2121
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:The success of health care provider counseling-based interventions to address vaccine hesitancy is not clear. In 2011, Washington State implemented Senate Bill 5005 (SB5005), requiring counseling and a signed form from a licensed health care provider to obtain an exemption. Evaluating the impact of a counsel...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2017-2364
更新日期:2018-01-01 00:00:00