Clinical Research Unit, Fairfield General Hospital, Bury, UK.
Emergency Department, North Manchester General Hospital, Manchester, UK.
BMC Pediatr. 2018 Sep 17;18(1):303. doi: 10.1186/s12887-018-1268-7.
Increasing attendances by children (aged 0-16 years) to United Kingdom Emergency Departments (EDs) challenges patient safety within the National Health Service (NHS) with health professionals required to make complex judgements on whether children attending urgent and emergency care services can be sent home safely or require admission. Health regulation bodies have recommended that an early identification systems should be developed to recognise children developing critical illnesses. The Pennine Acute Hospitals NHS Trust Paediatric Observation Priority Score (PAT-POPS) was developed as an ED-specific tool for this purpose. This study aims to revise and improve the existing tool and determine its utility in determining safe admission and discharge decision making.
METHODS/DESIGN: An observational study to improve diagnostic accuracy using data from children and young people attending the ED and Urgent Care Centre (UCC) at three hospitals over a 12 month period. The data being collected is part of routine practice; therefore opt-out methods of consent will be used. The reference standard is admission or discharge. A revised PAT-POPs scoring tool will be developed using clinically guided logistic regression models to explore which components best predict hospital admission and safe discharge. Suitable cut-points for safe admission and discharge will be established using sensitivity and specificity as judged by an expert consensus meeting. The diagnostic accuracy of the revised tool will be assessed, and it will be compared to the former version of PAT-POPS using ROC analysis.
This new predictive tool will aid discharge and admission decision-making in relation to children and young people in hospital urgent and emergency care facilities.
NIHR RfPB Grant: PB-PG-0815-20034. ClinicalTrials.gov: 213469. Retrospectively registered on 11 April 2018.
儿童（0-16 岁）到英国急诊部（ED）就诊的人数不断增加，这给国民保健制度（NHS）的患者安全带来了挑战，因为卫生专业人员需要对是否可以安全送回家或需要住院的紧急和紧急护理服务的儿童做出复杂的判断。健康监管机构建议应开发早期识别系统，以识别患有危急疾病的儿童。潘宁急性医院 NHS 信托儿科观察优先评分（PAT-POPS）是为此目的开发的一种特定于 ED 的工具。本研究旨在修订和改进现有工具，并确定其在确定安全入院和出院决策方面的实用性。
方法/设计：这是一项旨在通过在 12 个月内收集来自三家医院的 ED 和急症护理中心（UCC）就诊的儿童和青少年的数据，提高诊断准确性的观察性研究。正在收集的数据是常规实践的一部分；因此，将使用退出选择同意的方法。参考标准为入院或出院。使用临床指导的逻辑回归模型开发修订后的 PAT-POPs 评分工具，以探讨哪些组件最能预测住院和安全出院。将使用灵敏度和特异性通过专家共识会议判断，为安全入院和出院建立合适的切点。将评估修订后的工具的诊断准确性，并通过 ROC 分析与 PAT-POPS 的前一版本进行比较。
这种新的预测工具将有助于在医院紧急和紧急护理设施中做出有关儿童和青少年的出院和入院决策。
NIHR RfPB 资助：PB-PG-0815-20034。ClinicalTrials.gov：213469。2018 年 4 月 11 日回顾性注册。
Zotero 插件