Global Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada; Division of Urology, Department of Surgery, The Hospital for Sick Children, Toronto, ON, Canada; Institute of Urology, St. Luke's Medical Center, Quezon City, NCR, Philippines.
Institute of Urology, St. Luke's Medical Center, Quezon City, NCR, Philippines.
J Pediatr Surg. 2023 Dec;58(12):2416-2428. doi: 10.1016/j.jpedsurg.2023.07.006. Epub 2023 Jul 13.
Learning health networks (LHN) are consortia of institutions that collaborate and embrace the elements of the learning health system (LHS), including quality improvement, education, research, and stakeholder involvement. Their ultimate goal is rapid information dissemination in clinical care. Pediatric surgical specialties perform unique yet high-impact procedures that could benefit from LHN, thereby improving surgical outcomes and care through LHS approaches. Consequently, health system leaders should be aware of LHN and their importance in enhancing surgical care and improving outcomes. This scoping review aims to map and characterize the existing LHN applied in pediatric surgical specialties.
A systematic literature search was performed on Medline, EMBASE, and Scopus up to June 2022, with an update search conducted in May 2023. Additionally, Google Scholar, ProQuest and inquiry from topic experts were used for cross-referencing relevant review articles to identify grey literature. This scoping review was conducted and reported according to the PRISMA-scoping review extension.
A total of 56 publications for 19 LHN were identified and included in this scoping review. Out of 19 identified LHN in pediatric surgical specialties, 18 were organized in North America. Eight of the networks are related to pediatric general surgery and another eight were related to pediatric transplantation. The 16 out of 19 LHN were initiated after 2001. To date, only eight of the LHNs generated reports of comparative improved outcomes.
This scoping review provides an overview of the available LHNs in pediatric surgical specialties. Over the past decade, several pediatric surgical specialties have embraced the principles of learning health systems, forming inter-institutional collaborations that utilize information technology to generate big data on patient-level clinical information, engage in quality improvement cycles, adopt evidence-based practices, and actively involve patients and stakeholders.
IV.
学习型健康网络（LHN）是由合作机构组成的联盟，它们采用学习健康系统（LHS）的各项要素，包括质量改进、教育、研究和利益相关者参与。其最终目标是在临床护理中实现快速信息传播。儿科外科专业开展独特且影响重大的手术，这些手术可以从 LHN 中受益，从而通过 LHS 方法改善手术结果和护理。因此，卫生系统领导者应该了解 LHN 及其在增强外科护理和改善结果方面的重要性。本范围综述旨在绘制和描述应用于儿科外科专业的现有 LHN。
对 Medline、EMBASE 和 Scopus 进行了系统文献检索，截至 2022 年 6 月，并于 2023 年 5 月进行了更新检索。此外，还使用 Google Scholar、ProQuest 和向专题专家查询来交叉引用相关综述文章，以确定灰色文献。本范围综述按照 PRISMA 扩展范围综述进行，并进行了报告。
共确定了 56 篇关于 19 个 LHN 的出版物，并纳入本范围综述。在儿科外科专业确定的 19 个 LHN 中，有 18 个是在北美组织的。其中 8 个网络与小儿普通外科有关，另外 8 个与小儿移植有关。19 个 LHN 中有 16 个是在 2001 年后启动的。迄今为止，只有 8 个 LHN 报告了比较改善的结果。
本范围综述提供了儿科外科专业现有 LHN 的概述。在过去十年中，一些儿科外科专业已经接受了学习健康系统的原则，形成了机构间的合作，利用信息技术生成关于患者级临床信息的大数据，参与质量改进周期，采用基于证据的实践，并积极让患者和利益相关者参与进来。
IV。
